How Many Grafts Do I Need?

[FUEAsianHairline]

The shaved head pictures are recent and the the pictures with my hair grown out are from about a year ago and show how my hairline is recessed and uneven.

 

I also attached 2 goal photos one is a crew cut and the other is longer. Wondering if I can get an opinion on how many grafts needed to restore my hairline and achieve those goals. I am interested in getting an FUE procedure soon and recommendations are welcome.

 

Thanks

[FUE2014]

To my untrained eye, I would say no more than 1500, check out what Dr Reddy can achieve for a patient with more loss than you with less than 1500 grafts for example

 

http://www.hairrestorationnetwork.com/eve/170772-norwood-3-hair-loss-fue-transplant-dr-raghu-reddy-1207-grafts.html

[FUEAsianHairline]

Thanks FUE2014. Dr. Reddy's results look pretty amazing. Too bad he's in the UK.

[GraveD11gger]

Measure the transplant area using milimetric grid paper, (cm2), then multiply it with 35X40 (grafts)

 

(if the area is 40 cm2. 1500-1600 grafts will suffice)

 

more than this is just waste of grafts (you may need them in future for middle and top areas)

 

(do not rely on advertorial videos which show 80 grafts per cm2. this is technically possible (although very risky for the survival of all grafts because blood travelling is jeopardised), every HT surgeon can do this, but NW 3 (100 cm2 about) means 8000 grafts then, almost full capacity of normal high density donor areas, 80 grafts per cm2 at younger ages also means graft waste)

 

if you are younger than 30, do not lower the hairline, just fill the gaps at the sides (no grafting to the temples but, they look ugly with time when temporal area hairs become thinner and if temporal hairline recedes)

[FUE2014]

Thanks FUE2014. Dr. Reddy's results look pretty amazing. Too bad he's in the UK.

 

Oh you are in the US, I have been really impressed with Dr Diep's FUE, definitely worth an online consult.

[PupDaddy]

FUEAsianHairline,

I would second FUE2014's suggestion that you consult with Dr. Diep in California. He is a recommended hair restoration surgeon here, and his has posted numerous video examples of his FUE work on YouTube.

 

Good luck!

[Spanker]

1500-2000

[Sean]

Probably 1500 grafts with a doctor known to achieve great graft yield in the surgical method you request.

[FUEAsianHairline]

Thanks GraveD11gger.

 

Since my hair has recessed and I don't have any "markers" for where it started, what area would I measure to/from?

 

Measure the transplant area using milimetric grid paper, (cm2), then multiply it with 35X40 (grafts)

 

(if the area is 40 cm2. 1500-1600 grafts will suffice)

 

more than this is just waste of grafts (you may need them in future for middle and top areas)

 

(do not rely on advertorial videos which show 80 grafts per cm2. this is technically possible (although very risky for the survival of all grafts because blood travelling is jeopardised), every HT surgeon can do this, but NW 3 (100 cm2 about) means 8000 grafts then, almost full capacity of normal high density donor areas, 80 grafts per cm2 at younger ages also means graft waste)

 

if you are younger than 30, do not lower the hairline, just fill the gaps at the sides (no grafting to the temples but, they look ugly with time when temporal area hairs become thinner and if temporal hairline recedes)

[FUEAsianHairline]

Thanks everyone for your replies. I've been told by a surgeon who did an in person consult, that they thought I would only need about 1,000 grafts, although other surgeons (who have only seen photos) have given me the same estimate of 1,500-2,000. That's a big difference. Obviously the surgeon who saw me has a leg up, but even so that variance is so great. I do plan to do at least 1 other in person consult, but just wondered if you guys had any thoughts on that.

 

I mean sure I would love it if I only need 1,000 grafts, but based on what everyone else (you guys and surgeons) is telling me plus what I am seeing in photos of people with similar hair loss, I think something is a bit awry and I don't necessarily want to take one surgeon's opinion as gospel when it differs from everyone else.

