Do mega session doctors sometimes split grafts?

[olmert]

I had a consult with one doctor. He told me that anyone who claims to have done 7,000 grafts in one session is splitting grafts. He said you can't legitimately get even close to 7,000 grafts.

 

He said splitting a graft gives you no extra donor hair and sometimes actually damages donor hair.

 

Is this true? Do doctors sometimes split grafts for the sole purpose of claiming to have given you a bigger mega session?

[aaron1234]

You're opening a can of worms!

 

A few years back some posters were accusing H&W of splitting grafts. Of course, they had no evidence. But H&W didn't do themselves any favors by not releasing the hair count numbers.

 

Sometimes grafts are split if a patient needs more singles in the hairline.

 

But it just sounds like the doc is little envious of clinics that specialize in mega-sessions. Not many clinics have the staff or technical skill necessary to pull off strip sessions of more than 2,500 grafts.

[olmert]

Aaron, why did Dr. Shapiro do two separate sessions on you, instead of a mega session?

 

Personally for me I don't mind the hassle of having two sessions, but I would mind a bigger scar, if the scar was visible. Is there any other disadvantage to two sessions besides scar, hassle, and cost?

 

How much worse is the scar for having two sessions instead of one?

 

Might it be good to have the second procedure FUE so that the scar is not worsened?

[aaron1234]

Well, I was somewhat of a repair patient with already one scar (which was taken too high) and that complicated the situation a bit. Dr. Paul thought 2K grafts would be enough to turn things around and he was right at the time. I just a got a little hair greed (and probably some more loss) and so I went in again for more.

 

How you scar really depends on your physiology and how you heal. I have three separate scars now (two built on top of each other) and I'll have to go in for a scar repair eventually. Scars have the potential to stretch with each procedure.

 

Might it be good to have the second procedure FUE so that the scar is not worsened?

 

It all depends on your situation and what you want. Orlhair is doing just that in a few weeks.

 

With hair transplantation you just have to take it one procedure at a time. You never know how it's going to turn out and the same holds true for the scar.

[bonkerstonker]

What aarron said is 100% correct. Sounds like your doctor is jealous the reason hw can do such big operations is they have a lot of skilled staff and I'd imagine it's the same for rahal. Both clinics release actual hairs per graft so it can't be said with any decent claim that they cut grafts. My first op with hw was 5300 grafts and they actually doubled some of my single grafts into one slit which is the opposite to splitting grafts.

[michaeljames]

I had a consult with one doctor. He told me that anyone who claims to have done 7,000 grafts in one session is splitting grafts. He said you can't legitimately get even close to 7,000 grafts.

 

He said splitting a graft gives you no extra donor hair and sometimes actually damages donor hair.

 

Is this true? Do doctors sometimes split grafts for the sole purpose of claiming to have given you a bigger mega session?

 

Hey Mate;

 

I don't think it is appropriate to comment on what a physician may or may not do without fact. however I do agree that 7000 grafts in one session would be an overwhelming feat and a great demand on the patient and the medical team performing the procedure. Here's the bottom line with the great efforts of the folks at HTN, you can seek the advice of the competent and excellent surgeons who have proven themselves and like Dr. Mohebi are recommended by the HTN network. I don't want to express an opinion on a claim with so little information and not being completely aware of the facts, but the number is inconsistent with procedure and experiences in our centers.

 

 

"I am the patient advocate for Dr. Parsa Mohebi, who is recommended on the Hair Transplant Network. I am not a hair restoration physician. My comments are only for intellectual consideration and in no manner to be construed or accepted as medical advice. It is important to seek the advice of a physician in all medical circumstances including hair restoration, dietary or others directly or indirectly related to the subjects in this forum."

[olmert]

Michaeljames, what do you make of Hasson and Wong's representations that they have done 9,000 grafts, and that investment, training, and skill on their part allowed this?

[Bill - Seemiller]

All surgeons occasionally "split" grafts, at least a few in order to acquire enough single haired follicular units to re-create the hairline.

 

In my opinion, 7000 graft procedures without splitting grafts is possible however, the patient must have exceptional donor hair characteristics (density and laxity) and the surgeon must be willing and have the ability to harvest a long and wide enough strip to acquire that many follicular units.

 

Most patients however, will not have the donor characteristics for such a dramatic procedure.

 

Best wishes,

 

Bill

[Janna]

He said splitting a graft gives you no extra donor hair and sometimes actually damages donor hair.

 

 

It is absolutely true that splitting grafts doesn't give you extra donor hairs. However, there are instances when it's a necessary risk to achieve enough single hairs for the hairline and temple points. For example, if a small hairline case of 1000 grafts is performed and we only cut 150 single hair grafts, some of the 3 &4 hair grafts will have to be split to achieve approximately 400-500 single hairs.

