How many grafts should I realistically go for in a session?

[Melange]

Hello all, first time poster. I'm 27, been on min for 8 years and fin for 1.5 years. I've been quoted 3800-4200 by HLC, but doctors in the US have recommended no more than 2000 for now. I'm vacillating on which graft option I should be going for. 

[Britanium]

Hi

Will this be your first procedure ? Could you let us know which US clinics you have been consulting with so far ? Thanks 🙏 

[Melange]

1 hour ago, JohnAC71 said:

Hi

Will this be your first procedure ? Could you let us know which US clinics you have been consulting with so far ? Thanks 🙏 

This would be my first. I've talked to Dr. Konior so far, he's who suggested the 2000 for the front. I have a few more consultations I'm trying to schedule with others.

[Britanium]

From your pics it’s quite difficult to tell how many grafts are needed. In some I think yes 2000 is enough. Be interesting to see what the other quotes come in at… are you thinking of FUT or FUE ? 

[Melange]

29 minutes ago, JohnAC71 said:

From your pics it’s quite difficult to tell how many grafts are needed. In some I think yes 2000 is enough. Be interesting to see what the other quotes come in at… are you thinking of FUT or FUE ? 

I'm guessing FUE, but idk. My hair is buzzed now, but the long hair is what I look like if I grow it out. I've only had been buzzing it for 2 weeks.

[deeznuts]

I think it's important to distinguish between what each doctor is trying to accomplish. Maybe Konior is only going the area near the hairline/midscalp in which case 2k seems reasonable. And HLC might be saying... Well, we're going to fix your crown and fill in everything in which case 4k might be more reasonable.

[Kharmacoma]

The doctors that quoted you 2000 is because they will work inside existing hair which is dangerous, and I don't blame them at all. You will see a big difference with 2000. 

Realistically though you would need 3000+ to get full density. But you will need a really experienced doctor, willing to take the risk - cause there is one. Get a quote from Asmed in Turkey he is most of the times willing to take the risk.

Either of the above will make you happy I believe, final choice is on you. I if I was you and since you are young and I believe you will have another one in the future I would be conservative. 

Edited August 20, 2021 by Kharmacoma

[LaserCaps]

This is yet another example that can confuse anyone, even a doctor.  If you look at the very first photo, it almost looks as if the density on the very front is fine.  I'll bet to say most doctors would concentrate on the area right behind the hairline and through the mid scalp.  In later photos, this varies as the hair is rather short and the contrast between the darker hair and the lighter scalp gets in the way .  My first question, what are your goals and what are you trying to accomplish? I am glad you are on Fin. Pls stay on it and consider adding other modalities.  PRP and laser therapy can help reverse the thinning and you may see more enhancement of the native hair.

The 4th and fifth photos are the ones I am most concerned about.  While you are well demarcated in the donor, the crown does look like it can expand.  Remember, if you've shown the propensity to lose, you will continue losing.  I'll bet to say you have family history of hair loss and some with advanced patterns.

Reinforcing the hairline and adding density to the mid scalp may be a good plan.  Once happy, and pending the effectiveness of the medical regimen, you can then consider tackling farther back to minimize the size of the crown.  

Last question, how do you intend to grow your hair? If long, I would take make use of your entire donor and consider FUT.  If very short, FUE.  

 

 

[Future Hair Doc]

Based on the photos you've sent, I think 2k to 2.5 to the frontal 1/3 should work well. A lot of clinics are overly aggressive IMO and don't account for progressive hair loss. Has your hair loss stabilized from the meds?

Edited August 20, 2021 by Dr. Suhail Khokhar

[Melange]

11 minutes ago, Dr. Suhail Khokhar said:

Based on the photos you've sent, I think 2k to 2.5 frontal 1/3 should work well. A lot of clinics are overly aggressive IMO and don't account for progressive hair loss. Has your hair loss stabilized from the meds?

I think it has stabilized, though I'm also not sure. 

[Melange]

33 minutes ago, LaserCaps said:

This is yet another example that can confuse anyone, even a doctor.  If you look at the very first photo, it almost looks as if the density on the very front is fine.  I'll bet to say most doctors would concentrate on the area right behind the hairline and through the mid scalp.  In later photos, this varies as the hair is rather short and the contrast between the darker hair and the lighter scalp gets in the way .  My first question, what are your goals and what are you trying to accomplish? I am glad you are on Fin. Pls stay on it and consider adding other modalities.  PRP and laser therapy can help reverse the thinning and you may see more enhancement of the native hair.

