Is there an increased risk for doing megasessions? Lower yield?

[HairRun]

I'm thinking for each extra grafts, you're doing more damage to both the donor area, and then again the recipient area. During my last surgery I preferred to have less grafts done and more conservative hairline, and then build it up later, so that I can focus all of my healing on the few grafts and smaller FUT incision, and thus increasing the chance of graft survivability. Also, the surgeon and the team can put more focus on a fewer number of grafts. 

However, I never see any recommendations for doing smaller batch sessions instead of one big mega session. Thoughts? 

 

 

[Melvin- Admin]

There's more risk, but also more reward. It depends on the clinic, there are a few clinics that specialize in megasessions. Dr. Pittella, Eugenix and H&W are the top 3. 

[GoliGoliGoli]

Real question is what number of grafts defines a mega session? Anything over 4000? 

[shiba1985]

110% . Risk increases with mega sessions greater than 2500-3000 including

overharvesting of donor
shock loss that’s temporary

shock loss that’s permanent 

 

[Al - Moderator]

Since you had FUT one risk with a larger session is a wider scar. The Dr has to cut out a wider section, so the tension when closing is it greater which is what causes scar stretching. Smaller FUT sessions will have less tension and have a much greater chance of leaving you with a very thin scar.

 

Edited September 27, 2022 by BeHappy

[mr_peanutbutter]

On 9/27/2022 at 4:10 AM, Melvin- Moderator said:

There's more risk, but also more reward. It depends on the clinic, there are a few clinics that specialize in megasessions. Dr. Pittella, Eugenix and H&W are the top 3. 

why more reward?

[shiba1985]

I strongly believe that the best possible way to get the greatest hair is to do multiple small procedures (1-2k) over multiple sessions over a few years. Unfortunately most patients don’t have the patience for that. 
 

you hear the adage on this forum “you didn’t become bald overnight it took 10+years” yet most patients won’t even commit to a 2-3 year journey to get the hair back. 

[HairRun]

1 hour ago, shiba1985 said:

I strongly believe that the best possible way to get the greatest hair is to do multiple small procedures (1-2k) over multiple sessions over a few years. Unfortunately most patients don’t have the patience for that. 
 

you hear the adage on this forum “you didn’t become bald overnight it took 10+years” yet most patients won’t even commit to a 2-3 year journey to get the hair back. 

Assuming you're doing different areas, [vertex, mid scalp, front, etc] , what's the ideal wait time between procedures? 

[Curious25]

2 minutes ago, HairRun said:

Assuming you're doing different areas, [vertex, mid scalp, front, etc] , what's the ideal wait time between procedures? 

9 months + 

[Z--]

1 hour ago, shiba1985 said:

I strongly believe that the best possible way to get the greatest hair is to do multiple small procedures (1-2k) over multiple sessions over a few years. Unfortunately most patients don’t have the patience for that. 
 

you hear the adage on this forum “you didn’t become bald overnight it took 10+years” yet most patients won’t even commit to a 2-3 year journey to get the hair back. 

100% this. The only benefit of a mega-session is that you can have the results sooner and save on multiple travel costs. I am not aware of a single benefit beyond the above when compared to many smaller sessions (e.g. 3,000 or less).

[GoliGoliGoli]

So is the consensus opinion that anything over 3000 grafts is a mega session?

[Melvin- Admin]

2 hours ago, mr_peanutbutter said:

why more reward?

More hair in less time.

[Z--]

12 minutes ago, GoliGoliGoli said:

So is the consensus opinion that anything over 3000 grafts is a mega session?

Imo, I think 4,000 is 100% mega-session territory. 3,000 is debatable and i probably spoke too soon.

[MisterBreakfast]

If you are going FUT, there are a few variables involved.  A lot of surgeons tend to agree that reopening the first scar can increase risk of a wider scar later on.

 

FUE, if you make too many holes in a square CM, you can over harvest and kill other donor grafts.

 

Plus side is, if you are like me and have a large area to cover, you can minimize your downtime due to less surgeries.  My thought also is to go bigger on my first, and if it fails, I can give up, cover the scars with SMP or another FUE, and forget about it.  In my mind its better than having your 2nd or 3rd fail randomly and being stuck with a big patch somewhere you weren't planning on.

[GoliGoliGoli]

24 minutes ago, MisterBreakfast said:

If you are going FUT, there are a few variables involved.  A lot of surgeons tend to agree that reopening the first scar can increase risk of a wider scar later on.

 

FUE, if you make too many holes in a square CM, you can over harvest and kill other donor grafts.

 

Plus side is, if you are like me and have a large area to cover, you can minimize your downtime due to less surgeries.  My thought also is to go bigger on my first, and if it fails, I can give up, cover the scars with SMP or another FUE, and forget about it.  In my mind its better than having your 2nd or 3rd fail randomly and being stuck with a big patch somewhere you weren't planning on.

I don't get your logic, how does your 2nd and 3rd failing mean more liklihood of being stuck with a big patch as opposed to your first failing? 

[Doron Harati]

Mega sessions like 5000+ grafts can be done if the donor area is very strong much above average with FUE, meaning it won't be overharveste if the clinic know how to do the job well.

Edited September 28, 2022 by Doron Harati

[MisterBreakfast]

30 minutes ago, GoliGoliGoli said:

I don't get your logic, how does your 2nd and 3rd failing mean more liklihood of being stuck with a big patch as opposed to your first failing? 

Let's imagine you need multiple surgeries... you are likely norwood 4+, because lesser norwoods can get away with smaller proceedures.

Let's say you get a first surgery of 2000 grafts and it works.  Now you need to do the midscalp or crown.  Let's say that fails.  Now you have not completed your plan and you have used a large portion of your donor.  The question is do you blow the rest of your donor, or are you happy with an incomplete result.

Now let's say your doing your first surgery of 2000 and it fails.  You are still norwood 4+.  You don't have incomplete results.  Now you have the choice to do nothing or try again with a modified plan.  In my mind, this is leaves you with more options.