Verification of Grafts

[NewHairMan]

:confused:I recently had a hair transplant that claimed around 2,400 focular grafts. It was a good experience and I think they did a fine job. I took a picture of my scalp after surgery and counted roughly 1,000 punture/slit sites on my scalp. Does that mean I probably only recieved 1,000 grafts? Does anyone know a way to verify # grafts? Is there more to the surgery that I am not aware of? Is the only way to verify # grafts is to just TRUST your doctor to deliver what he promises?

Thanks

[Jotronic]

It really is hard to tell unless you've got experience counting incisions. I've done this many times but I do not necessarily enjoy it;) Whether or not you can trust what was done depends on the reputation of the clinic. If they are well reviewed and you were able to speak to a few patients, either in person or email, then you should be fine. If they are a mom & pop outfit that no one has heard of, well, no one knows but them. Maybe you could ask for a copy of your surgical chart so you can see if they documented the the grafts.

[NewHairMan]

Thanks Jotronic. I am not interested in finding out the exact # of follicles, just approx what I paid for. And I did not take the time to count each incision either. My appoximation of 1,000 is far off from the 2,400 I was promised, however. They advertised a low price per folicle, so maybe you get what you pay for

 

I am assuming everywhere I see a small blood scab is where an incision was made and a graft was inserted. If there are some incisions that do not cause a blood scab then maybe there are others I can not see.

[waveskier]

I have found that you can't count them yourself at least not accurately. And also you need a magnifying lens to be sure you can see them all.

[Happy]

Does anyone know a way to verify # grafts? Is there more to the surgery that I am not aware of? Is the only way to verify # grafts is to just TRUST your doctor to deliver what he promises?

Thanks

 

this is a very good question indeed! and i am sure that the answer would be interesting for any potential ht candidate, (well, at least for me). in particular, because i noticed that it is so easy to cheat with a ht. and i remember with all my research work that this potential problem was - and probably is still being - discussed in many threads (i can't remember whether it was this or other ht forums).

 

now the answer that i found for myself depends first of all on the type of surgery you have decided:

 

 

1. fue procedure

 

with fue it should be relatively easy:

 

since your head gets shaved before the surgery, the number of grafts that have been taken out can easily be spotted. so, if you take a picture of the donor site at least within days after the surgery, you just count the red dots in the donor area and which is equivalent to the number of grafts that have been taken out. at least in theory.

 

because, practically speaking, this doesn't mean that the same amount of grafts also got implanted into the recipient area:

 

not all the fue-drills are successful - eg. some grafts won't come out, some others might get lost due to transection; and the very first ones in the fue procedure often can't be used either. so, maybe there is a 2% loss of all extracted grafts (just to give you an example).

 

to be sure, i would suggest to also take a picture of the recipient area and what you have already done. now if you count the incisions the amount should normally be less than the the amount of the dots that you counted in the donor area for the reason that i just mentioned. there is just one exception:

 

sometimes ht surgeons split bigger grafts into smaller ones, "officially" for the reason to have more smaller grafts available for creating a natural hair line with single hair grafts. however, i also remember this created a lot of controversy within the ht world as being highly unethical:

 

as everyone can easily imagine this approach is first of all much more lucrative for ht surgeons as it artificially increases the amount of grafts and as such the money that surgeons can charge their patients. to give you an example:

 

say, you got a total of 1,565 grafts extracted and which would equal about 3,600 hairs if we apply the statistical average size of 2.3 hairs per graft. now if you initially agreed to pay, say $5 per graft, this would then come to $7,825. normally, if there is no splitting involved. because there have been cases when it turned out that the average graft consisted only of 1.5 hairs and which you can easily achieve by the above described procedure. so, in our example the surgeon could also create 2,400 grafts and which would come to a total bill of $12,0000 for having transplanted the same amount of hairs. not bad, isn't it.

 

to avoid this costly scenario, i would therefore recommend you first of all make the doc confirm before the surgery that he doesn't split grafts. this way, you can be sure that the incisions that you counted in the recipient area is the total amount of grafts he can actually charge. additionally, you should also ask him to count each and every graft while he is extracting them.

 

 

 

2. strip procedure

 

this is the much trickier one if you want to make sure that you don't get cheated but only get charged for the actual amount of grafts:

 

it is very very very easy to split natural grafts into smaller units while dissecting the original slice of skin that was cut out of your head. to get round this i would suggest a multi-stage approach to be on the very safe side:

 

a. pre-op consultation

 

make sure that you know your donor density beforehand. i remember in one of the other threads "1 EURO PER CRAFT STRIP, 2 EURO - FUE" the relevant surgeon used a densitometer to examine the donor area. the magnified fu's were then shown on screen so that the patient's fu's per cm2 could be calculated precisely. furthermore, you can also check the percentage of miniaturised hair and which shouldn't be used for ht (see also the other thread: "transplantation of miniaturised hair?"); finally, you can also have a look yourself what the average size of your grafts is.

 

once you have got these figures, you can calculate very precisely the length and width of the sliver that is needed. say, your average density of usable fu's is 80 per cm2. in this case, if you wanted to have 2,400 fu's transplanted, you would then need 30cm2 of skin.

 

 

b. surgery

 

when it comes to the surgery, just take a picture of the cut out skin. when you later view the image on screen it should be possible to count the fu's on screen provided your camera allows for close-ups in the first place and that your image is sharp. additionally and to be on the very safe side, you can also place a ruler when taking the picture so that also the total area of the sliver can be calculated. in any case, you should be able to easily check whether the number of grafts that you have been charged is correct. or not.

