Grafts count drastically varies by doctors

[skyhigh]

I am a female considering hair implant surgery. I do not have any hair loss, but I have a large forehead from birth and I wish to lower my hairline.

 

I have consulted with several doctors strictly from coalition members. All very reputable and have many years of successful practices. There are hardly any negative blogs to be found on internet. I obsessively searched for pros and cons of these selective doctors in the east coast area. I have finally narrowed down to 3 and went in for consultations. I find it very surprising that the 3 doctors gave me very different grafts counts. I have received 1300, 2000, and 2800. I am very specific in which area of the head I want to fill in and all 3 doctors drew lines on my head to be clear where we would implant. It really is not ambiguous which area needs to be covered, yet all 3 came up with these varying #s.

 

Why am I not getting consistent graft counts from flawless top notch doctors? How should I go about researching the most appropriate amount of graft counts? I have pin-straight medium thickness hair (not coarse hair and not fine). What is the average count for 1 square cm?

 

Thank you,

 

Skyhigh-forehead

[skyhigh]

I am a female considering hair implant surgery. I do not have any hair loss, but I have a large forehead from birth and I wish to lower my hairline.

 

I have consulted with several doctors strictly from coalition members. All very reputable and have many years of successful practices. There are hardly any negative blogs to be found on internet. I obsessively searched for pros and cons of these selective doctors in the east coast area. I have finally narrowed down to 3 and went in for consultations. I find it very surprising that the 3 doctors gave me very different grafts counts. I have received 1300, 2000, and 2800. I am very specific in which area of the head I want to fill in and all 3 doctors drew lines on my head to be clear where we would implant. It really is not ambiguous which area needs to be covered, yet all 3 came up with these varying #s.

 

Why am I not getting consistent graft counts from flawless top notch doctors? How should I go about researching the most appropriate amount of graft counts? I have pin-straight medium thickness hair (not coarse hair and not fine). What is the average count for 1 square cm?

 

Thank you,

 

Skyhigh-forehead

[Dr. Michael Meshkin]

Hello,

This site has an animation that gives an estimate for the number of grafts needed for an area based on the desired density. Each doctor differs in the technique they use, and also on the number of one, two or three hair units they use. The smaller the units the more incisions a doctor can make. Its a good idea to ask the doctor to give you a break down of the number of 1,2, or 3 hair units so you are able to compare them based on the total number of hair they are planning to transplant.

[Gorpy]

There are varying approaches doctors use. Some will try to go with a high density transplant even if you have some hair in the transplant area. Others believe that a conservative approach, placing a smaller number of grafts between existing hairs, helps to preserve your existing hair.

 

The fact that doctors disagree on approaches does not mean that some are not as good as others. It's just a different philosophy.

[JM]

Should the amount of grafts from the donor strip

be consistent from each doctor? That is to say that all the doctors you speak to should all have the same # of maximum amount of grafts they can get from a strip based on your hair density?

[Michael07]

Each Doctor has there own way of doing things. They have their own personality and this will affect the estimates they give you. If I were you, I would just go with the Doctor I felt the most comfortable with.

 

While their estimates may be different, I am sure they are all respected doctors and they will do a fine job. Just do not over analysis and do what you feel is right...

 

Hope that helps,

Michael

[wantego]

Just a FYI some people tend to find women with large foreheads very attractive. Tyra Banks and Uma Thurman have larger than average foreheads and are knockouts.

[skyhigh]

Thank you for all of your caring replies. I think I will go with the doctor I felt most genuine and felt who runs the most honest practice; which is the doctor who gave me the estimate of 1300 grafts. If anything, I can go back for more density. I have plenty of donor area, all 3 doctors and my hair stylist are impressed with how much hair I have in the back (and light in the front..)

 

Thanks to Dr. Mike Meshkin. I did check out the 'Hair restoration Graft Calculator', the animation that gives an estimate for the number of grafts needed for an area based on the desired density. It gave me 1500 (note that I had to choose more area than I wanted due to the functionality of the tool). The bottom line is, I could not possibly get more than 1500 grafts even at the fullest density.

 

I called the doctor's office a couple days ago with the question. (by the way, so sincere and not defensive) He said due to the shock loss he would not perform aggressive fill in's on the area where I already have hair. I do not need to force more density than I naturally have. Especially when I do not have any hair loss, it is not necessary to dense up my natural hair. I completely appreciate that he cared for possible side effect instead of saying "you'll be just fine"

 

I feel the other doctor who quoted me the double amount of the graft (2800) wanted to take this opportunity to maximize his paycheck. I just cannot figure out where he is putting all that hair in.

 

I shall keep posting my progress once I go through with the surgery.

[Dr. Ricardo Mejia]

As you note in some of the posts above that have been done by other physicians, the grafts are divided into singles doubles triples and quads. The main question is how much donor area is each doctor removing to give you the number of grafts quoted. IF you note both gorpy and wantego, they averaged about 2.2 hairs per graft. For example, if we assume each doctor removes the same amount of hair follicles from your donor strip, then you will be getting the same amount of hairs just divided differently.

 

 

Assume each doctor you visited was going to remove exactly 5320 hair follicles, then your distributition would be as follows:

 

DR A: 2800 grafts averaging 1.9 hairs / graft

DR B: 2000 grafts averaging 2.66 hairs per graft

Dr C: 1300 grafts averaging 4.1 hairs per graft

 

Every doctor uses different tecniques and instrumentations. SOme doctors divide the hairs follicles very fine, some, medium and some like to utilize double or triple follicular units or minigrafts. The double and triple follicular units have more hairs per graft. There are advantages and disadvantages to each technique which depends on where the hair is going to be placed, the caliber , texture and quality of the hair. For example in the hairline, we primarily use only single hairs. In this scenario above Dr. Each doctor is giving you the same anount of hair divided differently.

 

However, if we assume each doctor averages 2.2 hairs per graft utilizing strictly follicular units, then Dr A will be giving you alot more hair than Dr. C. In general the more hair you get the better. Dr A will be giving you 6160 hairs and DR C 2860 hairs or 54% less hairs than Dr. A.

 

So the issue of grafts can be confusing when trying to compare what one surgeon is doing compared to another. Obviously in the first example, you will get the same amount of hairs. In the second, you will get a lot less hair. I have never met a patient that said I gave them too much hair and asked me to take it out. In the end if you have done your due diligence and you have to put your faith that the doctor will be doing the right thing for you which is to give you more hair and not be thinking about padding his wallet. good luck.