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How many grafts you guys think I need?


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Hi all, just seeing what you folks think in terms of graft number needed. I'm fine with being conservative on the hairline as long as I get the crown covered. 3rd pic is fresh out of the shower and hair pushed down. I figure I will need a 2nd HT at some point to cover the area between the crown and hairline, but for now it's fine. Been on Min for 1 month so hoping that will help too. 

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The crown needs about 2,500. Your hairline depends on whether you want to reinforce it with more density or lower it. If you want to lower it, you will need at least another 2,000 grafts. 

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To fill in the sides and front and to advance the hairline a little is about 2,500 grafts. I think the crown needs about 2,000 grafts. Have you had any consults yet? If so, what did the surgeons say? Are you on oral minoxidil? How about finasteride?

Edited by Buck Naked
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Awesome thanks for the answer.

When you say "reinforce" versus "lower", reinforce would basically mean filling in the recessed areas in the corners? My goal is to go as long as possible before needing a 2nd HT  so I think reinforcing would better in this regard? 

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2 minutes ago, Buck Naked said:

To fill in the sides and front and to advance the hairline a little is about 2,500 grafts. I think the crown needs about 2,000 grafts. Have you had any consults yet? If so, what did the surgeons say? Are you on oral minoxidil? How about finasteride?

I've had a few consults. The only one I remember is with Nader and was told 2500-3000 for the hairline and 1000-1500 for the crown. But I'm worried this wont give me the coverage I want on the crown. 

I am on liquid min for 1 month and not on fin at all. Is the oral min supposed to work better? 

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25 minutes ago, GoliGoliGoli said:

I've had a few consults. The only one I remember is with Nader and was told 2500-3000 for the hairline and 1000-1500 for the crown. But I'm worried this wont give me the coverage I want on the crown. 

I am on liquid min for 1 month and not on fin at all. Is the oral min supposed to work better? 

I think in the hands of a great surgeon about 1,500 for the crown can be down. The 2,500-3,000 grafts for the front makes sense. Yeah, oral minoxidil is better. Have you tried finasteride? If not, get on finasteride ASAP.

Edited by Buck Naked
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Posted (edited)

Since I'm capped at 4000 grafts, I might go for 2000 on crown and 2000 on hairline. Does this seem like a decent enough plan? @Melvin- Moderator   @Buck Naked

 

I should say, despite how the picture looks I don't think I need to lower my hairline very much. My forehead looks huge in original picture, but isn't so bad with how I wear my hair. Here is another pic of me with it styled to cover it up. 

image.jpeg

Edited by GoliGoliGoli
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Posted (edited)
6 minutes ago, Buck Naked said:

I think the hands of a great surgeon about 1,500 for the crown can be down. The 2,500-3,000 grafts for the front makes sense. Yeah, oral minoxidil is better. Have you tried finasteride? If not, get on finasteride ASAP.

TBH I'm really not interested in trying oral or topical fin. I don't like taking any medicines really if I can avoid it, and generally don't trust the pharmaceutical industry (Despite working in it). I'm also ok with getting a 2nd HT if/when needed and would rather do that than get on fin

Edited by GoliGoliGoli
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1 minute ago, GoliGoliGoli said:

FUE. Curious as to why this would impact graft # needed? 

You mentioned cap of 4k grafts, usualy when donor is limited in some way,  pro FUT surgens would recomend strip to not deplete donor. Was your donor examined in person? 

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4 minutes ago, civic said:

You mentioned cap of 4k grafts, usualy when donor is limited in some way,  pro FUT surgens would recomend strip to not deplete donor. Was your donor examined in person? 

If anything I think I have a pretty strong donor, but I have never had it examined in person. But I have always had very thick hair, and my hair in the donor area feels super thick to me just like it did when I was 16. 

Regardless, I thought 4k was the max grafts for any procedure just because you don't want swelling to be too brutal and follices to be competing for blood supply? I don't think the 4k max is lifetime, just per surgery

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1 minute ago, GoliGoliGoli said:

If anything I think I have a pretty strong donor, but I have never had it examined in person. But I have always had very thick hair, and my hair in the donor area feels super thick to me just like it did when I was 16. 

Regardless, I thought 4k was the max grafts for any procedure just because you don't want swelling to be too brutal and follices to be competing for blood supply? I don't think the 4k max is lifetime, just per surgery

FUE can be split over 2 days, so 4-5k grafts over 2 days is ok with the right surgen. I don't think you need that many. See recent posts of recomended surgens , Dr Taleb posted update of patient he did around 1.7 k grafts & it looks fantastic, there are very good surgens here who work with less grafts & produce amazing results.

