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Graft survival rate


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Here's another question for the docs. The other day somebody asked me what the HT graft survival rate is, and I had to admit that I had no idea, though I would guess that it is in the 90-95% range for follicular units. How would you measure this? You can't really just count them!

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Here's another question for the docs. The other day somebody asked me what the HT graft survival rate is, and I had to admit that I had no idea, though I would guess that it is in the 90-95% range for follicular units. How would you measure this? You can't really just count them!

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Gary, A number of studies have been conducted in the past few years to determine survival of hairs in various size grafts. To start with minigrafts, I did a study 4 years ago on survival of minigrafts placed only at the third session and which were placed in the very center of a large transplant session (excluding the first two sessions) and found a 94.5% survival. Dr. Walter Unger last year did a study on minigrafts placed at the first session in "virgin scalp" and obtained a 100% survival. Several studies have been done on survival of hairs in follicular unit grafts, but the results vary tremendously. Dr. Seager and I both conducted studies on "skinny" FU's compared to "chubby" FU's (with more tissue left around the graft) and we both found around a 90-95% survival of the skinny ones and 113% and 133% respectively in the "chubby" ones. Our assumption was that the tissue around the grafts held unseen "telogen stage" hairs that later grew out. Dr. Limmer obtained around 95% survival in a study on FU survival, as long as they were placed within 6 hours. The bottom line on FU survival is probably that it depends tremendously on the conscientousness of the doctor and his staff, the care that they take in being gentle with the grafts, keeping them moist (probably the most important factor of all), and being skillful and reasonably speedy in the placing of the grafts, so that they are not out of the body for an undue length of time. I hope that helps answer your question.

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Dr. Beehmer,

 

Thanks for the detailed answer. It's interesting that it is actually possible to get more than 100% (hair count) with the "chubby" grafts. I was thinking in terms of just the grafts themselves, not hairs, but I guess hair count is what really matters!

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Very interesting. I would not have thought to ask a prospective Dr. as to which types they use. I would hope those performing FU procedure's use primarily Chubbies....

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Dear Alex:

 

The answer to chubby versus skinny grafts is not totally resolved. The reasons why chubby grafts resulted in more hairs may relate to more telogen hairs.The studies that were done wer relatively small and we mat need more data to be sure. Hair counts are very difficult to perform

 

In our practice,when we perform grafts on people who have grey or white hair we tend to use "chubbier" grafts in an effort to avoid damaging hairs and perhaps avoid cutting out telogen hairs.

 

In discussing overall graft survival one should also be concerned with the number of viable grafts available from the donor hair.That is to say if one obtains "more" hair from chubby grafts, is the net result zero or less than zero if more hairs are lost in the harvesting phase and cutting of grafts.It is thus important to find out how the grafts were obtained. Far more hairs may be lost as a result of transection in the harvesting phase. If multiblades are utilized there is a grater chance of transected hairs. Similarly there will be a greater chance of transection with punch graft harvesting.You should know that some controversy exists around transected hairs,as some of these hairs can grow;that is an entirely separate issue.

 

As Dr Beehner pointed out there are many other variables related to graft survival.There can be difficulties in harvesting, cutting and placement.

 

I would also like to add that I differ to a degree with those who favor "chubby" grafts all of the time.I compare a skinny graft to a split thickness skin grafts and a chubby graft to a full thickness skin graft. The fact is that split thickness graft have a greater chance of suvival than full thickness grafts. This is because the distance for diffusion of nutrients (blood-oxygen-glucose etc)is less.Similarly the skinny graft should allow easier diffusion.

 

I initiated a study of skinny. medium, and chubby grafts at last years meeting in Orlando. Hopefully we will have data from that to add to the discourse.

 

PaulT.Rose,MD

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All this talk about skinny vs chubby grafts has made me think of another question. We all have seen cross a section illustration of a hair follicle. What I was wondering is, what is the depth of the hair follicle below the skin surface? In other words, if "skinny" and "chubby" refer to the width or diameter of a graft, what is the length of the graft and the length of the follicle? I guess this also could be referred to as the vertical dimension of the follicle/graft as opposed to the horizontal dimension.

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Just want to thank Dr. Rose and Dr. Beehner for taking time to answer our questions here.

 

Taking the time to listen and caring enough to respond in detail is what makes them not only great posters but great surgeons.

 

Pat - moderator

 

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  • 1 month later...

From reading all the above messages, is the concensus that a person with thicker, coarse hair transplants will take longer to begin growing than someone with thinner hair?

By that logic, does hair transplanted in a thinning area take longer to begin growing than in transplanted into a completely bald spot?

I had my first procedure 4 months ago (650 grafts) with hair transplanted into a thinning part of my scalp and I can still fell many of the new transplanted hair stubs on my scalp that haven't started growing yet. In addition, my hair itself is thick and coarse.

Should I wait a little longer before calling my surgeon to complain?

 

Thanks.

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