New to the forum with questions.......

[RG]

Hello all........first, thank you to all the contributors on this forum. I've lurked and educated myself for the past year gathering information. I've developed a good "working knowledge" of transplant types, surgeons, results, costs and numerous additional issues due to the contributions here. So again...thanks. With that being said, I'd like to give a little background to my situation and solicit some feedback/opinions on a few specific questions.

 

I'm an advanced Norwood V to VI. Had a small transplant done 18 years ago at the age of 24. Miserable result and soon began wearing a "hair system" from a national company. I still wear a system to this day and absolutely hate it. So, I'm evaluating my options. My issue is transitioning from the system to a hair transplant result. I'm ok with an age appropriate and/or thin look. One challenge is that I have virtually nothing on top now all the way back to and through my crown area. So....my goal is to have as large of a session as I can and then evaluate my situation. I'll have to find a way to transition from the system to the no system look at some point, but I'll figure that out. My current donor is average with good texture and a little graying.

 

I've had online consultations with some of the best-H&W, Shapiro, Rahal and and in person consultation with Konior (who was absolutely top notch and I really liked). So, here are my questions:

 

1. I'm receiving a little bit of a mixed message on what can be accomplished in a mega session. Is the harvest area generally the same for each doctor? Can doctor "A" harvest more "grafts" than doctor "B" if the goal of both is a maximum harvest? Or are all doctors working from the same basic limitations? H&W typically get more grafts, but do they split some of the multiple hair grafts into smaller sizes and just call it more grafts? Or are they truly able to harvest more grafts and more hairs.

 

2. Two (2) of the consultations I had said they could harvest and plant 4500 grafts or so in a single session. Another thought the realistic expectation was around 3,000.......but I'm concluding the total hairs amongst all options would be roughly the same as they've all stated they won't waste any hairs. And the cost for all proposals was almost identical for a maximum harvest. It really doesn't make any difference to me whether it's 3k or 4500 if the end result of hairs is the same. So.......my question is.....assuming laxity is the same between all surgeons, what differentiates who can get the most hairs from a strip to the recipient area?

 

3. For a number of reasons, I'm probably going to need to wear a system some of the time while my grafts grow and mature. I have a plan to minimize it to make sure my scalp and growing region remain healthy. When I do remove it for good, I'd like to be able to cut my hair pretty short (3 or 4 in the back). I may try to conceal some of the scarring with SMP. How long after an FUT procedure can you have an SMP procedure performed? I know H&W and Shapiro will be offering this solution shortly, but I haven't asked the question yet. Also, does anyone know when the pricing for SMP will be available at H&W and Shapiro?

 

Thanks in advance and I look forward to contributions/advice the next couple of months as I'm looking to have my procedure done late spring or early summer.

[Blake Bloxham]

Hi RG,

 

Let me see what I can do to help:

 

1. Your available number of donor grafts and the ability to extract an appropriate sized strip is probably fairly standardized amongst top hair transplant surgeons. If a surgeon wasn't highly experienced with mega sessions or didn't have a large enough highly trained team, there could definitely be some variance. However, among the physicians who perform large FUT sessions on a regular basis, the overall number of possible grafts extracted is probably fairly standard. Additionally, if you'd like to maximize your yield in one session, you may want to research which clinics have the most experience with very large FUT cases.

 

2. I don't think the number of hairs would be the same with 3,000 versus 4,500 grafts. Follicular unit grafts should be trimmed the same, and wasting 1,500 grafts during a 4,500 graft case would not be standard or acceptable practice. If one clinic said 3,000 would be the max, it's likely that this is what they are comfortable doing in one session. However, it won't provide the same number of hairs as a 4,500 graft case.

 

3. You'll have to get the "ok" for the system transition from your individual clinic. I'm sure they've dealt with this in the past, so they will likely have some established protocol to follow. As far as SMP in the scar is concerned, I think I've heard some estimates on the boards before, but I don't recall if they were for the donor region (versus the recipient region). A clinic may actually want to wait until the scar is fully healed before performing any other work in the region (including SMP).

 

I hope this helps!

[TommyLucchese]

Good news is you've definitely consulted with the elite!

 

If your level of loss is massive then H&W would be great due to their track record with the 'megasessions'

[RG]

Thanks for the answers above. It appears as I read the surgery summaries, most sessions count the 1 hair, 2 hair, 3 hair, 4 hair grafts....etc. What prevents a clinic, doctor from taking a single 4 hair graft and splitting it into 2 grafts......and then calling it 2 grafts instead of a single 4 hair graft. Or taking a 2 hair graft and splitting it into 2 single hair grafts? Obviously the goal for a NW5+ like me is to capture as much coverage with a first session as I can. Just trying to figure out if (amongst the elite clinics and surgeons) a certain doctor/clinic can harvest more grafts/hairs than a counterpart and why/how they do that.

[TommyLucchese]

Can't help you there, that's way above my head with technicalities!

[JustOne]

some doctors feel more confident in there ability with wound closure . .. so those experienced doctors can get more grafts in one session . H&W seem to be very confident with their ability to preform mega sessions with leaving minimal scarring . .. welcome to the forum !

[JustOne]

i also forgot to mention your scalp laxity . that plays a huge part on how many grafts a surgeon can harvest as well! happy new year

[StaggerLee123]

Thanks for the answers above. It appears as I read the surgery summaries, most sessions count the 1 hair, 2 hair, 3 hair, 4 hair grafts....etc. What prevents a clinic, doctor from taking a single 4 hair graft and splitting it into 2 grafts......and then calling it 2 grafts instead of a single 4 hair graft. Or taking a 2 hair graft and splitting it into 2 single hair grafts? Obviously the goal for a NW5+ like me is to capture as much coverage with a first session as I can. Just trying to figure out if (amongst the elite clinics and surgeons) a certain doctor/clinic can harvest more grafts/hairs than a counterpart and why/how they do that.

