This hair loss question was answered by Dr. Glenn Charles of Florida who is a member of the Coalition of Independent Hair Restoration Physicians. His professional answer is below.
Many hair restoration doctors don’t perform hair transplant megasessions and they appear to be limited to do only 3500 grafts or maximum 4000 grafts. The few doctors that do perform megasessions go up to 5000 grafts plus. What’s the reason for this? Are megasessions unsafe due to limited blood supply? I know doctors recommended on the Hair Transplant Network do perform megasessions and their patients have great results, but why do other doctors limit themselves?
The answer to this question is quite complex. It would depend on what hair restoration physician was performing the surgery. Meaning does a particular surgeon and their staff have the actual capability of carrying out a procedure of greater than 4000 follicular unit graftss in a reasonable period of time? As important, does the hair transplant patient have the donor hair density and scalp laxity?
If all of the above is true there are still many other factors that should be considered. How large is the balding area in which the grafts are to be transplanted into? Would the patient prefer to have 5000 grafts placed into a specific area and have 4000 grafts actually grow hairs. That is an 80% success rate. Or would they prefer to have 4000 grafts placed into that same area and 3800 grow successfully? Giving a 95% success rate. Saving those other 1000 follicular units for later if needed. Is the physician really giving that patient those large number of grafts? It is awfully hard to go back and count.
Another important point is that in order to fit this large number of follicular units into a single session, the hair loss doctor must take out a large strip of donor tissue. There certainly is a greater chance of leaving a larger donor scar. Has the patient been notified of this possibility? I hope so. The list just goes on and on.
To clarify, I’m not saying that in every large session of 5000 follicular units or more there will be a 20% loss. It has a lot to do with how large of a bald area you are putting those 5000 grafts into and the techniques used. The point I was trying to make is that if you try to squeeze to many follicular units into too small of an area there may be a lower percentage of successful hair growth. By the way I have been to visit my friends Dr. Wong and Dr. Hasson in Vancouver and they perform excellent hair restoration surgeries. They have a very large staff with tons of experience. Because they perform these large cases on a regular basis I am confident they have a higher success rate than some of the clinics who rarely do cases of this magnitude.
Dr. Glenn Charles, D.O.
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