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Older HTs and graft numbers

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I don't have a lot of knowledge on how older hair transplants were performed, but from my understanding, it seems like a lot less grafts were used in the early to mid-nineties than today? I don't have a lot of information to back that up, but my father is a good example. He had multiple procedures (Bosley and some independents), but he claims he had no more than 1000 grafts in total. My father had prevalent loss in the frontal third and crown, so it amazes me when I see patients today needing 4000+ grafts to achieve a good result. In fact, most people tell you to expect very little from a transplant that is under 2000 grafts. I realize naturalness and refinement is centered around hair transplants today--and my father's work is not the most "natural"--but he has excellent coverage for the loss he incurred throughout his life. I guess I'm just wondering if the methods used 15+ years ago offered better coverage (with less grafts), but obviously at the cost of naturalness?

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In order to start to understand why the number of "grafts" differ today from yesterday, I'd recommend reading the History of Hair Transplantation.


What people typically refer to today on our forum when they use the term "grafts" are follicular units (hairs in groups as they occur naturally containing 1, 2, 3, and 4 hairs). But physicians have only started using follicular units within the last 5 or 6 years. Before that, larger grafts called "minigrafts" were state of the art containing larger hair groupings typically between 2 to 8 hairs. Before minigrafts, even larger grafts were used. To learn more about follicular units, minigrafts, and several other types of grafts and when they were used, visit Understanding Hair Transplant Graft Types and Terminology by Coalition member Dr. Ron Shapiro.


Regarding numbers, since larger grafts containing more hairs were used in the old days, 1000 grafts in 1995 may have been equivalent to approximately 2000 grafts today. Though some leading surgeons still make the occasional use of larger grafts when appropriate for the patient, follicular unit hair transplantation is considered today's Gold standard hair transplant since it's the most natural looking.


Over the years, surgeons have been able to do larger and larger sessions of follicular units due to refined techniques and tools and hiring and training a large enough staff to dissect and plant all the grafts in a single session.


I hope this helps.



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What you are saying is partially correct. Some of the older transplants did obtain good density with fewer grafts. This may have been because there were more hairs in those older grafts or the patient had some existing hair at the time of the transplant. In either case as the patient aged the transplanted hairs would look more unnatural. The patients own hair characteristics along with the doctors methods and grafts size are the biggest factors in the degree of naturalness.

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