Fusing grafts to create more density.

[nicoandgello]

Hello, 

I'm 20 year old dude with Norwood 2. I have been lurking hair loss forums for 2 years now as I started balding at 18. I'm not thinking about hair transplant till I'm at least 23-24. I know that some clinics fuse multiple grafts to achieve 5 hair graft. I know it's not realistic to have only 5 hair grafts but I am really interested in this idea as it could theoretically achieve great density results. This is question for more knowledgeable people and doctors here. Is it possible to take out, let's say 4000 grafts, and fuse them into 3000 grafts, so there would be no blood issue with dense packing them over 60 grafts per square cm. Im asking this question as I have never seen it answered anywhere before. Thanks for help. 

[Melvin- Admin]

I'm not sure I understand fusing. I know there are some clinics that promote 'max harvests' and coin techniques after their name, yikes. These clinics are doing nothing more than promoting old hair plugs that we're done in the 80s and 90s. Check out this video, it might help you understand density a little better.

 

[nicoandgello]

Thanks for reply, Melvin. I get the density problem. That is why I have looked into fusing. I know it can be done. I try to adress the issue of blood supply, which is the reason of grafts not growing well after 50-60 futs per square cm. My idea is fusing 4000 grafts into 3000 grafts, so instead of lets say 1.8 hair per graft you get 2.5 hairs per graft, which makes high density and fullness avaiable, beacuse instead of having 100 hairs per sq cm with 1.8 average hair graft, you could get 140 hairs per square cm. I don't know if i explained it well. English is not my first language.

[Melvin- Admin]

Just now, nicoandgello said:

Thanks for reply, Melvin. I get the density problem. That is why I have looked into fusing. I know it can be done. I try to adress the issue of blood supply, which is the reason of grafts not growing well after 50-60 futs per square cm. My idea is fusing 4000 grafts into 3000 grafts, so instead of lets say 1.8 hair per graft you get 2.5 hairs per graft, which makes high density and fullness avaiable, beacuse instead of having 100 hairs per sq cm with 1.8 average hair graft, you could get 140 hairs per square cm. I don't know if i explained it well. English is not my first language.

Here's the thing, you can't multiply hair. Let's say a doctor extracts 1,500 grafts with an average of two hairs per graft. That's 3,000 hairs. No matter what, you're gonna get 3,000 hairs. If you were to combine some of those grafts together, you would end up with less overall grafts. So instead of 1,500 grafts, you might end up with 1,000. So, it really wouldn't matter. What matters more is the thickness of your hair follicle, the angles the hairs are being placed, and the number of hairs the surgeons end up extracting. I'm not sure if you watched the video, but Dr. Konior and Dr. Bisanga gave an excellent response. The number of grafts are irrelevant. You could transplant 60 grafts per cm2. Another doctor could transplant 30 three-haired grafts, the 30 grafts will be a lot denser. The reason why I made that video is for questions like this one. 

[nicoandgello]

Again thank you for your reply, but I don't think we get each other. I know that to achieve natural result you have to put two rows of single grafts first in the harline. Then double grafts and so on. I understand that. My thinking is, we take 4000 grafts and make them into 3000 grafts. I know that 3000 hairs will always be 3000 hairs, but grafts can be fused and sliced from what i know. You can take Double graft and make it into two single grafts. You can take two double grafts and make them into 4 graft follicle unit. So in theory if we took 4000 grafts, and fused them into 3000 grafts we could realistically achieve better density results, beacue the number of hair would be the same with both 4000 units and 3000 units, but you could transplant those 3000 units to a smalles area with safe 60 follicular units per square cm. I'm not trying to argue you, as your knowladge is much better than mine, but it's a question if it could be done. Thanks.

Edited January 30, 2021 by nicoandgello

[Melvin- Admin]

2 minutes ago, nicoandgello said:

Again thank you for your reply, but I don't think we get each other. I know that to achieve natural result you have to put two rows of single grafts first in the harline. Then double grafts and so on. I understand that. My thinking is, we take 4000 grafts and make them into 3000 grafts. I know that 3000 hairs will always be 3000 hairs, but grafts can be fused and sliced from what i know. You can take Double graft and make it into two single grafts. You can take two double grafts and make them into 4 graft follicle unit. So in theory if we took 4000 grafts, and fused them into 3000 grafts we could realistically achieve better density results, beacue the number of hair would be the same with both 4000 units and 3000 units, but you could transplant those 3000 units to a smalles area with safe 60 follicular units per square cm. I'm not trying to argue you, as your knowladge is much better than mine, but it's a question if it could be done. Thanks.