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3 minutes ago, Gramatik said:

2.5 k grafts for front and 2k grafts for crown. Total 4500+ grafts you need for both Parts. 

Do you think I could get away with 2k front and 2k crown? Like I said I'm limited to 4k grafts per procedure 

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Goligoligoli,

The crown is often referred to as the black hole for grafts because it often takes a larger number of follicular units to re-create any real coverage and density. That said, while re-creating density in the crown takes very large number, adding just enough for coverage can go along way.  That said, I do agree that somewhere between 2000 and 3000 grafts in the crown would go along way. The actual number would depend on number of factors including hair shaft diameter, the actual size of the area to cover and hair color to scalp color contrast ratio.

As far as the hairline is concerned, I’d suggest probably around 2500 grafts to re-create a conservative looking hairline, refine the temple points and fill in some of the thinning areas in the frontal region.

Now, keep in mind that this is just my opinion and not the doctors actual estimate. I’m just basing these numbers strictly on my opinion and experience and the photos you presented.

Let me know if you need any additional assistance.

Best wishes,

Rahal Hair Transplant 


 

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Rahal Hair Transplant Institute - Answers to questions, posts or any comments from this account should not be taken or construed as medical advice.    All comments are the personal opinions of the poster.  

Dr. Rahal is a member of the Coalition of Independent of Hair Restoration Physicians.

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Talking realistically your crown needs 4000 grafts to look decently full. The crown is a black hole and it always requires a lot more grafts than you think. But of course you don't want to trynna do 4000 grafts in one go. That would be a huge mistake....

Get on medication first. Take your time. Do your due diligence. Research. 

I always recommend people to do a small test surgery i order to evaluate the survival rate and avoid big sessions and thus potentially wasting forever your limited grafts...

You are somewhere between Norwood 3V and Norwood 4. 

But I don't like the Norwood scale.

There are dozens of balding patterns that are not included in the Norwood scale. For example diffuse thinners...

Also the Norwood scale does not really measure your degree of baldness. It only shows SOME of the male balding patterns. That is the key thing to understand.  

For example you can be miniaturizing in a Norwood 6 pattern but still have a lot of hair. 

Actually an early Norwood 6 diffuse thinner will often have a lot more hair in appareance than someone who is Norwood 4 with a slick bald spot and no hairline but no miniaturization beyond the whorl unlike the Norwood 6 diffuse. You know what I'm sayin brah ? 

Also there are many different types of Norwood 5s or Norwood 4s for example. 

You can be an early Norwood 5 diffuse thinner with still 90% of your hair except all your hairs on top are beginning to thin, you can be a Norwood 5 with completely gone hairline but just slight thinning in the crown, you could be a slick bald Norwood 5 with huge bald spot etc...

The Norwood scale doesn't mean much. 

 

Edited by Jason Blaha
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17 minutes ago, Jason Blaha said:

Talking realistically your crown needs 4000 grafts to look decently full. The crown is a black hole and it always requires a lot more grafts than you think. But of course you don't want to trynna do 4000 grafts in one go. That would be a huge mistake....

Get on medication first. Take your time. Do your due diligence. Research. 

 

Wow tbh that is a bit discouraging to here 4000 to look "decently" full. Makes me re-consider getting a HT at all. 

I'm on minoxodil for about a month, but no real interest in starting on fin. 

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If your crown expands, 4000 is definitely necessary. However, your current hair loss, 2,500 should suffice. The key is preventing further hair loss. 

Check out my final hair transplant journey

My Final Hair Transplant Journey (Over 9K Total FUE Grafts) 

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Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

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Per our graft calculator. Keep in mind this 40 grafts per cm2, which is reasonable density, but will not be ultra full, as a hairline of 60 grafts per cm2 would be. 

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Check out my final hair transplant journey

My Final Hair Transplant Journey (Over 9K Total FUE Grafts) 

View my thread

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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You are 3V on the Norwood Hamilton Scale of baldness. For the frontal zone you shall require around 2000 to 2500 grafts depending on the hairline you choose. For the crown, you shall require 1500 to 1700 grafts with adequate density.

You shall also require finasteride. This medication can help prolong baldness as long as you take it. You can take finasteride for a couple of months and then observe it's effects in your case and then accordingly decide whether to take it or not.

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