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  1. #1
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    Default Maximum number of grafts in a lifetime?

    Hi Everyone

    I'm seriously considering a procedure in the next few months, i've been considering for about a year and have met many surgeons. I have one question for which i've been receiving many answers. Is there a ballpark figure for number of grafts you can have done in a lifetime?

    One surgeon suggested we go for 5000 in the first op and leave 2-3000 for a future op. I'm only 44 and I have no doubt there will be future loss that needs attention.

    Another surgeon suggested that we only go for 3000 grafts in the first op as 5000 is the maximum in a lifetime.

    I've got a really good donor region which is very densely packed, i also have very good skin laxity.

    What do you guys think?

    best wishes

    The Prodigy

  2. #2
    Doctor Representative mattj's Avatar
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    Hi prodigy,
    Based on the estimates I've seen given to patients in the past, if your donor is as dense as you believe it is then the upper figure you've been quoted is probably realistic.

    How long have you been losing hair and what Norwood stage have you reached? Obviously hairloss can continue past the age of 44, but as you get older, odds are it won't continue as aggressively. Most guys at a high Norwood stage lose a lot of hair during their twenties.
    I am a patient and representative of Dr Rahal

    My FUE With Dr Rahal - Awesome Hairline Result

    I can be contacted for advice: matt@rahalhairline.com

  3. #3
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    Hi Matt

    I've been losing my hair for the past 12 years but the proscar and minoxidil have slowed it down lately. I'm a Norwood 5 with a bit more of a tuft of hair at the front.

    I'm just nervous my sides will drop down in the next 10 years and I would need a good 2000-3000 grafts to fill that at some stage in the future. Both surgeons are very reputable but the second one gave me a fright when i told him I was considering 5000 for op number 1.

    thanks

  4. #4
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    It might be a good idea for you to talk to dr. Cooley about his plucking/acell technique. If this proves successful, you might be able to get (dare i say) an unlimited supply of donor hair in the future.

  5. #5
    Doctor Representative mattj's Avatar
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    How did the surgeon give you a fright? As you're a NW5, 5000 grafts wouldn't be an outlandish figure. Far from it. And 5000 graft surgeries are common these days. I don't know who either of the surgeons are, but some have higher comfort zones than others and make recommendations that are influenced by their limits.
    I am a patient and representative of Dr Rahal

    My FUE With Dr Rahal - Awesome Hairline Result

    I can be contacted for advice: matt@rahalhairline.com

  6. #6
    Senior Member gillenator's Avatar
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    Prodigy,

    The fact that you are mid forties and responding well to finasteride is a good sign. I was 40 when I did my first session and a Norwood 5 as well. I had the same tuft in the frontal zone. To date, I have undergone four seperate procedures, for a grand total of 6900 grafts.

    I don't think 5,000 sessions are as commonplace as some might think. There are several problems with that. First, VERY FEW document and publish their respective yields at those mega-session levels! And if anyone may think I am mistaken, then please tell me where they are published and emperically verified. The other is proper surgical team staffing. Don't get me wrong, there are some clinics that are staffed to do these larger procedures. My point is that they are not common place.

    My word, harvesting 5,000 sessions is one thing. Have you noticed that almost "no one" brings up the issue of graft survival? And keep in mind, that's a pretty hefty size strip to harvest "ear to ear" for most patients considering average size head (circumference), and average donor density (virgin scalp). And it would be a wide strip at that.

    And to keep the survival rate (yield) as high as possible, you want that strip microscopically dissected in a very expedient manner and back into the recipient area. Because the longer that strip is "out of body", the more deteriation that takes place (IR). All patients should verify up front that the clinic has the type of staff that is very experienced and how many very experienced people dissecting a strip that large. Ask, are the same techs who will be cutting my strip be the same ones doing the placing of grafts? Because if it is, that will be a very long day for a 5,000 session for two techs.

    I truly believe that a guy your age does not need to do a session that large in the first procedure. And if you do get those good re-assurances from a reputable clinic who will guarantee a yield of no less than 90%, be prepared for quite a transition in appearance. I am not saying that's necessarily a bad thing, but remember you're forty something now. Depending on your goals, you just may want that much hair! In my 31 years of experience, most men 40 something plus want a more subtle transition. At least 50% go back if they can afford it.

    Possibly consider doing 3500 - 4000 tops in the first session. You'll get less trauma to the recipient area, probably a better yield too. It's less demand on everyone in the OR including the techs who do almost 100% of the dissecting and graft placement.

    Remember, you can always go back for more if you want. I went back in 2006 for my last procedure at age 51 and did another 2570 grafts.

    Best wishes to you Prodigy and your hunt for the right doc!
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

  7. #7
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    Thank you for such a considered response Gillenator. There's plenty of food for thought there - I am a bit worried about the size of the scar and I guess the size difference between a 3500 grafts to 5000 grafts is significant and I would be interested to hear about graft survival from mega sessions. You are right with the subtle transition - ideally i'd not want to draw a great deal of attention to myself and I am still weighing up the pros and cons. I'm not sure i'd want to go through the procedure again and thought 5000 was a nice compromise, i can add volume to the front and strategically place 1500 - 2000 grafts on my crown to break up the massive bald patch but there cons include massive scar, more dramatic change in appearance (i think i can bluff my way through a reasonable change as I've told friends about a "magic pill" and i'm using toppik to great effect) and now i guess i have to factor in the graft survival rate.

    I'd certainly love to discuss these pros and cons a bit further....

  8. #8
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    i say in general 5000 grafts is a value for a person to have available. The rate is significant lower of course, when you got bad transplants done for example.

    But 5000 is an good and ok average value of available donor ressources

  9. #9
    Senior Member gillenator's Avatar
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    Quote Originally Posted by prodigy View Post
    Thank you for such a considered response Gillenator. There's plenty of food for thought there - I am a bit worried about the size of the scar and I guess the size difference between a 3500 grafts to 5000 grafts is significant and I would be interested to hear about graft survival from mega sessions. You are right with the subtle transition - ideally i'd not want to draw a great deal of attention to myself and I am still weighing up the pros and cons. I'm not sure i'd want to go through the procedure again and thought 5000 was a nice compromise, i can add volume to the front and strategically place 1500 - 2000 grafts on my crown to break up the massive bald patch but there cons include massive scar, more dramatic change in appearance (i think i can bluff my way through a reasonable change as I've told friends about a "magic pill" and i'm using toppik to great effect) and now i guess i have to factor in the graft survival rate.

    I'd certainly love to discuss these pros and cons a bit further....
    Prodigy,

    You're very welcome my friend. Listen, I forgot to address something for you. It is good that you were assessed to have good donor density. But remember, you must also have the "available laxity" that is left after each procedure. In other words, a doctor can assess your donor zone and state that you may have up to 8,000 harvestable grafts by conventional strip methods. Keep in mind you must maintain the scalp laxity to continue excising those strips in the future. With FUE added in the equation, a patient can have far more grafts harvested by extraction, not excision. Further, an experienced FUE surgeon can harvest from the parietal (side) zones as well as the occipital (rear) donor zones. Scalp laxity is not an issue with FUE.

    And listen my friend, if you want to converse in depth about this, feel free to send me an email for my home/office number and we can chat further by phone. I can talk faster than I type if you know what I mean.

    You can also email me some pics in strict privacy and confidence for a more precise opinion. Guys do this all of the time. And no one else will have access to them. You have my word.
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

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