grafts counting

[duchaine]

I will tell you my experience about grafts counting and I will share with you my perplexities about the real amount of graft that I got.
NOTE: I can't say if all the doctors and all the clinics calculate grafts in the same way.


1) hairline design and area measurement 

The doc designed the hairline.
Then he put a plastic transparent sheet on my head and retraced the hairline on the head.
The sheet had squares on it. Every square was 1x1cm, so 1 cm2.
In my case, he calculated 41 cm2 (the doc wrote the number on my head)

2) follicular units calculation

After the doc calculated the area, he decided the density
In my case, he said that I needed 50 FU/cm2, so he concluded that I needed 2050 FH

 

My perplexities

1) wrong measurement of the recipient area.

If the design barely touched one square, the doc calculated) 1 cm2.To show you what I mean, I attach a pic.
In the pic that I attached, I calculated the area as the doctor calculated the area for me.
So, using their method (if the line barely touches the square, is considered 1), the end result is 19 cm2.
But, if you see the image, you understand that the area is smaller, because some squares are not completely filled.
So, if the squares were not completely filled, the recipient area was obviously smaller than they said.
To see if I was right, I tried to calculate the trasnplanted area by myself.
It is not an easy operation, because all the surfaces are elliptical. I won't bother you with the calculations I made but my  friend (an engineer)  said they are ok.
The real treated area was 36 cm2
Making the math, 2050:36=56,94 FU/cm2.


2) bogus follicular unit calculation
If you see my pic, you will see that most of the recipient area still had hair.
I suppose that an area that has hair is not able (and in any case, has no need) to receive 50FU. Usually, from my readings, I see that the area should receive something between 30-40 FU/Cm2.
Because I am doing the math in good faith, let say 40.
Considering that half of the area was covered by by hair, that means 18X40=720 FU. Ok, we say 750 to be fair.

 

CONCLUSIONS:

If the clinic really extracted 2050 FU, according the the previous calculation, we have some really bogus number for hairless area.
According to that calculations, the hairless area got 1300 (2050-750=1300)
We said that the hairless area was 18 cm2
Now, 1300:18= 72 FU/Cm2.
That is not what I got and, for sure, is not the density I have.


 

Edited December 2, 2023 by duchaine

[gillenator]

The biggest flaw that I see is that this approach calculates the restored density at the same level (number) irrespective of each individual (1cm) squared area and does not consider the variations of graft size…obviously this would have a huge bearing on visual density…regardless, the density levels on any scalp are going to vary and why surgical hair restoration must be a subjective approach, not a precise numerical count for each area…and no I have not seen any other clinic take this same approach to substantiate a plan for the recipient area.

[Gatsby]

Everyone is an individual case when it comes to hair transplantation. Hair can be thicker, curlier, different colors, etc. There is never an exact cookie cutter approach. After the biology of surgery is mastered then this is when art is what it all comes down to. No two canvasses are the same.

[duchaine]

@gillenator @Gatsby

If agree with you but what you said is not relevant to my topic.
I am talking about my case, where I paid for 2050 FU.
I have some doubts that I really got 2050 FU.
First of all, they said that the recipient area was 41, while il was 36.
Second, they said that the recipient area was going to receive 50 FU cm2 but, considering that the area was smaller than they said and part of that area was covered of hair, in the "bold area" I should have get 70+ FU/cm2.
I don't think I got so much FU...

[duchaine]

1 hour ago, gillenator said:

 no I have not seen any other clinic take this same approach to substantiate a plan for the recipient area.

Because you have more experience than me, can you explain me please how other clinics calculate the number of grafts that need to be used?
I suppose that, after the doctor sees me and say "ok, you need hair in this area", he will "analyze" my hair and will say "guy, you have medium caliber hair, to get a good coverage effect you need X amount of FU/cm2". After this, what happens?

[gillenator]

My initial reply is more related to the flaws that I see in their approach.

Now please allow me to respond with some advice that I often convey to patients in ascertaining and an accurate accounting of grafts that are paid in advance…Always insist that the surgical staff “charts” the graft count that are being placed according to graft size and exact placement in a defined surface area that is clearly marked…after all grafts are placed, the recipient area needs to be photographed with all photos provided to the patient at checkout, NO EXCEPTIONS…photos taken before any placement and along the way as each section within the recipient zones are filled in accordance with the written surgery plan…this approach also provides a basis to track regrowth rates and yields…your chart should clearly document how many grafts were extracted by size: i.e. (total # of singles, doubles, triples, etc.) the photos should show and confirm the same total number that you paid for…make them account for EVERY graft that you paid for…all of this needs to be discussed beforehand at the time you schedule your procedure date.

[duchaine]

1 hour ago, gillenator said:

My initial reply is more related to the flaws that I see in their approach.

Now please allow me to respond with some advice that I often convey to patients in ascertaining and an accurate accounting of grafts that are paid in advance…Always insist that the surgical staff “charts” the graft count that are being placed according to graft size and exact placement in a defined surface area that is clearly marked…after all grafts are placed, the recipient area needs to be photographed with all photos provided to the patient at checkout, NO EXCEPTIONS…photos taken before any placement and along the way as each section within the recipient zones are filled in accordance with the written surgery plan…this approach also provides a basis to track regrowth rates and yields…your chart should clearly document how many grafts were extracted by size: i.e. (total # of singles, doubles, triples, etc.) the photos should show and confirm the same total number that you paid for…make them account for EVERY graft that you paid for…all of this needs to be discussed beforehand at the time you schedule your procedure date.

Thank you!
I think this is an ethical and smart approach!

[gillenator]

Thank you my friend…the key is to make them accountable…for every graft!

[gillenator]

I forgot to mention that every patient is entitled to a copy of their chart.