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Hair Transplant
HAIR TRANSPLANT TRANSPLANTS 101 HOW MANY GRAFTS WILL YOU NEED

HAIR TRANSPLANTS 101

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History
How transplants work
Getting natural results
Who are the best candidates
How many grafts will I need
How to choose the right doctor
What to expect after surgery
Glossary
 

H o w   m a n y   g r a f t s   w i l l   y o u   n e e d ?

One of the most frequent questions asked by potential hair transplant patients is: "How many grafts will I need?" The answer should:

•Take realistic expectations into consideration.
•Reflect the patient's degree of hair loss, donor supply, and hair characteristics.
•Be consistent with a long-term Master Plan to address future hair loss.
•Address the number of potential procedures and time commitment required.
•Consider the short and total long-term cost for the patient.

An individual's goals must be realistic. For example, if a person has significant balding (i.e., a Norwood Class 6 or 7 pattern) and fine hair, then he should not expect a full head of transplanted hair. If he does, dissatisfaction will be inevitable. With at least 65-75% of hair lost (the typical loss in Class 6 and 7 patients), a thin head of hair is a realistic and achievable goal. Although a thin head of hair can dramatically improve patient's appearance, if he were to attempt to achieve his original density, he would run out of donor hair before the process could be completed and an unnatural appearance would result.

Not a good hair transplant candidate
   
Not a good hair transplant candidate
   
1st Procedure
Incl Crown
800-1000 -
2nd Procedure   Incl Crown
900-1500 -
   
1st Procedure
Incl Crown
1300-1600 -
2nd Procedure   Incl Crown
1400-2200 -
   
1st Procedure
Incl Crown
800-1000 1100-1300
2nd Procedure   Incl Crown
900-1500 1300-2000
   
1st Procedure
Incl Crown
1100-1400 1500-1800
2nd Procedure   Incl Crown
1200-2000 1700-3000
   
1st Procedure
Incl Crown
1700-2100 -
2nd Procedure   Incl Crown
1800-3600 -
   
1st Procedure
Incl Crown
1500-1800 1900-2400
2nd Procedure   Incl Crown
1700-3000 2100-4000
   
1st Procedure
Incl Crown
2000-2400 -
2nd Procedure   Incl Crown
2000-4400 -
   
1st Procedure
Incl Crown
2000-2400 2400
2nd Procedure   Incl Crown
2200-4600 3000-5600
   
1st Procedure
Incl Crown
2000-2400 -
2nd Procedure   Incl Crown
2200-4800 4000-6600

Working within reasonable expectations, the total number of grafts required for any one patient will depend upon hair and skin color, donor density, scalp laxity the thickness of each hair shaft, the number of hairs in each graft, and the character of the hair itself. The physician must consider these factors and the expectations of the patient in order to calculate the amount of work required. Even when these considerations are combined with the expectations of the patient, the amount of work required to make a person satisfied is sometimes difficult to predict.

Naiveté of the physician, even in those who specialize in hair transplantation, seems to be more common than many care to admit. The failure of the physician to establish realistic expectations often leads to an unhappy patient. This can only be prevented by providing a clear explanation of the hair restoration process, and specifically defining the benefits that the patient may expect to achieve.

How Many Grafts Will Make Me Happy?


When patients ask how many grafts it will take to make them happy, what they are really saying is, "give me back what I lost and I'll be happy." When this is the case, what the bald man really wants is unrealistic; therefore, one must address how much work needs to be done to make the patient satisfied. Satisfaction should be addressed in relative terms to make this problem understandable.

A man who is accustomed to his balding will be easier to please, and will accept a less full appearance than a young man who is starting to lose his hair and who remembers the days when he looked in the mirror and saw the vibrant, full hair of a teenager. The young patient wants his adolescent hairline and density back and will often be satisfied with nothing less. Since surgery is permanent, the hair-restoring surgeon must plan a hairline that will be appropriate for the patient's entire life and he must transplant a density that is consistent with long-term donor reserves. Because of these factors, some young patients are not good candidates for surgery.

The older patient with significant hair loss, on the other hand, will often be ecstatic with his mature hairline restored and a modest amount of natural-looking hair covering his head for the first time in years. For the majority of patients between these two extremes, the physician's careful guidance will help the patient understand what goals can realistically be achieved and whether hair restoration will be worthwhile.

With an understanding of human nature, hair dynamics, and practical issues, we have concluded that it is not always wise to recommend a specific number of grafts as though this number is an absolute amount. Instead, we often recommend transplant sessions of the greatest number of grafts that can be reasonably and safely moved within the confines of four important constraints listed below.

1. The patient's goals.
2. The projected pattern of hair loss in a worst-case scenario, as determined by heredity, age and physical examination.
3. The amount of hair in the permanent zone (donor area) that can be safely transplanted (this is related to a number of physical factors including donor. density and scalp laxity and should be assessed by the doctor at the time of consultation)
4. Economic and time constraints of the patient.

The Physician's goal is to help the patient understand how close he or she can come to meeting personal needs and expectations, how much the hair restoration will cost, and how many sessions it is likely to require. Do not start the hair restoration process unless you understand what it will take to finish it. With proper planning, satisfaction is easy to achieve.

Keep in mind that the transplantable hair numbers generally reflect an average amount of total hair that can be moved and applied to one's hair loss. This movable hair can be transplanted in one or multiple sessions depending on the four factors above and your doctor's skill and experience. For example, if procedures are limited to only 100 grafts each, then patients will be committed to an extended number of surgical sessions. Possibly not obvious at the onset, such extended treatment sessions often end with the patient losing interest. Financial or personal reasons may also cause the patient to fail to complete the treatment course. Just as important, multiple, small procedures move hair inefficiently and waste precious donor supply.

The impact of the transplant depends both upon the distribution of grafts as the absolute number used. Nonetheless, it is still useful for the patient anticipating surgery to have a general idea of the numbers required, both for the initial procedure and for subsequent sessions.



Information Provided Courtesy of The New Hair Institute, taken from "The Patient's Guide to Hair Transplantation" William R. Rassman, M.D. and Robert M. Bernstein, M.D.

 
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