How many grafts can FUE yield after strip?

[TC17]

Assume that you can safely harvest the average 6,000 grafts via traditional strip, is there a way to estimate how many grafts would be left over for FUE?

 

Also, can't you conceivably get a much higher yield from only using FUE? If the average person can lose 50% of his hair before it becomes noticeable, can't a doctor theoretically take every other follicle in the entire donor area without it appearing thin? I may be wrong here, but I'm under the impression that there are close to 25,000 follicular units in the donor area and 12,5000 would be enough to fill in even Norwood 7's, right?

[hdude46]

from what ive read the average is more around 8,000 from strip. with some people only getting around 6,000 to some getting 10,000.

[the B spot]

TC---this is a great question(s)

 

First, I think for a majority of clinics seeking to maximize available donor via fue--the % of extraction is 25 to 30% maximum. Additionally, the surface area of the donor area is not reduced like with strip, leaving the surface area of the donor to be covered with less hair.

 

When we do "hair math" it is always the average patient who has a density of 80-85 fu's cm/2

 

That generally leaves a patient with 23-24 fu's to be taken per sq cm in an irregular pattern. Which generally corresponds to about 4500-5500 grafts available by using only fue.

 

Of course, there are some patients who can do more, but just as well, there are some patients who have less.

 

It is generally held that to maximize a patients donor both strip and FUE must be used in tandem--whereas using either strip or fue will reduce the amount of available grafts.

 

To answer your question directly, if a patient uses his 6000 available strip grafts---he should have roughly 1000-2000 grafts available by expanding into the untouched areas and taking a measured extraction over the entire donor region. This is simply a best estimate since again, patients may have more or less depending on their situation.

 

Once a clinic measures your donor density and takes into consideration your age, current level of loss, family history and response to meds, a more factual approach can be taken.

 

For most patients the 50% extraction rule is not an option---it is next to impossible to remove 50% in an irregular pattern over the entire donor region and not leave gaps or thicker/thinner spots in the donor region----- the issue with FUE is that if you approach it with the idea to take a large # of grafts, say 5000---your taking a chance on the condition of the donor post-op.

 

The better approach, (but albeit less instant gratification), is to take 2500-3000 grafts, let it grow in, observe the coverage, re-map the donor region and proceed accordingly.

 

We think there is a threshold for every patient that may occur at 4000 in some, and say 6000 in others, where the donor looks pristine and untouched, but by taking just a little more the donor becomes ragged or moth-eaten and is obviously very noticeably thinner/gapped when grown out. When you factor in the potential for white dots and that eliminates shaving down to a #2--forcing patients to maintain a higher buzz cut, then the actual benefit of fue is retarded.

 

I have actually seen this happen--it is not pretty and presents a real challenge to repair because we have try and thin the donor to match because a noticeable difference exists from the back of the head and the sides.

 

Again, FUE is tremendous and offers an excellent opportunity to approach baldness--but it has limitations and is not a "cure-all" ---if anything a patient wishing to attempt restoration wholly via FUE must be planned out well in advance and likely in increments that are smaller than our normal strip sessions.

 

Like anything else, seeking to move quickly or over-exaggerating the benefits of a procedure result in higher risk and potential greater harm to the patient--something that must be avoided at all costs.

 

Sorry for the long answer..I hope this is what you were looking for.

 

Take Care,

Jason

[TC17]

B,

 

That makes sense, thank you for the detailed response. Just to clarify though, the average person who has maxed out his strip still has an additional 1,000 to 2,000 available via FUE to harvest, right? And if that is true, then the average person has between 7,000 and 8,000 follicular units available for transplantation?

[the B spot]

Originally posted by TC17:

B,

 

That makes sense, thank you for the detailed response. Just to clarify though, the average person who has maxed out his strip still has an additional 1,000 to 2,000 available via FUE to harvest, right? And if that is true, then the average person has between 7,000 and 8,000 follicular units available for transplantation?

 

I would say the average person who has removed his allotment of strip tissue, regardless of the amount of grafts obtained, should generally have roughly 1-2K of grafts available via FUE simply due to the fact that there will still be a "donor region" untouched to extract from.

 

(ie. a patient is stripped out at 7107 grafts, but still has a donor region that looks the same as before the strip surgery, minus strip tissue, this donor region can be harvested from to yield additional grafts)--this patient would have yielded average strip graft numbers, BUT, by expanding the donor region through FUE may gain another 1000-2000 grafts possibly raising his total to 9000 grafts--where in years past, he would have been through after his last strip session.

 

Whether or not a clinic should extract them is another matter and specific to each patient.

 

Take Care,

Jason

[imissthebarber]

Jason thanks for the detailed post. I'm sure this is a question a lot of people having been wondering about and often the response is it depends on the patients characteristics. I understand that, but it is useful to get a ball park figure.

[imissthebarber]

from what ive read the average is more around 8,000 from strip

 

The multimedia presentation on this site says 4500-7500 if I remember correctly (?) as a safe number for strip. 10,000 is very unusual.