How many grafts do you think is required for my head?

[Jonny6]

So I have been looking into getting a hair transplant for the last couple of months, and I have been told different things from different companies. I am 27 years old from the United States. Some questions I have are:

How many grafts, follicles, and hairs do I need?

How many grafts can be extracted from a single session? Looking at my donor area, how many grafts can I receive at a maximum?

How many sessions do I need? I have been told I need 2 sessions, but other companies tell me just 1 is needed. How long should I wait between sessions?

Any advice is appreciated, thank you.

[Viney]

I have no idea how many grafts would be required but I think two sessions would definitely be wise. Start with the hairline then consider the crown at a later date. Ensure whoever is performing the first session plans carefully to ensure there's enough left in your donor for the second.

It's also probably worthwhile having someone take in person donor density measurements to see what you have to work with for a transplant.

You're still quite young and may be prone to further hair loss. Are you taking any medication to stabilise this?

Edited March 23, 2022 by Viney

[Britanium]

Proceed with extreme caution, you have a very high Norwood level already and also retrograde Alopecia. This would be a very challenging case. I would automatically say you need someone like Eugenix/Bisanga to consult with, both are very good with honest feedback. Be very wary of a clinic just accepting you without much thought of how it could end up. If it’s at all possible it would be multiple procedures and involve BHT, Beard/Chest hair. 

Edited March 23, 2022 by J.A.C

[Britanium]

And yes unless your on a med regime and stabilised the loss I wouldn’t even consider a procedure at this point. With what seems like multiple hair loss/thinning issues I think your just going to struggle. Seeing a dermatologist and/or a decent Clinic in person consultation is needed here. 

[Jonny6]

@VineyI am not taking any medications right now.

[NARMAK]

Just now, Jonny6 said:

@VineyI am not taking any medications right now.

You should very much consider getting on medication right now. Your hair loss is very much aggressive in terms of the overall pattern you have looking at the top down view and the donor area near the bottom looks like it's really affected by retrograde alopecia. 

You should do the following imo:

*Start 1mg Finasteride everyday if possible or taper use up till you get to everyday

*Start Minoxidil and combine with Microneedling once a week at 1mm to 1.5mm depth. 

*Use Nizoral 2% ketoconazole shampoo. You might not have a pot of hair with your top scalp at present, but this could help with some small Anti-Androgen effect. 

Ultimately i would strongly urge you to stick to a routine of medication and hair restoration for probably the next 12-24 months consistently and see how things shake out. In that time, save up, educate yourself on the hair transplants and send out consultations to see what the clinics think could be required. 

Anything you can regrow or save with medication will stand you in a significantly better position but the treatments are only as effective as long as you take them. So it is either indefinite or as long as you decide you want that hair. 

[Nw7HPE]

How s your beard ?

[Rahal Hair Transplant]

Jonny,

Because you have advanced balding similar to what I had prior to undergoing any hair transplant procedures, in my opinion you’ll need at least two mega sessions to produced any kind of coverage and density.   As far as the number of grafts as a very rough estimate I’d say approximately 7500 or more if you have the donor hair for it.

I have explained this before but for frame a reference to help you I will explain it again.  The human head has approximately 100,000 hairs and at an average of 2.2 hairs per follicular unit that leaves 45454 grafts - half of which make up the tip portion of the scalp (22727 grafts) - which is approximately a Norwood 5A pattern which is probably around where you fall.  Since hair loss is not typically noticeable unless you lose 50% of the hair in a concentrated area, you would only need 11,364 grafts on a Norwood 5A area assuming you were completely bald on top.

Now, obviously most people don’t have that many grafts available for transplanting but with proper placement and depending on patient characteristics, such as the size of an individual’s hair shaft, scalp to hair color contrast ratio, etc. - physicians can create quite spectacular results with less assuming growth yield is high.

You’ll still find that even the dentist of looking hair transplants Will appear a little thin under certain lighting conditions and possibly at certain angles, etc.   but you’ll be pretty amazed at what can be accomplished with today’s modern restoration surgery.

Now the above are a bunch of generalities and doesn’t include certain variables such as the size of the patient’s scalp, etc.  and the various graft estimates you received I likely because position philosophy varies and some doctors will use some double follicular units (DFUs) which are essentially two units combined and refer to them as one graft.

It can be very confusing however, as long as you’re done your research and are common certain you’ve selected regularly produces natural and dense looking results,  you will be in good hands.

Best wishes,

Rahal Hair Transplant 

[Future Hair Doc]

As others have mentioned, you should see your doctor and inquire about starting meds ASAP. My regimen is oral dutasteride 0.5mg every other day and oral minoxidil 2.5mg daily. You have retrograde alopecia as well and your NW level is also high. You might be able to regrow back some hairs and improve your NW level and thus require less grafts via surgery. I suggest taking meds consistently for at least 1 year to gauge your progress. In the interim, save up money for a great surgeon. Do you have good beard and chest hair? Where in the US are you located?