number of grafts per session

[albal smith]

ok I have a question about the number of grafts per session. I looked it up and I know it has been discussed many times before, but I am still curious...when I was reseaching for a doctor a couple said I needed about 1800 to 2000 follicular unit grafts, one doctor told me he could do 5000 follicular unit grafts. how is it that one can do 5000 and the others can't. Are they counting the grafts differently or is one counting by number of hair? can Bill answer....does follicular unit mean one hair or one hair graft.. when a graft has two hairs is it two follicular units and it counts as two grafts or is it one graft. when two seperate hairs are placed in one site is it one graft or two graft...please if anyone knows explain to me.....I am actually trying to have fal answer because he seems to know his stuff...thanx

[albal smith]

ok I have a question about the number of grafts per session. I looked it up and I know it has been discussed many times before, but I am still curious...when I was reseaching for a doctor a couple said I needed about 1800 to 2000 follicular unit grafts, one doctor told me he could do 5000 follicular unit grafts. how is it that one can do 5000 and the others can't. Are they counting the grafts differently or is one counting by number of hair? can Bill answer....does follicular unit mean one hair or one hair graft.. when a graft has two hairs is it two follicular units and it counts as two grafts or is it one graft. when two seperate hairs are placed in one site is it one graft or two graft...please if anyone knows explain to me.....I am actually trying to have fal answer because he seems to know his stuff...thanx

[fixing-it]

Hey a-s,

A follicular unit is a unit or bundle that can contain 1 hair,2 hairs,3 hairs or 4 hairs in a given graft.

[fixing-it]

Forgot to mention,this is how hair grafts occurr naturally 1's 2's 3's 4's grafts.

non-modern hair transplanting was done with mini-grafts or micro-grafts which were more than 4 hairs cut/disected in bundles and required larger incisions and were not refined.

make sure you stay away from these procedures because believe it or not there are still dr's doing this outdated procedure out their.

keep asking questions and gaining knowledge before committing to a HT.

[albal smith]

thanks, let me rephrase my question. Is there a universal language used by the hair transplant doctors to count the number of grafts done in one session. Is it by the number of hair transplnted, or the number of units or by the number of incisions made on the head? can a doctor or an expert answer please.

[Dr. Michael Beehner]

Albal Smith,

The total number of grafts planted in a hair transplant procedure simply refers to the number of "building blocks" used in that case, whatever their size or composition. In modern hair transplantation, that usually can range from a 1-hair follicular unit graft up to usually a double follicular unit graft of 4-5 hairs, both dissected under microscopes. Ordinarily the number of grafts equals the number of recipient site incisions with two exceptions:

One, if extremely tiny incisions are made over the entire planting area and the physician feels that 3 or 4-hair FU's are too large to use and instructs the assistants to split them into two smaller grafts each. Actually, two 2-hair grafts made by splitting a 4-hair FU will still count as two grafts, because the work was taken to cut them into separate units and two separate incision sites are made to place them in.

Two, if a patient has a larger percentage of naturally occurring 1-hair FU's in the donor tissue, often two 1-hair FU's will be "paired up" and placed into a single incision, which then becomes a 2-hair site, as opposed to making two separate sites and placing 1 hair into each one.

Fortunately most patients have around 20% 1-hair FU's, which works out to about the number needed to create a natural front hairline, and rear border. From the viewpoint of minimizing injury to the scalp and creating density, if there is an excess of 1-hair grafts, placing two into a single incision is probably preferable. Whether one charges for 1 or for 2 grafts for the grafts placed in such sites can sometimes be problematic, as you have carried out the work to dissect two separate grafts, but only one placement act is performed, as they are usually gripped together as they are placed. In our practice we prefer to keep 3 and 4-hair FU's intact and simply make sure that a few of the micro-slits are slightly larger than the others in order to accomodate them.

An earlier commentator spoke of minigrafts and micrografts as both being over 4 hairs each. That is true of the definition of a "minigraft," which was a cut-to-size graft cut under loupe magnification in the past. But a "micrograft" is a different animal and has always simply been a 1 or 2-hair graft, which in the "old days" was split off from a larger graft usually. The concept of the naturally occurring follicular unit wasn't appreciated back in the 1970's and early 1980's. Many of us still use the term "micrograft" to refer to a 1-hair graft that is the result of splitting up a 2-hair FU to make two single 1-hair grafts. This is sometimes necessary when a patient has hardly any naturally occurring 1-hair FU's and they are needed for either eyebrow work or for the edge of the front hairline.

Many people, including myself, feel that giving the NUMBER OF HAIRS transplanted is a more accurate way to describe what was accomplished in a single transplant procedure. My experience is that most patients require somewhere around 10,000-12,000 hairs on the top of the head (frontal and midscalp regions) to look relatively full. Persons with extremely fine hair sometimes require more.

Mike Beehner, M.D.

[Janna]

Nicely put Dr. Beehner.

 

Many clinic will keep track of the number of grafts as well as breaking down the number of each follicular units for each patient so you know exactly how many 1's, 2's, etc.. you received. This gives you the exact number of total grafts and total hair count. Most clinics charge per graft and not by the hairs. The patients with really good density yielding many 3's and 4's technically get a better deal all around.

[albal smith]

thanks so much Dr. Beehner. Very nicely put. I have one more question. Since all of these terminology is not ususally explained, and I am sure there are many others like me that are confused it would be nice for the coalation doctors to come up with an agreeable terminology so patients know what tey are getting. As to the number of grafts vs. number of incisions, is it possible for some doctors to make two single hair Fu and place in one incision and charge for two grafts?