[FUEAsianHairline]

Hi, I've received the attached mock ups from a prominent and respected hair transplant surgeon and wanted your opinions on it. The 3,600 grafts was the initial recommendation but I was told 2,800 would be fine also.

 

The main difference seems to be 600 grafts in the middle scalp area.

 

I've been leaning towards 2,800 primarily due to price, but I was also unsure of how beneficial 600 grafts in the mid-scalp would help. Including potential shock loss, I might not really see any major noticeable gains there. At the same time I don't want to regret not paying a few thousand more for "fuller" and thicker hair.

 

My hope is that I would only need 1 hair transplant and that maybe 5+ years later I would consider a 2nd one assuming my hair continues it's natural recession (I'm on finasteride). So I definitely don't want to feel like I have to go in for another one 12 months later.

 

Any thoughts or advice? Do you think I'll be fine with the 2,800 grafts?

 

BTW, it's interesting how some other surgeons and people on this forum commented that I would need no more than 2,000 grafts based on my pictures, although it seems several big name surgeons have recently suggested I would need in the 3,000 range. Hopefully if this happens my hair will be good to go for the near future.

 

TIA

Edited February 26, 2015 by FUEAsianHairline

[FUEAsianHairline]

Any thoughts?

[zyzz]

I'm no expert, but wouldn't the additional 600 grafts implanted in such an already dense zone result in a zero sum game?

 

Refer to this guy

 

http://www.hairrestorationnetwork.com/eve/178460-input-needed-fue-2521-grafts-1-year-post-op-results.html

Edited February 27, 2015 by zyzz

[FUEAsianHairline]

Thanks zyzz, that post was an interesting one. Very strange that 2,500 grafts were undetectable. I'm hoping to grow out bangs, so that could be one benefit with the 600 grafts in the midzone, but really I'm pretty much in agreement with you that it would be almost undetectable primarily due to potential shock loss.

[MyWHTC-HairlossClinic-0f-B]

FUEAsianhairline

 

The number of grafts is only important if you have realistic goals. I am pleased to see that you know the benefit of reserving your donor resources. You mentioned that bangs would be an improvement to your situation. Have you considered finding a hairstyle that can allow you to see a great effect from fewer transplanted FUE grafts?

[FUEAsianHairline]

WHTC, thanks for your feedback. From my talks with a number of recommended surgeons, most believe that bangs are realistic in my situation, but to achieve that a few surgeons have stated I need 3,000+ grafts. I could certainly go with less grafts for a shorter hair style, but if the option exists to have longer hair, that's what I want.

[JohnCasper]

Basing this strictly on my own personal experiences I would think 1,500 - 2,000 would be more than enough to accomplish your expectations at this time.

[Sean]

Careful of having grafts placed in dense native zones. They can shock or transect your existing hairs making no difference or worse in such areas of already distinct native density. You do not want to risk wasting your grafts. Work from the front where no hair exists, and taper it back to only where there is a distinct measurable loss of density. Again I would think 1500 or a little more, but 3000 is questionable as to where it will be placed. Unless you have a very low density donor that will give you minimal groupings?

[BMW1990]

I would have to say 1000 grafts would give you decent coverage but ideally you want to hit the "50% OF DENSITY" I have to agree with the other posters, 1500-2000 grafts should you yield you a pretty nice outcome. Personally, I would also recocomend getting on finasteride to help stablize your hair loss. 3000 grafts seems a bit steep for the amount of hair loss. Although I am sure with 3000 grafts and the amount of hair you have already lost, the outcome would be spectacular. Some things to consider, as Sean had already mentioned, when implanting grafts that closely together, you risk transacting follicles, resulting in a lower yield of growth and also you run the risk of depleting your donor area, if you need transplants later down the road.

