FUE 10K to 15K Donor Reserve Theory

[gazzasgoin2]

hello all,

 

There's been quite a debate on here and other forums regarding claims of donor reserves of 10k to 15k grafts. This is widely thought to be exaggerated, with conservative reserve estimates placed at c7k to 10k. I've been trying to understand where such numbers might come from and wanted to share a few thoughts.

 

- Okay, so let's say the average head has 100k to 120k HAIRS before the effects of DHT produce MPB.

 

- The average follicular unit contains 2.2 hairs. So a head unaffected by DHT will have 45k to 55k Follicular units available.

 

- Is it fair to say the hairs would be split 40% on top, 40% on back of head and 20% on sides? (Kind of thinking out loud here so please let me know if you disagree with the weighting).

 

- That leaves 60% (on back and sides) available for FUE. 60% X 45K to 55K = 27k to 33k FU's in the available donor for FUE.

 

- I believe the most optimistic opinion is that 33% of donor can be moved via FUE before it becomes thin or moth eaten effect. Which makes 9k to 11k of FUE grafts available.

 

Not quite the 15k that has been mooted but can this be the basis of the thinking behind the inflated FUE reserve?

 

As I said, just thinking out loud at to how this higher number could be substantiated. You may agree or disagree with some of the assumptions and I would be interested to hear your thoughts.....

[gazzasgoin2]

hello all,

 

There's been quite a debate on here and other forums regarding claims of donor reserves of 10k to 15k grafts. This is widely thought to be exaggerated, with conservative reserve estimates placed at c7k to 10k. I've been trying to understand where such numbers might come from and wanted to share a few thoughts.

 

- Okay, so let's say the average head has 100k to 120k HAIRS before the effects of DHT produce MPB.

 

- The average follicular unit contains 2.2 hairs. So a head unaffected by DHT will have 45k to 55k Follicular units available.

 

- Is it fair to say the hairs would be split 40% on top, 40% on back of head and 20% on sides? (Kind of thinking out loud here so please let me know if you disagree with the weighting).

 

- That leaves 60% (on back and sides) available for FUE. 60% X 45K to 55K = 27k to 33k FU's in the available donor for FUE.

 

- I believe the most optimistic opinion is that 33% of donor can be moved via FUE before it becomes thin or moth eaten effect. Which makes 9k to 11k of FUE grafts available.

 

Not quite the 15k that has been mooted but can this be the basis of the thinking behind the inflated FUE reserve?

 

As I said, just thinking out loud at to how this higher number could be substantiated. You may agree or disagree with some of the assumptions and I would be interested to hear your thoughts.....

[the B spot]

good post--- It comes down to what is actually the "Safe Zone"

 

I believe the safe zone is 2.5-3.5cm wide and roughly 28-30cm long.

 

That will put the AVERAGE guy with 85 fu's per cm/2 strip 3.5cm wide 30 cm long at 8925 grafts.

 

If your donor density is higher, you have more available grafts.

 

However, you could not extract 9000 grafts from a 3.5cm wide 30cm long section of the donor region--- with 8925 STRIP grafts available, you could extract only 33% or 2945 FUE grafts.

 

So where do you go for the additional grafts?

 

I will DOUBLE the FUE extraction zone to 7 CM wide.

 

That is 6000 grafts at 33% FUE extraction.

 

I will TRIPLE the FUE extraction zone to 10.5cm wide

 

That is 9000 grafts through FUE.

 

So, what must be done to extract 10000+ grafts is either leave the safe zone OR overharvest the donor area.

 

The math is constant and NEVER lies.

 

There is only 2 ways to refute me:

 

1. State that "moth-eaten"/over-harvesting is subjective and in the eye of the beholder and go past 33-35% per cm/2 in the donor.

 

2. Leave the safe zone and harvest grafts that may or may not be susceptable to DHT and prescribe Prop/Dut to patients in the hopes that the transplanted hair does not fall out.

 

Take Care,

J

 

(there ARE freaks of nature out there--NicNitro for example-- but they are RARE--- Armani's claims target the AVERAGE bald guy)

[gazzasgoin2]

Hi B Spot,

 

I fully agree with you. To get remotely close to the 10k - 15k FUE mark the grafts must be outside the safe zone and/or the donor region must be over harvested.

