2500 grafts enough for front 1/3?

[Reptile]

Hi,

I've been to about 3 HT surgeons in the Toronto area and have consulted over 10 of them online. I basically am 30 years old and wore a hairpiece for the last 6 years and want to get a HT now, my front portion of my head about 1/3 is pretty much bald (some microscopic hairs still there), so I've been quoted by a majority of the HT surgeons about 2500 grafts while a couple online said 3000 or so, do you think 2500 grafts would be decent amount of hair in the front portion of a pretty much bald front? I basically don't want my scalp to shine through but be covered with somewhat decency. I have been told I am between a NW 5 and 6 (sucks I know at my age).

 

My 2nd HT would probably either be in the front for thickening or most probably in the crown area. But am still curious as to how dense a bald front would look with 2500 grafts?

 

I tried searching for some pics online but the majority of people already had some hair in the front, so I can't tell.

 

Thanks in advance!

[Reptile]

Hi,

I've been to about 3 HT surgeons in the Toronto area and have consulted over 10 of them online. I basically am 30 years old and wore a hairpiece for the last 6 years and want to get a HT now, my front portion of my head about 1/3 is pretty much bald (some microscopic hairs still there), so I've been quoted by a majority of the HT surgeons about 2500 grafts while a couple online said 3000 or so, do you think 2500 grafts would be decent amount of hair in the front portion of a pretty much bald front? I basically don't want my scalp to shine through but be covered with somewhat decency. I have been told I am between a NW 5 and 6 (sucks I know at my age).

 

My 2nd HT would probably either be in the front for thickening or most probably in the crown area. But am still curious as to how dense a bald front would look with 2500 grafts?

 

I tried searching for some pics online but the majority of people already had some hair in the front, so I can't tell.

 

Thanks in advance!

[dakota3]

Its hard to tell w/out pic's but I'd say if the majority of doc's are saying between 2500 and 3000 then that's propably what you need. Post some pic's and you'll get alot more opinions.

[Reptile]

Hi Dakota3 and company,

I'm attaching a pic of my top, please any suggestions are much appreciated.

 

Thanks

[Desperately Seeking Hair]

From what I've seen here and elsewhere, I'd say at least 6000 grafts overall. But I would think 3000 in the front would be a big improvement.

[Eman]

Reptile-

 

2500 will not accomplish what you are looking to do. I really believe that a larger session in the front is what you will need, especially being your first HT. And a second HT will add density and work on the crown area. I really feel that a larger session would be more appropriate for your level of loss, that is if you are a good candidate for a HT.

 

When measured, my transplanted area was almost 90-cm2 (I believe that includes my temples). I have a big dome, have a look at my pics. I was a NW4v moving to a NW5. I had approximately 4200 grafts in an area that looks similar to yours in the front, but my loss was only frontal recession (I still have good crown coverage).

 

Again, this is solely my opinion, but I feel you need a much bigger session.

[Reptile]

Hi guys,

thanks for you suggestions, I think I have just 2 HT's in me that is what kinda scares me, here is another pic of my crown, again the top is cut short because of my hairpiece but I have lost quite a bit in the crown for my age. So I'm hoping still if I can get away with 2500 or so in the front and then have a 2nd to add a few hundred more grafts in the front while about 2000 in the crown?

 

Thanks

[dakota3]

Reptile,

 

PM Jotronic from Hasson and Wong and he'll be able to tell you what they can do. I'd say 5000-6000 would be what you would need to achieve a really good result, and H&W can SOMETIMES do that all at once depending on your characteristics.

[Chuckisduck]

I had about 2450 in a much smaller are.

[Reptile]

I asked one of the HT surgeons and he was saying that mega sessions of 4000+ usually are possible only when splitting up 2 and 3 hair grafts into 1 hair grafts, so if there are 2500 grafts to give, surgeons usually would split these up these into a majority 1 hair grafts to give more grafts (4000+) for more coverage but with less density, is this right? This is what he said:

 

"It is also well know that the average head has about 10-15% one hair grafts. Therefore in a person who gets a 4326 grafts transplant, they should get about 436 to 649 single hair grafts. They quote a total of 2129 single hair grafts!! The only way to do this is to cut the two and three hair grafts into one hair grafts. Most doctors think that this is not a good way to go since you will lose density. Single hair grafts produce less density than doubles or triples. However, some doctors claim that at least the patient has some hair there even if it is only a one hair graft. Furthermore, most doctors charge by the graft so the cost is significantly higher. For example, typically 2500 follicular units will have about 250 singles and about 2250 double and triples in equal ratios. If we cut up all the doubles and triple into singles we will get about 3375 ( 2250x0.5x3) + 2250(2250x0.5x2) + 250= 5875 single hair grafts. YOU do not have 4326 real follicular units to give in one sitting ??“ no one does"

 

Please comment, thanks!

[dakota3]

I asked one of the HT surgeons and he was saying that mega sessions of 4000+ usually are possible only when splitting up 2 and 3 hair grafts into 1 hair grafts, so if there are 2500 grafts to give, surgeons usually would split these up these into a majority 1 hair grafts to give more grafts (4000+) for more coverage but with less density, is this right? This is what he said:

 

was this a doc recommended on this site?

[Reptile]

dakota3, the doctor isn't recommended on this site, but when I spoke to him he seemed very detailed in his analysis. I just saw him again today and he said I definately have 2 HT's in me, enough to cover the front to middle (or 1/3) with 2500 grafts in the 1st transplant while in the 2nd transplant go from middle to the back. He said I might have very little to give for the crown or nothing at all. He said I have an area of 77cm2 to cover, do you think 2500 grafts would be enough to cover this area with some decency? The doctor said he would use around a density of 30cm2 or so, I just don't know if the scalp will show or not? I'm just having some difficulty visualizing this!

