We’ve all seen the headline-grabbing posts and eye popping photos for the huge single hair transplant sessions of 3,500 to 5,000 grafts or more. All things equal – who wouldn’t want to get faster and more dramatic results sooner? Well, if all things are truly equal I would absolutely agree.
But a patient must consider multiple factors and considerations in determining the ideal session size for him or her. In general I strongly support the evolution towards smaller and less invasive incisions, which have enabled patients to get more hair density and coverage after a single session (see the Recent Advances section of the Hair Transplant Network). However, I do have concerns regarding huge hair transplant sessions.
Some of the potential medical issues that patients need to consider:
1) Are large hair restoration sessions of 4,000 to 6,000 grafts potentially masking lower growth rates?
2) Are the graft counts really comparing apples to apples or are the new huge follicular unit sessions actually using “sub follicular unit” grafts (less hairs per graft than standard follicular unit grafts) which therefore produce a higher graft count? Ultimately, it is the amount of hairs that are relocated and how they are arranged that determines the appearance of density – not just the graft count.
3) Are these huge follicular unit cases potentially taking too much donor tissue from the donor area in one particular session thus increasing the danger of scarring?
4) Are young patients in particular in danger of depleting their limited donor area by dense packing their receding hairlines too aggressively, thus not enabling them to achieve an optimal long term distribution of transplanted hairs?
The fundamental question that many leading hair restoration physicians are asking about these huge mega mega sessions is – are such large cases really in the long term best interest of the patient? Patients must also consider this question for themselves.
Based on all the information I have been exposed to, I believe that in experienced hands surgeons using the newest ultra refined procedures can and do achieve good growth rates when dense packing and doing large sessions.
However, patients need to be aware of all considerations when choosing the session size that is right for them.