1st and 2nd ht

[Johhny]

If I had a 3000++ grafts for my first procedure, is it possible to get the same number of grafts or higher for second ht or it must be a lower number compare to the 1st ht.

[Jotronic]

This depends on two factors. First, was your 3000 grafts taken with the intent to get amap (as many as possible)? Second, it depends on your doctor. I'm not asking you to name names but I can say this. 3000 grafts as a max in one's first session usually means that the doctor isn't used to getting the big numbers as to get only 3000 in one session as a max would mean that you have very low donor density and/or very low scalp laxity.

[Radius]

It also depends on the technique used? FUT or FUE?

[Johhny]

It was 1.7 x 28 cm. Strip.

[orangehair]

Your total donor supply, future hair loss progression, laxity are several factors as well as whether or not you want to replace the previous strip scar. What is your current age / norwood classification?

[NEWHAIRPLEASE]

Lots of factors to figure in, for the most part I think they have all been mentioned in the above post.

[Johhny]

I'm 29, diffuse 4a-5a. About density, is 50 grafts/cm2 good enough? Or maybe more to something close to natural and non balding. My hair shaft is very thick.

[mahhong]

Hi Johhny,

 

As most people have mentioned there are loads of variables here. Did you and your doctor decide on 3000 for the first procedure, or was that the maximum he/she could harvest despite their best intentions?

 

Most people have about 6-8,000 follicular units in their donor area and so, based on the information about the extent of your hairloss, we can presume you probably do have another 3,000 or so up there for your next procedure. But nobody on these boards can say for certain because unless you're a doctor with access to your history and a physical examination there's no way of telling.

 

Usually, if people get the maximum number of grafts they can for their first procedure, subsequent procedure produce lower numbers of grafts. It's usually a case of the law of diminishing returns. But, as Jotronic says, it depends a lot on your doctor. Good doctors these days are regularly performing 3-5,000 graft megasessions and if you're looking for maximum yield 3,000 doesn't sound particularly high.

 

Did you discuss an overall plan with your doctor when you went for your first transplant procedure? It sounds to me like you only planned one procedure with your doctor and you're now thinking about another totally separate procedure. That's obviously doable, but usually people have a good idea if they're going to need one or more procedures to reach their goal and what each procedure will aim to do.

 

In regards to density, it's hard to say but 50grafts/cm2 sounds decent. But it really does depend on so many other factors - there's not necessarily any number to aim for. But to get to 50g/cm2 would require a lot of grafts. If you had 150cm2 of baldness to cover you'd need 7,500 grafts. You describe yourself as 29 years old and NW4/5a. This could potentially mean further loss in your future - perhaps more 5a/6 even. This might not happen, but if it does, you may need to have donor available to cover additional balding in the future.

 

I think you need to have a proper discussion with a good doctor who will develop a long term plan for you that takes everything into consideration; balding pattern, potential future loss, medication, goals, hair type, donor left etc. etc. As you know donor hair is finite and if you use it all up aiming for 50g/cm2 you may end up losing the battle. Few people manage to get to 50g/cm2 across their entire balding region - in higher hairloss patterns you'd need an awful lot of grafts and many men would simply not have enough. You could be different, but only a doctor and you can make that call.

 

So yeah, I'd get in with a doctor and come up with a long term plan that balances your goals and your available resources. Just getting disjointed procedures done trying to get your hair back could lead to trouble - you need all the facts and a few frank discussions before you make the next move.

[Johhny]

Thanks Mahhong, in your opinion what is the best density per cm2 ?

[mahhong]

Thanks Mahhong, in your opinion what is the best density per cm2 ?

 

There isn't a best I don't think, because there's too many individual circumstances to take into account. In addition, most transplants involve different densities in different regions, with the hairline usually being the priority for density and the crown not as much so.

 

It really depends on how much donor you have, how extensive your balding is (or is likely to become) and your goals. If you were able to get an average of 50g/cm2 that would likely look very good, but it would require a very large amount of grafts on a NW5a. What most doctors would do is look to put a higher number in the hairline and then fade it back, so maybe around 50g/cm2 in the hairline and come back to 20 or 30g/cm2 in the crown (these are just example numbers, not facts or anything).

 

Only a doctor can tell you what's best. What did you do for your first procedure? Were you happy with it? What are your goals with this second procedure?

[Johhny]

My goal is to increase density so that it will look dense, my crown is fine and it's diffuse thinning, well the role of donor area is important and I will keep that in mind. Thanks mahhong.