 

Graft splitting does happen at reputable clinics only when there are not enough single hair grafts for the hairline. This is perfectly acceptable as one would not want multiple hair grafts in the hairline because it looks unnatural. Now I am sure there are some clinics that do split grafts in other situations to bump graft count. This is precisely why you want to go with top shelf clinics who are ethical and honest.

[MrJobi]

Hi

 

Different doctors have different approaches: some are more agressive (i.e. they will do 6-8k grafts in a single session) while others might suggest less (4k-6k in a single). One thing I have learned both in life and in HT's is you can get to A to C many different ways. My approach was gradual due to my circumstance and I will stack my results with anyone in the world. The most important is to select a doctor YOU are comfortable with regard to bedside manner and approach! Keep in mind there are several other factors which will dictate your situation

 

- amount of baldness you currently have( norwood)

- donor hair available, scalp laxity and hair type

- your budget and time frame

- how you want to deal with post op and "hiding" the surgery

- future hairloss (i.e are you on meds?)

- what your goals are ( i.e. do you want coverage or lots of hair)

 

In your case, if you are wearing a significant hair system, chances are you will not get the same amount of "hair" from a HT (or several) as your system. It is important you have realistic expectations . Unless you have 20K to drop on an super FUE megasession (with ideal circumstance above) you are most likely in for a gradual yearly process of getting back your hair.

 

Develop a strategy with your surgeon considering the above and you are on your way!!!

[Postdoc]

Hello all........first, thank you to all the contributors on this forum. I've lurked and educated myself for the past year gathering information. I've developed a good "working knowledge" of transplant types, surgeons, results, costs and numerous additional issues due to the contributions here. So again...thanks. With that being said, I'd like to give a little background to my situation and solicit some feedback/opinions on a few specific questions.

 

I'm an advanced Norwood V to VI. Had a small transplant done 18 years ago at the age of 24. Miserable result and soon began wearing a "hair system" from a national company. I still wear a system to this day and absolutely hate it. So, I'm evaluating my options. My issue is transitioning from the system to a hair transplant result. I'm ok with an age appropriate and/or thin look. One challenge is that I have virtually nothing on top now all the way back to and through my crown area. So....my goal is to have as large of a session as I can and then evaluate my situation. I'll have to find a way to transition from the system to the no system look at some point, but I'll figure that out. My current donor is average with good texture and a little graying.

 

I've had online consultations with some of the best-H&W, Shapiro, Rahal and and in person consultation with Konior (who was absolutely top notch and I really liked). So, here are my questions:

 

1. I'm receiving a little bit of a mixed message on what can be accomplished in a mega session. Is the harvest area generally the same for each doctor? Can doctor "A" harvest more "grafts" than doctor "B" if the goal of both is a maximum harvest? Or are all doctors working from the same basic limitations? H&W typically get more grafts, but do they split some of the multiple hair grafts into smaller sizes and just call it more grafts? Or are they truly able to harvest more grafts and more hairs.

 

2. Two (2) of the consultations I had said they could harvest and plant 4500 grafts or so in a single session. Another thought the realistic expectation was around 3,000.......but I'm concluding the total hairs amongst all options would be roughly the same as they've all stated they won't waste any hairs. And the cost for all proposals was almost identical for a maximum harvest. It really doesn't make any difference to me whether it's 3k or 4500 if the end result of hairs is the same. So.......my question is.....assuming laxity is the same between all surgeons, what differentiates who can get the most hairs from a strip to the recipient area?

 

3. For a number of reasons, I'm probably going to need to wear a system some of the time while my grafts grow and mature. I have a plan to minimize it to make sure my scalp and growing region remain healthy. When I do remove it for good, I'd like to be able to cut my hair pretty short (3 or 4 in the back). I may try to conceal some of the scarring with SMP. How long after an FUT procedure can you have an SMP procedure performed? I know H&W and Shapiro will be offering this solution shortly, but I haven't asked the question yet. Also, does anyone know when the pricing for SMP will be available at H&W and Shapiro?

 

Thanks in advance and I look forward to contributions/advice the next couple of months as I'm looking to have my procedure done late spring or early summer.

 

I was really in the same boat as you, i.e., a Norwood 5a and fed up with wearing a hair system. I decided on H&W because they have such a good track record for megasessions. From an online consultation they suggested between 4000 and 5000 grafts to get reasonable overall cover. When it came to the actual surgery, my laxity wasn't that great and I also had quite a pronounced erythematous reaction when the incisions were being made. The total length of the strip removed was 37 cm and involved 120 staples. That amounted to 4416 grafts in total. That's really very long and I'm sure other surgeons would have been more conservative.

 

The end result is very good and I was able to make the transition from bandana to short haircut four months after the HT, which means that I've been free of the hairpiece for eight months now. I thought that I might have to wear some sort of piece while the hair was growing in, but the bandana was a much easier option.

[MrJobi]

Yes, only difference is I did not wear a system, rather used concealers for more than 10 years!

 

H & W are one of the best in my mind - no doubt you are in good hands!!!! 4416 is a nice number and you will get some good growth out of that procedure!!!

 

At 8 months, you still have some significant growth left AND softening of the hair which makes a big difference.

 

Bottom line - you are getting better hair everyday and I would imagine you can have another procedure in a little time. It is tough to be patient but remember, you are moving in the right direction!!!

 

One thing you might want to do next time are scalp exercises ( although H & W suggests them so maybe you did do them). I did them only before my 3rd procedure as Dr. True wasnt big on them . To our surprise, it made a big difference in my laxity hence you see my 3rd procedure being the largest yield

 

Good luck!!!