[Bill - Seemiller]

Albal,

 

Yes, this is possible and probable. As Dr. Beehner described in his detailed and informative post above, there may be times when a patient has an abundant number of single haired follicular unit grafts and it may be determined that coupling these hairs and transplanting it into single recipient sites may be more beneficial overall, especially to potentially minimize scalp trauma and the risk of shock loss.

 

A physician may still charge you for 2 follicular units even though they were combined. After all, the technician did the work to cut the separate follicular units.

 

A physician / clinic may decide to cut you a break and charge you for the actual grafts after all coupling or DFUs are created however, many will charge for how many follicular unit grafts were cut rather than how they were transplanted.

 

You may want to ask your clinic their philosophy on this before entering into surgery.

 

Dr. Beeher, thanks for your detailed professional input on this thread.

 

Best wishes,

 

Bill

[PLEASE GROW PLEASE]

So if two single hair grafts are put in one site is the patient charged for one graft?

[Julian888]

Hello, I just had a HT surgery. The doctor charged me 3000 grafts. I'm skeptical about the actual count. Can anyone give me an estimate based on the picture I attached?

 

the following flickr url has the same pic in case you cannot see it

 

Thank you so much, I need the answer asap because according to our contract, I can dispute with him within 30 days.

Edited October 26, 2011 by Julian888

[Janna]

It'd be difficult to count exactly how many grafts you received with pictures. Even in person it would be difficult. What is there to dispute? Your doctor told you that you received 2900 grafts - 100 grafts less than what you paid for so he should give you a credit for the 100 grafts. Much of the surgery is based on trust. I would think you went to this physician because you placed your trust in him. At this point, you can only go by his word. Good luck.

[Julian888]

Spex, could you explain a bit about what you said? I don't quite get it.

Edited October 21, 2011 by Julian888

[Julian888]

Thank you so much Spex. I don't have a pre-op pic with me (the doc has). I lost lots of hair last year due to the switch from minoxidil 5% solution to foam. The doc did mention I might need a second operation to achieve better results. I'm wondering if I should do the second with him or not.

My question is, based on the current pic, can you estimate how many grants I've had already?

I really appreciate your replies. I made a decision within 1 day before doing any research. I've been using proscar and minoxidl 5%. Considering adding biotin 5000 mcg.

 

thanks,

Edited October 26, 2011 by Julian888

[Jotronic]

No one can say for sure how many grafts are planted. Even if one were to literally count the visible grafts on your photo one can only discern the numbers based on the scab that has formed and is still visible on your scalp. At this time though a good number of them most likely have fallen off. In my opinion you have between 2000 and 3000 grafts planted but there is no real way to tell from the photo.

 

The best thing to do now is allow the procedure to progress to fruition and then evaluate where to go from there. It would probably be a good idea to not rush into a 2nd procedure and allow some other clinics evaluate your case.

[Julian888]

thank you so much. the pic was taken on day 1. so no scabs have fallen off.

Edited October 26, 2011 by Julian888

[gabrieljose43]

Julian, am not an expert o hair transplants, but I have done my research. By the picture your grafts do look too spread out on the back, but yet you have only 2900 graft for a lage area of coverage. I can not tell if the hair you have closer to your forhead has been implanted or not because I dont see any scabs, but if it has, I know at least the front looks nice and full to me. The middle I think might be a little noticeble. How about having someone helping you do a count at home? and take a reallly high res picture of your scalp, just incase you need to dispute it against the doctor in a later time. It looks like 2900 to me, if your take in consideration the density on the front. I would say the a second procedure is needed, but once ;your hair grows it will be less noticeble. If your procedure went well with this riskI would not risk it and change to someone new.

Edited October 22, 2011 by gabrieljose43

[Julian888]

thank you so much gabrieljose43. the front was implanted. the doctor did say he focused on the front. so the front has better density now.

Edited October 26, 2011 by Julian888

[Montreal]

I beleive that numbers of grafts doctors charges you could not be the exact amount,maybe some dr will want to take advantage because you will pay more,it's something that is hard to count so I bet you anything that 70% you dont pay for the right amount of grafts.

[Montreal]

70% of the time

[Julian888]

Thanks buddy. 70% of the time is fine, as long as the error rate is small. e.g., < 3% each time.

Edited October 26, 2011 by Julian888

[ParraPhil]

If you work on the basis that a top of head needs 6,000 grafts, then you are looking at 2 procedures:

 

1) Option 1 - 2 x Whole Head Sessions

 

- 3,000 grafts to whole of head to get you started (thin coverage)

- 3,000 grafts a year later to "thicken" up the first session

 

(this is where I believe you are at)

 

2) Option - 2 x Dense Packing Sessions

 

- 3,000 grafts to the hairline & front 3rd of head

- 3,000 grafts a year later to mid/back of scalp

 

Both options will do the job. If you are losing hair in the hairline, you would select option 2. If you are losing hair allover your scalp you would select option 1.

 

3,000 grafts will not be a complete job, but it will get you started.

[Julian888]

thanks for the explanation. I think the doctor focused on the front of my head actually, closer to your option 2. not sure. i don't mind doing a second session. i'm lucky to have a nice job so money is not a big issue.

 

my original question was to ask for help to estimate the number of grafts i have received from this operation. the doctor claimed 2900, in a very random manner, leaving me in doubt.

[ParraPhil]

Whole of head is 6,000, and its a thin job, so divide by 2.

 

Judging by your photo's, it looks like around 3,000. Certainly not more.

[ParraPhil]

Why don't you blow the photo up, print on A1 size paper, and use a green pen to circle each graft you can see.