How Hair Transplant Surgeons Determine the Appropriate Number of Grafts for Each Patient

This following article from our [tag]Hair Loss[/tag] Social Community and Discussion Forums was written by recommended hair restoration surgeon Dr. Ali Emre Karadeniz.

I see many discussions where the decision on graft numbers are discussed fiercely. Before we discuss the recommended number of follicular unit grafts for each case we should take a look at what goes through the minds of patients and [tag]hair transplant[/tag] surgeons.

There are two main types of factors that are considered when deciding on a grafts number:

Practical factors that patients consider can be:

It is clear that all these factors lead to the highest possible graft number.

[tag]Hair restoration[/tag] physicians may consider one or both types of factors depending on their personality, surgical background, ethical understanding and marketing strategy.

Scientific factors may be:

It is clear that all these factors lead to a number significantly lower than practical factors.

Practical factors that the surgeon may consider are:

It is clear that these are related to the highest possible graft number.

The graft number that gives the highest coverage and density not only satisfies the patient, but also gives the best before and after result. Transplanting a high number of grafts on existing hair gives the best possible density. The increase in hair per area is much more significant than the hairs that may be sacrificed during the procedure. A surgeon that puts 5000 grafts on a young patient with diffuse thinning is going to get a much better result than a conservative surgeon who would do only 2000.

Who is going to vote for the conservative surgeon when the 1 year postop photos show good density at the hairline and some thinning at the rest? The conservative surgeon is going to come on top 10 years later if he has the chance to do his 3rd or 4th transplant, but are we all going to be here to witness it?

Practical factors and scientific factors usually oppose each other. Patients want a significant result and they want it now. They usually don’t care about or at least are not aware of scientific factors. The surgeon risks confronting his patients if he cares about scientific factors. However this is very controversial, as arguing with a patient for the patient’s own benefit, while the patient is not understanding what is to his own benefit puts the surgeon in a difficult position. He can easily avoid these controversies by surrendering to practical factors.

The controversies remain unresolved.

Dr. Ali Emre Karadeniz
—
David (TakingThePlunge)

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
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