Golden Rules for hair Transplant

[sydneybaldman]

Hi All, as a fellow who has now just had his 2nd transplant (1st one didnt turn out so well, but more on that later) I have compiled a list below of the Golden Rules every guy should follow when going for a hair transplant. This is based on the fair few number of consults Ive been through aswell as the 2 hair transplants Ive had. Feel free to comment and/or add to this list....

 

1. When going to a clinic for a consult, always have a consultation with the surgeon who will be doing your hair transplant ! The first clinic I went to for my first hair transplant used a sales consultant and that was a big mistake. But hey I was niave and now Im wiser so please new guys, DONT use these clinics who use sales consultants, the recent clinic I went to for my just completed hair transplant was consulted by the surgoen who did my hair transplant.

 

2. Don't let the clinic tell you how many grafts you need ! Always do your own research before hand and discuss with the surgeon the amount you were looking for. The reason I say this is simply, all clinics are there to make money and the more grafts you "need" the more it costs and hence the more money the clinic makes. I've seen a few guys on here who have had 2000+ grafts implanted and based on my own 2 hair transplants...there is no way these guys actually needed 2000 grafts.

 

3. If a clinic (surgeon) tells you that they can implant more than 40 grafts per cm2, they are lying !! Look it up, how can anyone implant more than that in each square cm. Look at your own results and can you really see more than 40 grafts in each sqaure cm ? Of course not....In my recent hair transplant the surgeon advised me and implanted about 35 grafts per sqaure cm (which gives about 70 hairs per square cm). This gives a decent coverage without compermising the yield etc. The average pre-balding guy has about 60-70 grafts per sqaure cm and thats gives a thick coverage which hair transplant can NEVER do..! Think about it, if you implant say 60 grafts per square cm, that would be too much trauma for the skin, therefore produce less yield etc. If any guy on here says they have received more than 40 grafts per sqaure cm, PLEASE prove it via close up high quality pics taken post op..!!

 

4. No need for sedation ! Trust me, you want to be able to be fully aware of what is happening during your procedure and when you are sedated, you arent !

 

5. Only allow the sugeon to do the implatation ! Alot of clinics have "technicians " who do most of the implanting and all I can say is, what the hell are you paying $1000's of dollars for if some low skilled, low paid "technician" is doing most of the implanting ? Yes some people on here and some clinics claim that their "technicians" are highly experienced etc, but can they prove that ? How many of you guys were told how much "experience" the "technicians" who did your implantation had ? The recent hair transplant I had was done 100% by the surgeon.....my firslt hair transplant was done mostly by technicians. Only the front hairline was done the surgoen (which turned out well) but the rest by the technicians with poor results. So in other words..the areas where the surgoen implanted turned out good growth but the ares where the technicians implanted turned out poor growth ! Is that just a coindidence ?

 

6. Use saline solution to spray for the first few days ! If a clinic tells you that its not required ....its all lies. Trust me, using Saline solution for the receiptant area is needed big time to help keep the grafts moist and help speed up recovery. My first hair transplant, they didnt provide me with any saline solution, and i didnt heal well...the 2nd hair transplant, they gave me Saline solution in a take home pack and told me to use it every 1/2 ghour for the first few days.....

 

All I can say is that based on my 2 hair transplants, my 2nd one was a much better experience to date and all this is based on the 6 golden rules I listed above. There are actually alot of other things that made my 2nd experience better ( such as the surgeon cared ALOT about me and not about just getting me out the door and also they showed me my grafts after they were extracted etc) feel free guys to add or comment to this list........

[RodG]

Hi,

 

Most of what you said is correct but I don't agree with your rule regarding technicians not planting grafts. The general accepted procedure is for the surgeon to create the recipient site and the technician places the graft. The surgeon does the hairline, removes the donor strip and sutures it up.

 

My doctor placed 50% of the grafts. Its my understanding that fatigue can be a problem if the surgeon does the whole procedure. Check out of some of the really good doctors on this forum and see how they perform their procedures.

 

Btw I see your from Australia and I'm curious to know who did your hair transplant?

 

Cheers Rod

[moopookoo]

Valid points by OP

ARE there any recommended clinics where doc does everything from start to finish?

 

cld somebody give us names pls

[Buzz2]

I went to Dr Saifi in Poland. He does a lot of work himself. He done the injections, strip removal , incisions and about 50% of the graft placement. He had another tech helping him

 

However , I only had 1680 grafts and I know from other members on here who had more grafts with Dr Saifi, in this case he had 2 or 3 techs helping.

 

As Rod says fatigue can take place , so its a good idea to have constant breaks which is whay my doc did, but he was always in total control and didnt wonder off like i hear a lot of docs do. (not the ones recommended on here though)

 

I think it would be pretty impossible for the docs to do everything , if you include the splitting of the grafts. If you dont include this then I still find unusual but doable if there are a small number of gtafts needed.

