This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY. Dr. Beehner is one of our recommended hair restoration physicians. His professional answer is below.
I was looking closely at the hair transplant I had 15+ years ago and noticed many of the individual follicles appear to have several hairs per follicle in them. What is up with this? The hair on my sides is too thick to really tell if it is the follicles themselves doing this or if it’s a byproduct of something unusual that happened during the hair restoration surgery or healing. I counted at least 12 individual grafts that contained a follicle like this. Has anyone else experienced this?
By definition, a single hair follicle can only have one hair growing out from it. It is impossible for two hairs to come off of the same follicle. Obviously, it is hard to know the number of follicles under any given group of hairs since the follicle resides completely under the skin.
What you are seeing may have resulted from “pairing” of the follicular unit grafts. In other words, your hair transplant surgeon may have inserted a two-hair FU into a small slit opening and then later on had some extra 1-hair or 2-hair grafts and slipped one of them in along side the previously placed 2-hair graft in the same slit. Many doctors do this in the front-central area to increase density somewhat. However, when you look at one of these, it can look like an awful lot of hairs coming from a tiny opening all together.
When our clinic places a DFU (double follicular unit graft), the slit is slightly longer and the normal spacing between the two FU’s within the DFU are maintained. The result looks very natural. In contrast, when two FU’s are “paired”, they can look concentrated in density and it especially looks bad if it is done anywhere near the front hairline.
Another thing that might give a viewer the impression of multiple hairs coming out of a small space on the head is if the graft was “pitted.” Pitting gives the impression that the hairs are coming out of a dark hole and they usually look compressed. This was commonly seen 15-20 years ago when some clinics had their techs put the grafts in a little deeper to make sure they wouldn’t fall out or when roundish grafts were placed into slits. The top of the graft was then tucked down under the slit, leading to a pitted look.
Mike Beehner, M.D.
David – aka TakingThePlunge
Assistant Publisher and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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