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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.
| |
|
 |
| 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 |
|
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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.
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