How do you know you are being told the truth regarding the number of grafts you get

[albundy]

I have always wondered, How do you know the number of grafts they are telling you that they have transferred are the true correct number? You just have to trust your DR?

 

 

I specially became suspicious, since I just recently went for two different consults same day (it was with the Doctors themselves in their office), one of the surgeons said that he could probably get 3000-4000 graft from my donor area (I already had a surgery using 4200 a year ago), the second one said, I don't see it being possible to get more than 2000 grafts, and that was the maximum. He said it was impossible mathematically to reach anywhere close to 3000-4000.

[England]

Firstly, it's absolutely essential going into your op that you trust your doctor. If you don't trust him to give you accurate numbers - you shouldn't go into surgery with him

 

That being said, Dr Feriduni showed me all of my grafts in petri dishes once they had been extracted. He also took photographs so he and his team could later go through the images and count the 1's, 2's and 3's.

[s2thoudriver]

I agree with England, you should be able to see the grafts separated into the different trays of single, double and triple hair follicles.

 

Good suggestion about taking the photos of the trays, i never thought to do that!! :rolleyes:

[Spanker]

While I never saw my grafts, I trusted my doctor. If you don't trust him enough to give you an accurate count, run away.

[Dr. Carlos Wesley]

Great topic. As a patient, it's also important to know what to look for when viewing your very own follicular grafts. There's a big difference between "healthy" versus "denuded grafts". Ideally, each graft should possess a healthy amount of subcutaneous and dermal tissue that protects the stem cell-containing portions of the follicle: the bulb and bulge, respectively (as seen on the right side of the first image as well as the second image). Denuded grafts do not have that tissue and are more susceptible to dehydration and traumatic handling (both of these hazards decrease hair survival when transplanted).

 

Another way to be gain more confidence in the actual number of grafts may be to be charged a flat fee rather than being charged by the graft. This way, there is really no incentive to "fudge" on the numbers or to take a naturally-occuring 3 or 4-hair graft and split it into 3 or 4 single-haired grafts (that, as a result, do not possess much protective tissue around them).

 

Finally, in addition to being able to see the grafts, as a patient, you should also be free to view the physician as he/she is making the recipient sites. This is really where the artistry comes into play and the time and attention the physician is taking to follow the exact angle and direction of the pre-existing hair is critical for natural-appearing results.

[gillenator]

Yes, determing the count graft count is important and the techs should be charting the numbers in your medical file as they are being dissected and arranged in the petri dishes by graft size.It is also important for the patient's chart to show the breakdown and exactly where the grafts were placed. Quality photos can be taken after the grafts are fully placed, and then downloaded to your file.

 

And I totally agree with Dr. Wesley's comments regarding competent dissection and preparation of the grafts. If too much of the surrounding protective tissue is cut from the grafts, transection can occur and will affect the overall yield. You want to make sure that your donor strip is being dissected under a microscope, not a magnifying lense.

 

Although the industry charges by the graft, the patient is paying for the result. Whenever in for the consultation, ask the doctor if you can look where the grafts are dissected and ask questions about who and how your grafts are prepared. In other words, ask for a tour of the OR rooms (providing they are not being used )and ask to be walked through who does what when. Some clinics are very accomodating to take you on a walk through tour, some are not. It does not hurt to ask. There may even be a procedure going on whereby you may have the opportunity to watch grafts being cut and prepared by the tech team.

 

If you discover that the clinic does not microscopically dissect the grafts, run for your life!

[TommyLucchese]

I completely trusted my doctor and his team to the point where I didn't even think to ask the final total count of grafts til a few days after I'd been back in the UK after flying to the US for surgery. I don't think it's wise to have a doctor that you don't trust with these things.

[gillenator]

You can also ask the surgical team to provide a breakdown of the total graft count after surgery. Simply inform them that you are keeping a life log of all of your HT procedures and that you want to keep a log on how many singles, doubles, etc were placed. You simply need this info as you plan into the future.

 

Reputable clinics are happy to provide you with this.

[Dr. William Lindsey]

First of all, make sure you have some element of trust with whoever you choose.

 

Second, you ought to be able to see examples of his/her work with cases of similar sizes. Meaning, if you need 2500, ask to see a few examples of 2500 graft cases YOUR doctor has done. You'll see that he covers more scalp if its thick wirey hair, and less with thin hair...but you'll see the range. Then figure which kind of hair you have...ask him, don't guess that you have perfect hair when it might be on the thin side. And you should have a good idea of what will be done and how much it will take to do that job.

 

Third, I suspect alot of doctors do what we do which is at the end of the day, I show you your pictures and tell you exactly how many 1s 2s and 3s you received based upon the cutter sheets that each cutter did. Now I suppose anyone can fudge those sheets, but paragraphs 1 and 2 ought to keep you from having to worry too much about that.

 

If you can't find similar examples that your potential doctor has done himself, I'd probably do a bit more research on doctors before you commit.

 

Good luck to you.

 

Dr. Lindsey McLean VA

[mattj]

To address the issue of the differing graft estimates you receive: this could be down to the confidence and/or the ability of each doctor. Remember, there are still many doctors who don't go any higher than around 3000 grafts in one procedure, regardless of the number the patient's donor can provide and how many they need to achieve a good result.

 

Chances are, the discrepancy in the recommendations you received has more to do with that than one of them scheming to charge you for more grafts than you'd be getting.

 

Of course it's completely possible that the one who quoted the lower figure is right. Another thing to watch out for is that some clinics charge by the hair rather than the follicular unit. This can make their quotes seem greater than they are.