How many grafts do I need?
I was wondering how many grafts I need.
I have been told anywhere from 1200-3000 from various doctors.
Thank you
Thank you for your question!
You submitted several photos and you are asking how many grafts you would need.
Certainly, that is a very typical question that people ask all time because when you
look for solution for hair loss, in variably you learn about the option about hair transplant
surgery and all the things that hair transplant surgery have to deliver.
And it is common to speak in terms of grafts.
So what I’m going to do is walk you through the steps that we use in our practice to determine
the best solution for someone like yourself and if you are asking about grafts, I think
that you’ll be surprised to learn there is another alternative that we’ve developed
in our practice that can probably help someone like yourself with this situation.
So what do we need to learn first?
First we need to know the age of onset.
You look very young in this photos so we want to know how old were you when you started
losing hair.
Then we ask of course about family history.
Typically what you appear to have is male pattern hair loss.
So we look if there are uncles or cousins and siblings with a similar pattern so that
we can get an idea of what the rate of progression is.
Hair loss is not a single event.
It is a process of hair thinning eventually leading to hair loss.
This is an important factor to think about when you’re thinking about surgical hair
restoration.
Then we ask about the medications that you are taking.
In the United States, there are two FDA-approved drugs for hair loss in men: one is finasteride
which is a pill you take daily.
Finasteride works but inhibiting an enzyme called 5-alpha reductase.
This is the enzyme that converts testosterone to dihydrotestosterone.
Dihydrotestosterone is responsible for causing thinning for dihydrotestosterone or DHT sensitive
hair follicles.
The idea is, if you diminish the DHT, you diminish the triggering factor that causes
the hair to thin.
Minoxidil is the other drug that is used topically that appears to prolong the growth cycle which
actually gets shorter when hair is thinning sot that it appears to have more hair in the
scalp.
Currently, there is a lot of concern about finasteride and many people particularly younger
men as men in their middle ages who are in their 30s, 40s, 50s will not take finasteride
because of the fear of long term sexual side effects.
So that leads everyone to conclude that they need hair transplantation.
But let’s learn some things about hair transplantation that is very often underplayed because hair
transplant, if you get down with it, is a very a much a business.
First of all, you don’t stop losing hair especially if you are not able to take any
medication like finasteride.
What does that mean?
Regardless of the number of grafts that are placed, you’ll continue to lose hair.
That’s fact number one.
Fact number two is, you only have a limited area to transplant hair from.
Currently, it’s very popular to look at follicular unit extractions as “scar less
surgery” but why is it scar less?
Well, in order to do follicular unit extraction, you have to go way outside of the true donor
area or the genetically resistant area where hair is taken from for hair transplant.
This is the area that you see in the baldest man you’ve ever seen who when you look at
the band of hair that remains, that’s the hair that truly genetically resistant.
So, where does that leave you?
Well first of all, regardless of the number of grafts that is estimated that you’ll
need in order to achieve density, you typically need at least two transplants especially in
the temporal peak areas.
Because what you are looking at is a lot of area of bare scalp.
And when you look at bare scalp, you think of the density that a natural hairline has.
Now what does that mean?
Density does not only mean a line but also the hair that are behind that line.
So essentially, you have to crowd the hairs in layers so that you can actually have the
impact of having density.
What happens typically with a hair transplant is that even with as close as possible the
hairs are placed together, a certain amount of hairs will not survive and invariably,
you would need more than one transplant to fill in those corners to get the volume that
you want in the face of progressing of hair loss.
So you can imagine why more than 65% of people having hair transplant, according to the International
Society of hair restoration surgery, are not satisfied or desire more density after hair
transplant.
In our practice, we have developed a method of restoring hair in way that is non-surgical
and can appear to be too good to be true but actually is not.
The concept is that hair that is thinning is going through this progressive hair loss
until the point of hair loss but with a microscope, we can see a lot of potential hair.
What we are doing, we are using extracellular matrix which was originally used for wound
healing combined with platelet-rich plasma which is derived from your own blood through
a formulation and method of technique of delivery to actually treat the thinning hair and that
results of reversal of hair thinning and the hairs starts to become thicker.
We have hundreds of patients to prove the validity of this procedure.
We have been able to demonstrate by simply looking critically at the numbers that for
the majority of patients who come in early enough in their hair thinning process that
the volume correction that we can get far in a way exceeds the results of almost any
transplant and I would challenge any hair transplant doctor to get the same patient
and match them appropriately and compare the results with doing a transplant compared to
Hair Regeneration.
Now that means, particularly for younger people, without surgery, they can have an injection
that results in significant correction of volume and area of coverage and halting of
the hair thinning progression.
We have patients who come from all over the world and we have tremendous data to support
its benefit.
------------------------------------------------------------------------------------------------------------------------------------------ And so, someone like yourself who would come
to us, we would certainly estimate for you the number of grafts that you would need by
determining the area that needs to be covered and the hair that is available but we would
probably insist that you would first do Hair Regeneration treatment to halt progression,
improve the density and volume of hair and reassess.
We use about 18 months as our gauge to determine when that is the right time.
So at 18 months, we are usually able to tell that.
When someone like you comes to our practice and wants to discuss the number of grafts,
what we do is essentially look at the area of hair loss and estimate for you the number
of grafts that you would need and what the area of hair that is readily available would
be necessary to fulfill that requirement but before doing the surgery, I would actually
insist that you would first do the Hair Regeneration procedure so that you would benefit from the
reversal of hair thinning and thickening of the existing hairs so that you would actually
get the volume of hair that you would otherwise needed to be grafted and then at the end of
18 months, which is our typical timeframe, because people can respond as early as one
month but take as long as 18 months to get the full benefit.
We would then reassess and then if you want more hair, then we can be more secure in the
strategy of doing a transplant because we know that your progression of hair loss would
not be continuing and we can be more strategic in the way we are able to place the hairs
because we are actually dealing with a limited number of hairs in the donor area but when
you have less scalp to cover, you can actually be able to place more hairs in a more dense
way and get the results that you are looking for.
So as I said, the typical approach that we would have is to go through understanding
what your limitations are and avoiding just going through the surgery because you would
end up having short term benefit but in the long term with progressive thinning, you’d
only have the hair grafts left and that’s why so many people are dissatisfied with hair
transplant and why so many people are forced to continue getting hair transplant.
So in our practice, Hair Regeneration has become the treatment of choice for people
who are thinning and are having existing hair before moving on to hair transplant.
But I can tell you that more than 90% of our patients, once they have Hair Regeneration,
they don’t feel that they need a hair transplant.
And again, that’s contingent again on how much hair they have existing.
So with that being said, you have more enough information to guide you as to what would
be the choice for you besides shopping for the best doctor you’re looking for to transplant.
So I hope that was helpful, I wish you the best of luck and thank you for your question!