[bonkerstonker]

Just research a good clinic and you don't need to know any of them rules. Simple!

 

I'm glad you learnt your lesson and found a good surgeon second time round so i can understand why you would believe them rules are so important when you've had completely different experiences.

 

I strongly don't agree with the surgeon doing all the implanting when he will be tired from huge operations all the time it's best to have skilled women who specialise in inserting grafts day in day out and can swap for breaks, i don't agree with saline solution there's a lot of top successful clinics that believe in dry healing and believe you have much more chance of a infection with wet healing, there's some class consultants out there i did all communicating questioning with my consultant i never seen or spoke to the surgeon until the op day the offer was there if i wanted it but i had no wish to see him before and a good clinic will know exactly what density you will need and how many grafts.

Edited May 6, 2012 by bonkerstonker

[Dutch]

If its a significant amount of grafts being inserted, a surgeon needs help from techs. Fatigue kicks in if a surgeon spends all day in the operation room doing everything

[Cant decide]

Clinics are able to pack far more than 40 grafts per sq cm in many cases. Otherwise, many of us are being hussled by top clinics every day and I highly doubt it.

[mattj]

I think I'd go as far as to say that it's impossible for the doctor to do everything, including the placement of the grafts, if the procedure is anything but a very small one.

[bonkerstonker]

Can't decide remember that the average none bald man has about 80 HAIRS per square cm so 40 GRAFTS per cm would be about 70 ish hairs making 40 grafts good for density but I agree surgeons can do a bit more than 40 grafts and it is possible. I'm sure Matt will know a definite answer to that.

Edited May 6, 2012 by bonkerstonker

[orlhair1]

Just research a good clinic and you don't need to know any of them rules. Simple!

 

I'm glad you learnt your lesson and found a good surgeon second time round so i can understand why you would believe them rules are so important when you've had completely different experiences.

 

I strongly don't agree with the surgeon doing all the implanting when he will be tired from huge operations all the time it's best to have skilled women who specialise in inserting grafts day in day out and can swap for breaks, i don't agree with saline solution there's a lot of top successful clinics that believe in dry healing and believe you have much more chance of a infection with wet healing, there's some class consultants out there i did all communicating questioning with my consultant i never seen or spoke to the surgeon until the op day the offer was there if i wanted it but i had no wish to see him before and a good clinic will know exactly what density you will need and how many grafts.

 

Agree......the top clinics in the world use this process. You are right Bonkers.....the real key is research and going to one of the top clinics.

[Cant decide]

Bonker - I think you mean the ave non balding man has 80 grafts per sq cm and not hairs. Average hairs would be 160 per sq cm. I was packed at 59 on the hairline, 55 behind that and so on. If what is being said above is true, then Dr. Rahal actually packed no more than 40 and my yield was 60% or less and I know for a fact, that that is not the case as my yield was quite high.

 

As an overall average, 40 per sq cm makes sense but most docs pack at least the hairline at above 40 in many many cases.

[bonkerstonker]

Suppose average is wrong word but I have about 80 hairs per square centimetre given to me by god but I do have curly coarse hair maybe others have 130 or whatever we're all different pal. I wonder what the average actually is do you know what you are naturally without hairloss?

[Cant decide]

Bonker - I would estimate that my non balding areas are at about 200 hairs. I know my donor density is above average in terms of hairs per graft and grafts per sq cm. I heard that ave grafts per sq cm is 80 in the donor so I am thinking that I am at 100. My hairs per graft are 2.3 but rounding down, I come up with 200.

[England]

Agree with 1 very much - important to consult with your actual surgeon.

 

Not sure on 2 - before going into my recent 2nd operation I thought I needed about 1,000 to thicken up the hairline. Once I consulted with multiple surgeons and they all said I needed 2,400 grafts (pretty much bang on) that was all the confirmation I needed that that was the correct amount. I realised during the process that my recession had carried on more than I realised. Surgeons are far more experienced and knowledgeable so to second guess their recommendation is a risky game. Any ethical surgeon will not overstate the amount of grafts you need, but if concerned just have a consultation with multiple surgeons and compare what they say. Since all top surgeons are booked up well in advance they gain nothing by telling you you need more grafts than you do. If you have fewer grafts, they can fit in another surgery around you on the same day, or a larger one than they otherwise could have. They are also judged on their results and with the proliferation of online forums it's very important that they get the approach right.