 

 

 

ps: from an ethical strip ht surgeon i would agree before the surgery that he provides such a documentation of his surgery so that the number of transplanted grafts can always be double checked - either by providing a photograph of the cut out skin as just described or, even better, by providing a relevant flatbed scan and which also only takes seconds!

 

from an fue surgeon i would agree before the surgery that somebody of his team would count the fu's including their relevant size while they are being extracted. as soon as the extraction procedure is finished, i would then expect to receive a copy of the tally list.

[wb280]

Happy, meticulous indeed I agree that will be fair to both surgeon and patient in case there is finger pointing. In my case, i did not really bother to be honest so i just went along with the count they informed me

[LasVegas2Orangecounty]

this is a very good question indeed! and i am sure that the answer would be interesting for any potential ht candidate, (well, at least for me). in particular, because i noticed that it is so easy to cheat with a ht. and i remember with all my research work that this potential problem was - and probably is still being - discussed in many threads (i can't remember whether it was this or other ht forums).

 

now the answer that i found for myself depends first of all on the type of surgery you have decided:

 

 

1. fue procedure

 

with fue it should be relatively easy:

 

since your head gets shaved before the surgery, the number of grafts that have been taken out can easily be spotted. so, if you take a picture of the donor site at least within days after the surgery, you just count the red dots in the donor area and which is equivalent to the number of grafts that have been taken out. at least in theory.

 

because, practically speaking, this doesn't mean that the same amount of grafts also got implanted into the recipient area:

 

not all the fue-drills are successful - eg. some grafts won't come out, some others might get lost due to transection; and the very first ones in the fue procedure often can't be used either. so, maybe there is a 2% loss of all extracted grafts (just to give you an example).

 

to be sure, i would suggest to also take a picture of the recipient area and what you have already done. now if you count the incisions the amount should normally be less than the the amount of the dots that you counted in the donor area for the reason that i just mentioned. there is just one exception:

 

sometimes ht surgeons split bigger grafts into smaller ones, "officially" for the reason to have more smaller grafts available for creating a natural hair line with single hair grafts. however, i also remember this created a lot of controversy within the ht world as being highly unethical:

 

as everyone can easily imagine this approach is first of all much more lucrative for ht surgeons as it artificially increases the amount of grafts and as such the money that surgeons can charge their patients. to give you an example:

 

say, you got a total of 1,565 grafts extracted and which would equal about 3,600 hairs if we apply the statistical average size of 2.3 hairs per graft. now if you initially agreed to pay, say $5 per graft, this would then come to $7,825. normally, if there is no splitting involved. because there have been cases when it turned out that the average graft consisted only of 1.5 hairs and which you can easily achieve by the above described procedure. so, in our example the surgeon could also create 2,400 grafts and which would come to a total bill of $12,0000 for having transplanted the same amount of hairs. not bad, isn't it.

 

to avoid this costly scenario, i would therefore recommend you first of all make the doc confirm before the surgery that he doesn't split grafts. this way, you can be sure that the incisions that you counted in the recipient area is the total amount of grafts he can actually charge. additionally, you should also ask him to count each and every graft while he is extracting them.

 

 

 

2. strip procedure

 

this is the much trickier one if you want to make sure that you don't get cheated but only get charged for the actual amount of grafts:

 

it is very very very easy to split natural grafts into smaller units while dissecting the original slice of skin that was cut out of your head. to get round this i would suggest a multi-stage approach to be on the very safe side:

 

a. pre-op consultation

 

make sure that you know your donor density beforehand. i remember in one of the other threads "1 EURO PER CRAFT STRIP, 2 EURO - FUE" the relevant surgeon used a densitometer to examine the donor area. the magnified fu's were then shown on screen so that the patient's fu's per cm2 could be calculated precisely. furthermore, you can also check the percentage of miniaturised hair and which shouldn't be used for ht (see also the other thread: "transplantation of miniaturised hair?"); finally, you can also have a look yourself what the average size of your grafts is.

 

once you have got these figures, you can calculate very precisely the length and width of the sliver that is needed. say, your average density of usable fu's is 80 per cm2. in this case, if you wanted to have 2,400 fu's transplanted, you would then need 30cm2 of skin.

 

 

b. surgery

 

when it comes to the surgery, just take a picture of the cut out skin. when you later view the image on screen it should be possible to count the fu's on screen provided your camera allows for close-ups in the first place and that your image is sharp. additionally and to be on the very safe side, you can also place a ruler when taking the picture so that also the total area of the sliver can be calculated. in any case, you should be able to easily check whether the number of grafts that you have been charged is correct. or not.

 

 

 

ps: from an ethical strip ht surgeon i would agree before the surgery that he provides such a documentation of his surgery so that the number of transplanted grafts can always be double checked - either by providing a photograph of the cut out skin as just described or, even better, by providing a relevant flatbed scan and which also only takes seconds!

 

from an fue surgeon i would agree before the surgery that somebody of his team would count the fu's including their relevant size while they are being extracted. as soon as the extraction procedure is finished, i would then expect to receive a copy of the tally list.

 

 

 

Wish I found this thread sooner... Now I am having that dilemma right now....Trying to ascertain whether 650 or 1500 grafts were placed on my head,,