“Chubby” verus “Skinny” Grafts in Hair Transplantation
Some hair transplant doctors believe that “chubby grafts”, which are trimmed to contain more of the tissue surrounding the follicles, have a higher rate of survival and growth than follicular units that are trimmed into skinny or tiny grafts.
This belief was held by Dr. David Seager and was presented in a study that he authored in 1997 entitled “Micrograft Size and Subsequent Survival”. Thus the “chubby grafts” that both Dr. McKenzie and Dr. Simmons and their staff continue to create using microscopes are based on the assumption that this study and its support for larger grafts continues to hold true. However, many physicians have subsequently questioned and challenged this assumption in both debates, papers and in daily practice.
Many of the leading hair restoration clinics who provide large sessions of ultra refined follicular unit grafting believe that they consistently get both high rates of survival and growth using follicular unit grafts that are trimmed smaller called “skinny” grafts. These skinny grafts enable these physicians to provide patients with higher density sessions using smaller and less invasive incisions.
Thus I find it ironic that Dr. Seager’s “one pass” procedure, which was famous in the nineties for its high density in one session results, now appears to be less refined and dense than the ultra refined techniques employed by leading edge clinics today.
I believe that many hair restoration clinics that use “chubby” grafts are reluctant to trim smaller grafts and place them into smaller and potentially denser packed incisions when they are confident in the results they now produce.
However, over the past few years, there is a large and growing amount of evidence that skinny grafts, when carefully trimmed and handled, do yield high rates of growth.
Any hair transplant clinic’s adherence therefore to trimming “chubby grafts” may limit their ability to dense pack grafts to achieve true “one pass” densities when appropriate.