 

Thanks for any comments and suggestions.

[HairDew]

You can most certainly get the whole thing done in 1 shot with Hasson or Wong. These 2 guys never fail and do HUGE megasessions. Just look on these forums for Hassor or Wong and you will see MANY megasession results.

[Reptile]

Hi HairDew,

by one shot do you mean they can do the entire head from front to back (crown area) at once? That's pretty decent. Otherwise I would be covering 77CM2 area the first time. The 2nd time from middle to close crown.

[latinlotus]

If your laxity permits, go for the maximum grafts possible, and try to achieve everything in one megasession. If you can't get 4000-5000 grafts, then a second smaller HT may be planned later.

[Chuckisduck]

Some docs like mine do 2 days in a row. What is your limiting factor Reptile?

[Reptile]

Hey Chuckisduck,

I think my only limiting factor is the donor area and how much I can give, I have 2 HT's in me for sure but that's like a total of 2500 each so 5000 altogether, unless I can get close to that in one sitting. You can look at my pics above, my crown and my front, I have 77CM2 to cover the front with 2500 and then have a 2nd to cover the middle to back (not the crown).

[Chuckisduck]

Hey Reptile,

My opinion, and not a professional one, is that you would have to use all 5000 to get a descent result. If money is no issue, Wong seem to do great work, and could probably do it all in one session.

[TheEmperor]

I had a 4500 graft session and your balding area is larger than mine; you will need 6-7K grafts to cover it all, and that with not too great density.

 

I would suggest not to touch the crown. Most patients can get at most 4500 grafts in a single session, which I would advise to cocentrate in the front and top.

 

Also, I think there is some truth in the larger sessions splitting larger grafts to get 1's, but if your hairline has any 2's in it, it will look unnatural, especially if you have coarse hair as it looks like you do. If you go to your doc asnd get a 2500 graft session, that is only 250-300 singles by his admission and that is NOT enough to give a natural hairline. Therefore, clinics like H&W that may be splitting grafts smaller will get maybe 1000 singles from a 4500 graft session which will be enough to complete the hairline and look natural. Yes, hair for hair it will be more expensive, but for someone with coarse dark hair like yours, it is the only way to proceed, IMHO.

 

If you cant get 4000+ grafts in your first session, then I would not proceed; it will look too thin and too sparse to do any good, and with only 10-15% 1's it will look pluggy as well.

[Bill - Seemiller]

I disagree that "most" patients have the density and elasticity to get 4500 grafts in a single session. Clearly some do, and in even those that do, only a handful of clinics is willing to harvest this much tissue in one session.

 

Splitting follicular units to acquire more single hairs for the hairline is common practice in most if not all hair transplant clinics.

 

I also disagree that this patient shouldn't proceed if he can't get a session larger than 4000 grafts the first time around. Two sessions of 3000 grafts for example, will make a huge difference in this patient's appearance.

 

It's important we set the bar high for clinics to achieve the very best results. But in setting the bar, we have to deal in reality and recognize that session sizes exceeding 4000 grafts are the exception rather than the rule.

 

Best wishes,

 

Bill

[Reptile]

Hi guys,

thanks again for all the suggestions, TheEmperor, what you say makes sense and I wouldn't mind getting 4000 grafts if I can but Bill as you say 2 sessions of 3000 grafts would be enough. It seems if I either go to Dr. Ferreira of SureHair or Dr. Cotterill (both in Toronto) then I will be getting about 2500 grafts my 1st session and then more then likely another 2500 in my 2nd, do you think that would be enough? Would that give me some decent density? Remember I have 77CM2 in the front to cover with 2500 grafts taking me to almost the middle and then another that would continue to the back but just missing my crown probably. Here is another Pic of the front and top. I'm just finding difficulty finding a pic that is similar to mine who got around 2500-3000 grafts in the front.

[Ja-Man]

Hi Reptile, I agree w/ the others that 2500 will not be enough. Even 2 surgeries of 3000+ grafts each, may still leave you with a bald or very thin crown (however, I believe a nice cosmetic difference). Also, being 30 and having a significant amount of loss, there's always a chance that you could end up a NW7 (check your family history). Are you on any hair loss meds (propecia/proscar) to stabilize your hair loss? Doctors will strongly recommend the hair loss meds.

[Eman]

like I have said and others have said, 2500 will not give you the coverage you are looking for. It is not enough! The cosmetic difference will not be worth it, IMO.

[Reptile]

Hi guys,

yeah I started both Minoxidil 5% and Proscar last week. So I guess 2500 grafts should not be the best to go for, perhaps I should try another doctor who said around 3500-4000 grafts, the only thing I'm afraid is that they will take the same 2500 grafts and just split it up into some 2's and 3's but mostly 1's for coverage. Would that be the best way?

 

 

Thanks!

[Bill - Seemiller]

Reptile,

 

Just to clarify, I'm not telling you what is "enough", but simply making a point that 2 sessions of approximately 3000 grafts will make a significant difference for you. At your stage of hair loss, it would be unrealistic to expect you will receive a full head of hair. If you take a look at my hair restoration story and photos (link below), you will see I've received over 7500 grafts. The before photos are a little decieving because I had some natural hair left, whereas now, all that is left is grafted hair and maybe a hundred or so natural hairs in the vertex. But as you can see, though I'm happy with my results, I don't have great density.

 

I was also making a point that excising over 4000 grafts in a single session is more of the exception than the rule. Consult with a few top clinics who regularly perform large densely packed sessions and they can evaluate approximately how much donor you have and work out a long term hair restoration plan for you.

 

Best wishes,

 

Bill