Thank you for your question. You are asking what is the
recommended number of grafts that you can have in a given session. Also you expressed
a concern about megassesions and about survivability. Well certainly you asked a question wherein
you will get a lot of opinions regarding the best number of grafts to do in a given session.
I’ll tell you our perspective and our approach in our practice. A little bit of background,
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon. I have been doing hair transplant for many years and we in fact
developed a non-surgical alternative based on this very challenge of maximizing the yield
of a hair transplant which ultimately limited by several factors including graft survivability.
The company we developed is called TrichoStem™ Hair Regeneration and this is a non-surgical
treatment for hair thinning that we developed in our practice.
To get back to this concept, I’ll tell you how I make this decision with my patients.
First, there is realistic number of hairs that you can place in a square centimeter
so instead of thinking large numbers, you can think of the area that you want to get
covered. So unfortunately or the harsh reality is when you ask a typical male pattern hair
loss patient who frequently comes who are more advanced with hair loss and we will discuss
the options and recommendations which tend to be, in my opinion, to put more towards
the front and towards the center and less towards the back because you just don’t
have enough grafts. But invariably, patients want the front, the middle, the back and everything
covered. And although you may spread the army out and from the limitation of number of grafts
you can harvest, you are not getting the density and the volume. So what I do is I draw squares
and I’ll say this is the number of square centimeters we want to cover. Now realistically
in my experience, you can place no more than 20 hairs per square centimeter. There are
more than a few hair transplant doctors who claim they can do 75-100 which may be true
in terms of method but how much of those hairs will survive? I came from a background of
eye surgery and I am very good with my hands. I am a cosmetic surgeon and I do a lot of
very delicate fine particular surgery but I can tell you it is not the placement that’s
not the challenge but it is the health of the tissue that you are placing the grafts
in. If you make too many openings in the skin, you compromise the circulation and so the
grafts will not survive.
We developed in fact a system first to try to help the grafts survive better using a
material called Acellular matrix. One of the benefits that we are able to achieve was better
graft survivability. Another benefit was improvement of healing in the donor area and we also saw
thinning hairs get thicker. And so we developed Hair Regeneration which is a non-surgical
treatment that we do separately from hair transplant. Basically the majority of male
and female who come to consider hair transplant as an option have thinning hair and so what
we are able to do is with this injection stop the progression of hair loss. We are able
to stop, we are able to reactivate the hairs that are not growing as well as cause hairs
that are thinning to shed and thicker hairs to grow in. In fact non-surgically, we are
able to achieve results which actually exceed one, if not two, hair transplants in the right
candidate.
So the question that you are asking is also an opportunity for you to explore other options
in addition to hair transplant. The reality is if you are too far along and you have lost
a lot of hair, yes transplant will ultimately bring you where you want to be but stabilization
is very important. If you are able too stable and thicken what you got then every hair that
is salvaged is the hair that doesn’t need to be transplanted.
I share your concerns and I would say that being conservative is better because you want
to protect the hairs which are limited in supply. I always feel bad for people who don’t
have any hair from a hair transplant because of just the limitation of the wound healing
so you don’t want to overfill and over harvest and so certainly discuss that with prospective
hair transplant doctors to understand how many hairs they can put in square centimeters
in your situation. Remember there can be variable like thickness of the hair, the quality of
the hair, the quality of the skin. These are the finesse and the art of surgery and asking
a hair transplant doctor about what’s the best number of grafts is like asking a facelift
surgeon what’s the best way to a facelift. You are going to get a lot of different answers.
So I hope that was helpful, I wish you the best of luck and thank you for your question!