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How
many Grafts should I get?
Should a full head of hair really be the goal of your hair transplant
procedure?
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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.
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Recommended
Resources |
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- Ask questions and get information on Hair Transplants
in our Men's
Forums and Women's
Forums!
- Information provided courtesy of the New
Hair Institute, taken from "The Patient's Guide to
Hair Transplantation" William R. Rassman, MD and Robert
M. Bernstein, MD
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