 

The result being transplanted hair is not DHT resistant and will fall out over time and/or a thinned out donor region.

 

I cannot see any other way to get close to these graft counts????

[Bill - Seemiller]

B Spot,

 

Well documented my friend. I couldn't have stated it better.

 

Bill

[calvinmd]

The answer to the question is already out there on the heads of thousands of HT patients who didn't stop getting HTs until they ran out of donor grafts. See how many 15K patients you can find. Armani's been doing FUE long enough to have produced them by now, and there's PLENTY of men out there with the cash to actually pursue Dr.A's limits.

 

 

Wanna hear a train of thought that makes Armani REALLY seem full of sh*t?

 

Okay, Dr.A insists that 10-15K is "average," right?

Well, then it stands to reason that there's a few "above average" patients out there to have established that bell-curve with . . .

So this means that, for all intents & purposes, Armani is claiming to have at least encountered some men out there whom he feels have WELL IN EXCESS OF 15K GRAFTS harvestable!

(Hell, anything resembling a normal bell-curve would indicate at least a few 20-25K candidates out there when you're wearing Dr.A's fuzzy glasses!)

 

 

Armani's donor-size estimates are fraudulent. Prosecutably so. There's no other way to view the situation.

 

 

------------------------------------------------

[Bill - Seemiller]

Calvin,

 

Excellent bell curve analogy...you are right. Clearly there must be the above average patients who can yield more? Yet, we can't even find patients of Armani who have had beetween 10-15K grafts (the supposed average).

 

Interesting...

 

Bill

[thanatopsis_awry]

Its too bad Armani isn't just up front about his aggressive transplanting philosophy...I'm sure it would still appeal to many while saving some from making a major decision based upon fale-confidence and mis-information.

 

Also, the "bad press" he receives can't be helping his status within the community.

[gazzasgoin2]

I think Armani does fantastic work from a technical perspective. No question his hairlines are amazing but many of the Coalition Drs. could produce the same hairlines with 3000 grafts to expend. It does seem he lets himself down with the long term planning aspect that is a must for younger patients.

 

On the bell curve analogy, is he possibly stating 10k being bottom of the curve and 15k the end of the curve, with average being 12.5k. Trying to give him the benefit here otherwise the theory is even more unbelievable!!

[bverotti]

I would like to state that at this moment we consider 4000-5000 grafts (1,2,3 and 4 hairs) to be average.

Forget 10000-15000 FUE grafts (full grafts) to be average ... that my friends is science fiction.

[Hair to Style]

I just had 3815 graphs, not sure of the hair count, I will ask. Dr Gabel Hillboro or.

He was very skilled. I had 1.5cm by 25cm.

no sign of problems after 8 days.

[P.J]

All this math got me interested - so I took the measurements off my own head.

 

Donor area = 32cm long X 4cm wide at the safe zone

Density average = 100cm2

12,800 grafts in the safe zone

FUE available to harvest with 60 grafts per cm left for coverage = 5120 grafts

 

That would lead me to the same conclusion as everyone else = I would need a density of 200 grafts per cm2 to achieve 10,000 FUE grafts

 

Now with the strip method - if I pulled half of my safe zone (32cm X 2cm) out I would have 6,400 grafts by strip to use.

 

I have one idea about the strip method - correct me if this is wrong:

 

When you cut out a section of skin and pull it closed you are pulling one side down and one side up - which lead me to believe you are lowering your safe zone by half of the strip on each procedure.

So in my case that would lower my safe zone by 1cm X 32cm - which may have to be filled in the future. And at 60 graft per cm - I could possibly need 1960 more graft in the future to fill in the lowered hairline from the strip.

 

Rough Conclusion:

FUE = 5,120 harvestable grafts

Strip = 6,400 harvestable grafts with possible 1920 needed in future

 

 

PJ

[Alexander]

Great point Gazza- I believe if most of the top notch docs used as many grafts as Armani their work would be as good if not much better time in and time out. Personally while I think Armani does decent hairlines, I still think others like H&W and Shapiro do much more natural-looking work w/ much fewer grafts anyway.