How are the number of grafts determined?

[Sunset Dune]

Hey guys, I have a hair transplant scheduled in a couple months at H&W clinic in Vancouver Canada. I’ve been emailing back and forth with one of their employees, I asked them “How will the final graft number be determined?”

Their response:

“The final number of grafts will be decided by many factors which Dr. Hasson will determine the day of surgery.”

 

Again I ask:

“What factors are those exactly that determines the final number of grafts?”

Their response was: 

“The factors that determine how many grafts you have will be the amount of donor hair you have and the amount of scalp laxity there is.  They can usually only determine the final number once they are extracting the grafts and that’s why they won’t know until you are in surgery”

 

This final response was very alarming for me, what do they mean they can only determine the final number once they are extracting the grafts during surgery??

I thought the number of grafts required would be determined from a visual examination of the scalp by the doctor BEFORE surgery not during surgery! And that’s also the same time when the doctor outlines the new hairline design and determine number of grafts at that time. 
 

Pardon my ignorance but am I missing something here? 

[BackFromTheBrink]

It sounds like they are talking about an FUT procedure. 

They'll extract a strip, the size of which they will determine based on the amount of grafts they believe you'll need.

They'll only know the final number when they've cut up the strip and counted them.

So, they're answering your questions very literally.

What they'll do is examine your scalp and assess your loss.  Look at your donor area, the density, number of hairs per follecular unit etc. With strips they'll be able to get a larger strip if you have good scalp laxity. 

Armed with that, and an estimate on the number of grafts they think they can get, they'll then be able to plan the hairline and work with you to find an agreeable plan. 

On the day they may get more grafts than they forecast, and we able to change the design slightly.

 

 

Edited February 17, 2023 by BackFromTheBrink

[LaserCaps]

Before anything starts, you'll have the opportunity to visit with the doctor.  He'll confirm your candidacy and give you his recommendation.  He'll confirm you have no skin conditions, check density, what the Norwood pattern is, etc.  He will then give you a range of grafts.  Just for the sake of argument, let's say he tells you 2000-2500 grafts.  It's typically not what you need but what he estimates he can harvest from the donor at any one time.  Either FUT or FUE.  Patients will normally want to the the max.  The more grafts, the better the results.  At the end of the day, whatever the yield was, will be exactly what you will pay.  Why is it done this way?

Once you're under a local anesthetic, no one can talk to you about money.  So you'll be asked to pay in advance for whatever number you decide. The clinic, provided they're ethical, will refund at the end of the day. What if there are more?

A clinic could just give them to you for free.  This is what I refer to as building intrinsic value.  Clinics that charge you more money at the end of the day without saying a word, in my view, are just swindlers.  Have that conversation in the morning to avoid ugly interactions later on. 

[shiba1985]

you have selected a very experienced doctor, i am assuming you selected him for a reason. dont second guess yourself and trust he will do what is best for your situation. Your main focus should be conveying you goals, and expectations. The rest let him detrmine. 

Read that again :  Explain your goal in the clearest way possible so the surgeon knows exactly what you want. Dont worry about how you detrmine the grafts needed etc. It takes time and experience, and some of it is subjective. 

[Sunset Dune]

1 hour ago, BackFromTheBrink said:

It sounds like they are talking about an FUT procedure. 

They'll extract a strip, the size of which they will determine based on the amount of grafts they believe you'll need.

They'll only know the final number when they've cut up the strip and counted them.

So, they're answering your questions very literally.

What they'll do is examine your scalp and assess your loss.  Look at your donor area, the density, number of hairs per follecular unit etc. With strips they'll be able to get a larger strip if you have good scalp laxity. 

Armed with that, and an estimate on the number of grafts they think they can get, they'll then be able to plan the hairline and work with you to find an agreeable plan. 

On the day they may get more grafts than they forecast, and we able to change the design slightly.

 

 

No this is going to be an FUE procedure

[BackFromTheBrink]

2 minutes ago, Sunset Dune said:

No this is going to be an FUE procedure

I'm not sure why laxity has anything to do with it then.

Usually doctors will give a FUE estimate, and a margin of a few percent that they'll include in the quoted price.