Can it be done? Yes, but if you start combining a bunch of grafts you will not be able to cover as much area. This would work for someone with a small patch of hair loss. But it doesn't make sense on anyone who needs coverage. Grafts from the 80s contained 20-30 hairs per graft, just because it was a chunk of hair doesn't make it better. The best hair transplants are the ones that mimic nature. If you're a norwood 2 at 20, you will probably need to cover a lot of area. Generally, hair loss at a young age = aggressive hair loss. There's a balance between density and coverage. You don't want to dense-pack a hairline and end up with a thin midscalp or crown. That will not look good.

[nicoandgello]

Agree with you fully, but im not usual case, as im a person that will take hormonal treatment in the future, so for me there is no chance of further Androgenic Alopecia happening, as i will have less Androgens than born females. I was thinking about graft fusing so I could get the most dense result possible, as my hair everywhere else is very thick, and I would want to match that with my hairline.

[Abhinay Singh]

You can have a dense growth on your scalp using the normal amount of grafts. Considering your age, you will have a fantastic donor. The trick in achieving the illusion of a great looking density is not planting excessive number of grafts but planting the grafts intelligently. The expertise of the doctor, the planning of the procedure (in sync with what the patient wants) and immaculate execution of the procedure would give you fabulous results. Most patients look for a general coverage and are not usually bothered by having extreme density or other specifications. However, mostly in the female patients, they are very specific about the look, density and feel of the final result. Therefore, this being a COSMETIC surgery field, it is possible to give what patients desire.

[Melvin- Admin]

14 hours ago, nicoandgello said:

Agree with you fully, but im not usual case, as im a person that will take hormonal treatment in the future, so for me there is no chance of further Androgenic Alopecia happening, as i will have less Androgens than born females. I was thinking about graft fusing so I could get the most dense result possible, as my hair everywhere else is very thick, and I would want to match that with my hairline.

Even if you’re transgender, you could develop further hair loss. Women still develop hair loss. Are you on dutasteride? 

[nicoandgello]

1 hour ago, Melvin-Moderator said:

Even if you’re transgender, you could develop further hair loss. Women still develop hair loss. Are you on dutasteride? 

I don't really consider myself a transgender. Right now I am taking 1.25 mg finasteride and use keto shampoo every 4 days. It halted my hairloss for 2 years now. I ordered oral minoxidil, and will start using it soon enough. I'm gonna move out from my parents by end of the year, and propably start low dose of oral spyro,as I want to still have sexual function. Right now I'm just trying to to do some research and form some realistic expectations. I will propably wait till 24, and get a small 2k FUT with either Gabel or Bloxham. Thanks for answer.

[Britanium]

Either Gabel or Bloxham are really good choices. I really like the FUT work that Bloxham does. I’m not sure they would do a ht on someone at 24. Usually they will wait until someone has turned 25. 

[nicoandgello]

4 minutes ago, JohnAC71 said:

Either Gabel or Bloxham are really good choices. I really like the FUT work that Bloxham does. I’m not sure they would do a ht on someone at 24. Usually they will wait until someone has turned 25. 

I know, I want either of them cause they seem very ethical and enthusiastic to help people. I believe, they will take me as I have great donor, and if I maintain NW2 till 24, I will make a decent candidate.

[PizzaWolf]

18 minutes ago, nicoandgello said:

I don't really consider myself a transgender. Right now I am taking 1.25 mg finasteride and use keto shampoo every 4 days. It halted my hairloss for 2 years now. I ordered oral minoxidil, and will start using it soon enough. I'm gonna move out from my parents by end of the year, and propably start low dose of oral spyro,as I want to still have sexual function. Right now I'm just trying to to do some research and form some realistic expectations. I will propably wait till 24, and get a small 2k FUT with either Gabel or Bloxham. Thanks for answer.

This drug protocol will not give you "less Androgens than born females" as stated in your earlier post.

A small 2k FUT will not give you any kind of unusually high density.

[nicoandgello]

3 minutes ago, PizzaWolf said:

This drug protocol will not give you "less Androgens than born females" as stated in your earlier post.

A small 2k FUT will not give you any kind of unusually high density.

Yeah, I know. 100mg oral spyro should lower my PSA by at least 40%. What i meant, was that I'm willing to take stronger medications, than majority of people. If i lose hair with spyro i will just use bicalutamide. If i lose with that, I will castrate myself. 2k FUT can easily give me density of 55 FU per sq cm. Im norwood 2 not 3, and my head is smaller than average.