The 4th and fifth photos are the ones I am most concerned about.  While you are well demarcated in the donor, the crown does look like it can expand.  Remember, if you've shown the propensity to lose, you will continue losing.  I'll bet to say you have family history of hair loss and some with advanced patterns.

Reinforcing the hairline and adding density to the mid scalp may be a good plan.  Once happy, and pending the effectiveness of the medical regimen, you can then consider tackling farther back to minimize the size of the crown.  

Last question, how do you intend to grow your hair? If long, I would take make use of your entire donor and consider FUT.  If very short, FUE.  

 

 

I would like to have my hair three length it the longer pictures, as I liked to do a side comb

[MachoVato]

4 hours ago, deeznuts said:

I think it's important to distinguish between what each doctor is trying to accomplish. Maybe Konior is only going the area near the hairline/midscalp in which case 2k seems reasonable. And HLC might be saying... Well, we're going to fix your crown and fill in everything in which case 4k might be more reasonable.

Yeah, I agree with this.

HLC has a bias towards density. So they are surely looking to cover your front and crown. Maybe even potentially lowering your hairline 1cm or so. When you're in the chair, the hairline design and scalp coverage is a conversation. So you'll be able to be more conservative or aggressive with the graft count.

Also, your beard looks like it you could harvest 500 grafts or so from there. 

[Melange]

10 minutes ago, MachoVato said:

Yeah, I agree with this.

HLC has a bias towards density. So they are surely looking to cover your front and crown. Maybe even potentially lowering your hairline 1cm or so. When you're in the chair, the hairline design and scalp coverage is a conversation. So you'll be able to be more conservative or aggressive with the graft count.

Also, your beard looks like it you could harvest 500 grafts or so from there. 

I should have noted earlier that hlc said they are not touching the crown much, they're focusing on the hairline and mid scalp to give cover. They suggested a second operation later for the crown using body/beard hair. 

[MachoVato]

3 minutes ago, Melange said:

I should have noted earlier that hlc said they are not touching the crown much, they're focusing on the hairline and mid scalp to give cover. They suggested a second operation later for the crown using body/beard hair. 

Two procedures is probably a very smart approach. I think 4000 grafts is a lot for your condition. You can see what 4261 grafts look like on my head, and I had much more thinning than you.

Keep in mind that every cm you lower your hairline at 50 grafts/cm2 can be up to 1000 grafts. 

[Melange]

1 hour ago, MachoVato said:

Two procedures is probably a very smart approach. I think 4000 grafts is a lot for your condition. You can see what 4261 grafts look like on my head, and I had much more thinning than you.

Keep in mind that every cm you lower your hairline at 50 grafts/cm2 can be up to 1000 grafts. 

I looked over your first operation with hlc, I honestly feel you had more hair than me. I'm definitely jealous of your donor area. Should I probably get hlc to only do 2000 or so instead? I'm feeling torn on it I should go for the gold, or settle for silver 😅

[MachoVato]

8 minutes ago, Melange said:

I looked over your first operation with hlc, I honestly feel you had more hair than me. I'm definitely jealous of your donor area. Should I probably get hlc to only do 2000 or so instead? I'm feeling torn on it I should go for the gold, or settle for silver 😅

No matter who you go to, that's the conversation you want to have. The plan, you should be given options... 1 procedure or maybe 2 procedures. Here's a good video of a patient from HLC and the hair design process.

 

 

[Melange]

6 hours ago, MachoVato said:

No matter who you go to, that's the conversation you want to have. The plan, you should be given options... 1 procedure or maybe 2 procedures. Here's a good video of a patient from HLC and the hair design process.

 

 

Thanks man, I saw it, very informative. I'll need to look for the 2nd half

[Melange]

I had a consultation with Dr. Melamed at West LA hair restoration. He offered to do 3500 grafts for $12,500. Extraction would be by the artas, implantation by him manually. I'm fairly happy by this offer

[Melvin- Admin]

Realistically you're way better off with FUT first, if you want to maximize the number of grafts. If you were to stick with FUE, I wouldn't go beyond 2,500 grafts for your donor. Now, with FUT you could probably get to 3,500-4,000 if you have good elasticity.