 

Not sure on 3 either - I've seen cases of dense packing from the very best surgeons of up to 60 grafts per cm2, with great results. 35 grafts per sq cm doesn't give you 70 hairs in the hairline, because for a hairline to achieve a natural result the hairline should consist of single hair grafts. This is why a typical dense packing approach is say 60 single hair grafts per sq cm in the hairline, perhaps 40 doubles going back per sq cm and maybe 30 triples per sq cm at the back. This gives you 60, 80 and 90 hairs per sq cm respectively and gives a very natural result. Average native hair ranges between 60 to 110 grafts so even 60 grafts per sq cm is still lower than native, despite being labelled 'dense packing'. I've seen many great results from it. I myself had over 2,500 grafts spread over an area of just over 50 sq cm so my average was around 50 grafts per cm2. Dr Feriduni even showed me, using a blade and a piece of paper, how easy it is to cut ~50 incisions into a sq cm (7 x 7). There was plenty of room to spare and the paper held up fine.

 

On 4, I guess there are different levels of sedation. I agree there's no need to be knocked out before the op but a little sedative helps ease the pain of the injections whilst keeping you fully aware of what's going on.

 

On 5 - if the surgeon was solely responsible for the implantation you would end up with a number of undesirable side-effects. Firstly, fatigue as others have mentioned, which could mean sloppy work. Secondly, the grafts would be out of the scalp for longer which would risk losing more of them, so yield could be lower. Thirdly, the technicians in many cases are every bit as skilled as the doctor at the top clinics when it comes to placing the grafts into the pre-made incisions. Because it's all they do, it becomes their speciality. There is little danger of the techs making a mess of this stage because if the incisions have been made correctly there is only one way the grafts can be placed inside them. Another consequence of the doctor managing the whole process would be increased cost because obviously a doctors time costs more than a technicians, and similar amounts of man hours would be required. Again, I think there are many top top clinics which often speak about the whole team of doctor and technicians being important, not just the doctor.

 

On 6 - each doctor gives you their own post-op instructions with their own sprays, etc. The vast majority give you vitamin sprays or other healing-agents which should be used post-op, and their results speak for themselves. I don't think it must necessarily be saline solution, they all seem to have found their own working formulae.

 

Thanks for sharing your experience and opinions though! :-)

Edited May 7, 2012 by England

[England]

Just whipped up a quick and to-scale example of 49 incisions per sq cm.

 

This assumes a flat edged 0.9mm blade (which I believe is quite common, blade sizes can be as small as 0.6 or 0.7mm especially for single hair grafts).

 

1 pixel = 0.1 mm

 

As you can see there is loads of space inbetween the incisions.

Edited May 7, 2012 by England

[Buzz2]

Hi

 

I might be a bit thick here, but the above scale looks like a square inch to me. A square cm would be a lot less, therefore less space between each incision. ??

[bonkerstonker]

Just whipped up a quick and to-scale example of 49 incisions per sq cm.

 

This assumes a flat edged 0.9mm blade (which I believe is quite common, blade sizes can be as small as 0.6 or 0.7mm especially for single hair grafts).

 

1 pixel = 0.1 mm

 

As you can see there is loads of space inbetween the incisions.

 

 

Very clever that nice work.

 

Buzz it looks to me like he's blown it all up but kept it to scale.

Edited May 7, 2012 by bonkerstonker

[England]

Hi Buzz,

 

It's to scale, in that 1 pixel is 0.1mm, but it's not 'Actual Size' because the size you see depends on how large your screen is - for example on a phone it will appear smaller than on say a TV being used as a monitor.

 

If you zoom in or out on your browser so that the box is 1 cm sq on your screen then you will get a true indication. You can do this by pressing control and - . You can then use control and 0 to reset your screen zoom. The reason why this is OK is because if you see the box bigger, the incisions also appear larger (in the same ratio) - so whichever size you are using you can see how much gap there is inbetween. The surgeon will typically have many times of magnification - you can also simulate this by zooming in.

 

Thanks Bonker :-)

Edited May 7, 2012 by England

[Buzz2]

Sorry, to many vino's on a Sunday afternoon and not reading the post fully.

[Dr. William Lindsey]

Here are a few golden rules. They are free so take them for what they are worth.

 

1. Research as much as you can before you make a decision.

 

2. Be realistic

 

3. Avoid the 3 mistakes: A-hairline too low and won't look good as you age, B-big donor scar, and C- too little hair sprinkled over too much bald head.

 

4. Research as much as you can before you make a decision.

 

Dr. Lindsey McLean VA

[bonkerstonker]

What do you mean by big donor scar? Length or width. Or are you saying don't have a big operation that will give you a big scar?

[Dr. William Lindsey]

I'd pick someone who has a decent track record for scars. Some clinics really don't seem to care what the donor area looks like and that may be ok for some patients, but it really doesn't take a lot of extra work to at least attempt a nice trichophytic closure...so I'd suggest going to a clinic that puts effort into the donor and recipient areas.

 

A related issue though is that if you try to excise too wide of a strip in order to get more hair, sometimes even the best of closure attempts will still result in a bad scar, simply due to wound tension.

 

I hope that helps clear the issue.

 

Thanks

 

Dr. Lindsey McLean VA

[bonkerstonker]

I see what you mean now thanks.