Increasing/decreasing the amount of grafts suggested?

[Falconary]

I have a hard time deciding on what surgeon/clinic to go for my HT. I narrowed down my choice to the top 2 I would like to go for, but they have quoted me different amounts of grafts based on the same pictures and same area that I would like to do. See attached picture. One surgeon quoted me 2000 grafts, which I thought were way too low, and the second surgeon/clinic quoted me 4000 grafts, which I think is a little to high and makes me afraid of loosing too much density on the donor... The second surgeon is recommended here on the forum. I wanted to land on the middle, about 3300 grafts, and have a reserve donor for the future. I asked the second surgeon (my most preferred) if the grafts can be decreased to about 3300-3500 grafts, but no answer since a few days ago. 

Does anyone here have any experience of "negotiating" the amount of grafts that is to be transplanted? Is it disliked by the surgeons, is it reasonable to do? I've also asked many other clinic and each on of them gives me a vastly different amount of grafts so it's really confusing what to go for, and how to plan for the future.

Edited June 16, 2021 by Falconary

[Al - Moderator]

Did you see any of them in person or was it all done online with pictures. If they only saw pictures of you then it's very likely that their estimates will change (either up or down) once they actually see you in person and go over the plan with you.

 

[deeznuts]

4000 grafts doesn't seem that crazy. Actually, 4000 seems perfectly reasonable since you're covering the front and midscalp. I've seen 4000 grafts used for much less lol.

Yeah surgeons suggest different graft amounts but part of the estimate is the surgeons personal style. I actually had an estimate of 1200 and then an estimate of 3000 in my two consultations so far. Obviously, there is some amount that is probably calculated based off the area that needs to be covered. But the other part of the equation is just whether the doctor wants to be aggressive with density, whether they think you have future loss, whether they are willing to do larger sessions (i.e. megasessions), whether they think you should go for a followup transplant in the future, what kind of hairline/coverage they're going for, and whether they're concerned with preserving donor or going for a great result.

My first doctor came off as super conservative. He wanted to transplant a fairly low density to give a "thinning" appearance. 1200 grafts was his estimate for the temples. My next consult suggested 3k. 

You can definitely talk down the doctor I feel. I've read of patients doing so by discussing with the doctor.

[gillenator]

It's very possible that both surgeons have a different idea where your hairline will commence...still, I think even 3,000 grafts would provide a nice result.

[Falconary]

3 hours ago, BeHappy said:

Did you see any of them in person or was it all done online with pictures. If they only saw pictures of you then it's very likely that their estimates will change (either up or down) once they actually see you in person and go over the plan with you.

Only online with pictures, and I clarified that I want a rather conservative hairline, No need to have it as a 20 year old.

2 hours ago, deeznuts said:

4000 grafts doesn't seem that crazy. Actually, 4000 seems perfectly reasonable since you're covering the front and midscalp. I've seen 4000 grafts used for much less lol.

 

2 hours ago, deeznuts said:

You can definitely talk down the doctor I feel. I've read of patients doing so by discussing with the doctor.

4000 would perhaps give me great density, but I just care about having a good coverage and good donor area because In like to have my hair rather Short, especially the sides and back and afraid that it would look depleted if I do 4000 grafts as many I know have obvious low density in the donor after 4000+ HT. The thing is that the conversation is with the coordinator, not with the surgeon, and if I book a time, travel, and discuss the amount of grafts with the surgeon only hour/s prior to the HT, it would be rather stressed. But perhaps Im over thinking the whole thing...

 

1 hour ago, gillenator said:

It's very possible that both surgeons have a different idea where your hairline will commence...still, I think even 3,000 grafts would provide a nice result.

It probably is so, thanks for your input, I personally would Love to have "only" 3000 grafts if it give me pleasing cosmetic result. I've seen others cover such an area with about 3000-3300 grafts with good results so i think it is very reasonable. 

[ITA]

12 minutes ago, Falconary said:

The thing is that the conversation is with the coordinator, not with the surgeon, and if I book a time, travel, and discuss the amount of grafts with the surgeon only hour/s prior to the HT, i

Are you only talking to the coordinator?  Are you sure you are not in contact with a low-cost clinic?  This is a habit of hair mills, yes ... you will see the surgeon only an hour before your HT and he will talk to you for a maximum of 5/10 minutes, the time to draw your hairline with his marker.  I advise you to be careful.

[Falconary]

1 minute ago, Egy said:

Are you only talking to the coordinator?  Are you sure you are not in contact with a low-cost clinic?  This is a habit of hair mills, yes ... you will see the surgeon only an hour before your HT and he will talk to you for a maximum of 5/10 minutes, the time to draw your hairline with his marker.  I advise you to be careful.

Yes when I contacted one of the clinic (the one i prefer), a coordinator reached out and answered me, but he doesnt answer all questions. But I will probably try to contact the doctor directly somehow. It is not a hairmill, and recommended in this forum. And the other clinic is not on this forum but also not a hairmill, the doctor does almost everything, great results also, and I'm in direct contact with the doctor, but he firmly believes that 2000 grafts is enough. 

[Britanium]

Would you be able to let us know who the 2 clinics are .? 🙏

[deeznuts]

1 hour ago, Falconary said:

4000 would perhaps give me great density, but I just care about having a good coverage and good donor area because In like to have my hair rather Short, especially the sides and back and afraid that it would look depleted if I do 4000 grafts as many I know have obvious low density in the donor after 4000+ HT. The thing is that the conversation is with the coordinator, not with the surgeon, and if I book a time, travel, and discuss the amount of grafts with the surgeon only hour/s prior to the HT, it would be rather stressed. But perhaps Im over thinking the whole thing...

 

Actually, from what I hear, it's the opposite of what you're saying. You can disguise lower density with longer hair. With shorter hair it's just harder to hide the fact that you have less density

[Melvin- Admin]

You need all the grafts you can get, to be honest you are a Norwood 6 with diffuse loss. You probably need at least 5000 grafts. Is there a reason you want to lower the number?

[Falconary]

9 hours ago, JohnAC71 said:

Would you be able to let us know who the 2 clinics are .? 🙏

You got PM.

6 hours ago, Melvin-Moderator said:

You need all the grafts you can get, to be honest you are a Norwood 6 with diffuse loss. You probably need at least 5000 grafts. Is there a reason you want to lower the number?

Yes I know that I will be a slick Norwood 6 in the future and need about 6000 grafts to cover everything. I will probably need a total of a 2-3 HT in the future, so I try to plan ahead and don't deplete my donor too much. If I do 4000 grafts now to cover the front and middle scalp, I would only have about 2000 grafts left for the crown and other "fixing" in the future. Or am I wrong? I don't want to end up with patchy donor

[Falconary]

8 hours ago, deeznuts said:

Actually, from what I hear, it's the opposite of what you're saying. You can disguise lower density with longer hair. With shorter hair it's just harder to hide the fact that you have less density

Can I have a fade with longer hair on topp scalp if I do 4000 grafts? I've never had the sides and backside longer than #3.

[deeznuts]

7 hours ago, Falconary said:

Can I have a fade with longer hair on topp scalp if I do 4000 grafts? I've never had the sides and backside longer than #3.

Idk but having it longer on top would give you better coverage based on what I think I've seen melvin post. Whether 3k or 4k, I wouldnt know