[FUEAsianHairline]

Careful of having grafts placed in dense native zones. They can shock or transect your existing hairs making no difference or worse in such areas of already distinct native density. You do not want to risk wasting your grafts. Work from the front where no hair exists, and taper it back to only where there is a distinct measurable loss of density. Again I would think 1500 or a little more, but 3000 is questionable as to where it will be placed. Unless you have a very low density donor that will give you minimal groupings?

 

Sean, thanks for the advice. Messing up the "good" hairs I already have is the last thing I want to do. As far as my donor supply, I've been told it's very good by doctor's who've seen the photos, so I would hope that I don't have minimal groupings back there.

 

I would have to say 1000 grafts would give you decent coverage but ideally you want to hit the "50% OF DENSITY" I have to agree with the other posters, 1500-2000 grafts should you yield you a pretty nice outcome. Personally, I would also recocomend getting on finasteride to help stablize your hair loss. 3000 grafts seems a bit steep for the amount of hair loss. Although I am sure with 3000 grafts and the amount of hair you have already lost, the outcome would be spectacular. Some things to consider, as Sean had already mentioned, when implanting grafts that closely together, you risk transacting follicles, resulting in a lower yield of growth and also you run the risk of depleting your donor area, if you need transplants later down the road.

 

BMW1990, thanks for the advice. I've been on finasteride for 1.5 years, although I wish I had started much earlier. That said, I think my hair loss is pretty stable at this point. (I'm also using a laser helmet, but I know the controversy around that...)

 

I 100% agree with wanting to hit 50%+ density. The surgeon who sent me those evaluation photos stated they plan to "implant 60 grafts per 1 cm2" and from what I understand anything over 50+ grafts per 1cm2 is good, with 40 being 50% density I believe.

And your comment about a "spectacular" outcome is precisely what I and I'm sure everyone else wants:)

 

My goal from the beginning has been to get 1 hair transplant that will hold me over for 5+ years and some of the top recommended doctors from this forum have given me estimates of 2,500+ and their before and after photos have been spectacular. Numerous other surgeons have quoted 1,500 grafts, but their photos are not quite as spectacular. So I think a lot of that has to do with the high graft count.

 

As far as my donor area, I am definitely trying to get that to last as long as possible while also trying to obtain a great result.

 

Thanks guys for your very helpful comments and advice! Please keep them coming!

[Noodles123]

The one thing I would change if I had to do it over again is that I would have done a much larger procedure and reach as much of my goal as possible in one shot (granted if you have a fairly good guess as to your ultimate balding pattern). Getting a hair transplant is incredibly disruptive to one's life for at least 3-4 months before you get out of that ugly duckling period. If you are sure you want to do a future session anyway, I'd go for a larger procedure and stick with the medicine so that you can have a great result for as long as possible.

[zyzz]

I would also try not to put too much expectations on a specific hairstyle especially ones with dense bangs like a kpop artist. After reading many posts by more experienced people here and going through a procedure I realize that Hair transplant should be a last resort to improve your balding appearance and at best it gives an illusion of more density but you can never get back the density you had 10 years ago, and certainly not what you see on specific hairstyles with a full head of hair. Be realistic with your expectations.

[FUEAsianHairline]

Thanks guys.

 

Blah, I'm not saying i'm planning to get a 2nd HT in the future but I'm being realistic and understanding that I may need one later on since my hair will probably (hopefully not) continue to recess as I get older. But point taken on getting a much larger procedure the first time around which is my plan.

 

zyzz, I hear you and I'm certainly not looking for a specific hair style like those guys that go to the barber with pictures of celebs, I'm just looking to get a lot more density in the front forelocks to be able to have the option to grow out bangs understanding that it won't be exactly the same as 10 years ago. HT's are certainly the last option but also one of the best options because really nothing else is going to regrow hair to a great degree unless you recently lost the hair.

[FUEAsianHairline]

Any thoughts guys?

[SteveMadani]

Since your hair is thick, 1000 grafts will probably make it dense enough. I think most important is to trust and feel comfortable with the surgeon. What area are you in? Keep updating on what you decide. I have a few appointments for consultation also.