 

Generally, our graft percentage breakdown is as follows:

 

1 hair grafts - 15%

2 hair grafts - 51%

3 hair grafts - 29%

4 hair grafts - 6%

 

Depending on ethnicity, the standard distribution will vary but those are the averages.

 

Is this true? Do doctors sometimes split grafts for the sole purpose of claiming to have given you a bigger mega session?

 

I don't think this happens very often as the final result will determine the success or failure of the mega session. For example, did the patient get the look of the said number of grafts?

[Jotronic]

Olmert,

 

The doctor that told you this either has his head in the sand and is completely oblivious to how the industry keeps moving forward. We've been beat up left and right for going on ten years now about if, how, why we are able to get bigger sessions. It never ends and I can see now that after so many years it will only continue as long as there are people/doctors that will only do just enough to get by.

 

These bigger sessions have been going on for quite a while. Back in 2004, eight year ago, about 600 doctors came to Vancouver for the ISHRS Conference. We had 25 patients that we brought in to challenge the critics that even back then were saying that 4000 to 5000 grafts in one session were not possible. Hundreds of doctors came through and looked up close and poked through all of the patients heads. Dr. Richard Shiel said the following in the ISHRS publication after the meeting...

 

The indeligible image I will take away from this meeting is that of the patients of Drs. Victor Hasson and Jerry Wong. These were demonstrated at the Live Patient Viewing on Friday afternoon.

 

To say that these results were "mind-blowing" would be an understatement. Please picture a young man with over 5000 FUs harvested and planted in A SINGLE SESSION and growing with close to 100% perfection. Not only growing, but planted at up to 80 grafts per square centimeter and giving the appearance of completely normal hair direction and density with no "crinkle" whatsoever and a donor scar of 1-2mm.

 

The rest of us will be a long time catching up with the skills of Jerry and Victor and their wonderful staff of assistants.

 

 

The secret to getting 7000 grafts is to find the right patient and to take a big strip. Then the secret is to know how to do this without creating a big scar and low growth. We pioneered how to do this and still do it more than anyone. Just before seeing this thread I posted yet another 7000 graft case. Here are some of the pics....

 

 

 

 

The above patient's donor strip was 30cm x 2.5cm - 3.0cm. At 7046 grafts that means he had a donor density of about 85 per cm2 which is not considered to be super high.

 

Or how about this patient? He had 8402 grafts in one session.

 

 

 

 

His donor strip was 35cm long and between 2cm and 3cm wide. When you have this size strip with donor density of between 85 and 95 per cm2 then the math adds up. If you are wondering how the scar turned out then look at this HD video and fast forward to the 6:22 mark. When you get there tell me where you see the scar.

 

 

 

So Olmert, you should ask your doctor why he doesn't take bigger strips, hire more techs, buy more microscopes etc. and learn how to do the same thing. If he still insists that we are turning fewer grafts into more grafts have him show you NW5 and NW6 patients like those above transformed even remotely in the same manner as these two patients were in one surgery. He won't because he can't.

[aaron1234]

I don't care if every single one of those 7,000 grafts were split (and of course they weren't), the results speak for themselves. I still think the patient with 8,400 grafts above is the best one session job I've ever seen.

 

And what's amazing about the patient with the 7K grafts is that his hair is shorter in the after pics and you still can't see the scar.

Edited May 30, 2012 by aaron1234

[HARIRI]

Splitting grafts is very delicate thing that should be done ONLY in top clinics. In my case I went to an unknown doctor who may extracted my grafts in the right way but asked his technicians to split all of my extracted grafts into singles which ended up to 2000 hairs I guess which he mentioned on my bill at the end 2000 grafts. So with poor handling of the grafts, they turned out to be frizzy and kinky. Thus Im not really a big fan of splitting grafts.

 

The confusion is, do these clinics charge you per how many grafts extracted from the strip? OR by how many grafts were implanted into your scalp after splitting them? If its the second answer then it would a huge income for HT clinics.

[Janna]

Hariri,

 

I think as long as the clinics and patients are aware of why grafts are split and that it's a necessity then it's justifiable to charge accordingly to the final prepared graft count. However, if you split grafts unnecessarily just to pump up the graft count, then obviously the patient is overcharged.

 

How can you tell if grafts have been split? Know the average graft breakdown percentages according to your ethnicity and ask for your own graft breakdown. If the total for the 3 & 4 hair grafts combined are less than the total of 1 hair grafts, it's likely that many of the 3's & 4's grafts were split. Again in such cases, if the clinic and patient felt they wanted more coverage rather than density and opted to split the grafts then I feel it's appropriate to charge according to the final graft count as it took time to prepare the grafts.