Hairloss Experiences Hairloss Forum Home 
Home Search search Menu menu Not logged in - Login | Register

Welcome to Hairloss experiences hairloss forum.Free informatiom on hair transplants,hair loss medications and general hair loss concerns. If you register and dont receive your confirmation email,could you check your spam/trash box as some go there. Please note the 5 digit code when registering is case sensitive(capitals are usually required) You can also contact myself directly at hairlossexperiences@googlemail.com

 Moderated by: Bigmac Page:    1  2  Next Page Last Page  
New Topic Reply Printer Friendly
How much donor does the average joe have - Hair Transplant-Hair Restoration Topics - Hair Transplant section - Hairloss Experiences Hairloss Forum  Rating:  Rating
AuthorPost
 Posted: Mon Dec 29th, 2008 11:36 am
  PM Quote Reply
1st Post
bullitnut
4 awesome repairs with SMG


Joined: Wed Dec 24th, 2008
Location: United Kingdom
Posts: 3787
Status: 
Offline
User Gallery
i know everyones different regarding, head size, laxity and quality of donor hair etc but how many grafts could your average joe expect to pull in total before the donor looks poor.
(i realise my situation is lower but im just asking for others as a general question):)



____________________
1.http://www.hairlosstips.co.uk/html/my_repair_with_smg.html
2.http://www.hairlosstips.co.uk/html/my_repair_stage_2.html
3.http://www.hairlosstips.co.uk/html/my_repair_stage_3.html
4.http://www.hairlosstips.co.uk/stage4/
Back To Top PM Quote Reply  

 Posted: Mon Dec 29th, 2008 02:52 pm
  PM Quote Reply
2nd Post
janna
Invaluable Member


Joined: Fri Dec 26th, 2008
Location: Minnesota USA
Posts: 2058
Status: 
Offline
User Gallery
On the average, I've heard our doctors say 6,000 to 8000 in the safe zone. 



____________________
Clinical Operations Manager for Shapiro Medical Group.
janna@shapiromedical.com

http://www.shapiromedical.com/
http://www.facebook.com/pages/Shapiro-Medical-Group/323838379464
http://www.youtube.com/user/jannasmg?ob=video-mustangbase
Back To Top PM Quote Reply

 Posted: Mon Dec 29th, 2008 03:37 pm
  PM Quote Reply
3rd Post
TBF
Valued member


Joined: Sun Dec 28th, 2008
Location: United Kingdom
Posts: 7
Status: 
Offline
User Gallery
HI Janna,you say 6000-8000 could be had as the average,is this in the form of strip only, or all forms stip and fue?.

Back To Top PM Quote Reply  

 Posted: Mon Dec 29th, 2008 03:53 pm
  PM Quote Reply
4th Post
janna
Invaluable Member


Joined: Fri Dec 26th, 2008
Location: Minnesota USA
Posts: 2058
Status: 
Offline
User Gallery
I'm referring to strip donor harvesting.  For clinics performing majority o f FUE work, I've seen the donor area to be much larger where they seem to go outside the traditional strip safe zone.   



____________________
Clinical Operations Manager for Shapiro Medical Group.
janna@shapiromedical.com

http://www.shapiromedical.com/
http://www.facebook.com/pages/Shapiro-Medical-Group/323838379464
http://www.youtube.com/user/jannasmg?ob=video-mustangbase
Back To Top PM Quote Reply

 Posted: Mon Dec 29th, 2008 04:04 pm
  PM Quote Reply
5th Post
TBF
Valued member


Joined: Sun Dec 28th, 2008
Location: United Kingdom
Posts: 7
Status: 
Offline
User Gallery
Thanks for that Janna,with a combination of the two of a 6-8000 via strip and then maybe another 2-3000 if your lucky with fue,that really would be some change even for worst on the NW scale.

Back To Top PM Quote Reply  

 Posted: Mon Dec 29th, 2008 04:24 pm
  PM Quote Reply
6th Post
janna
Invaluable Member


Joined: Fri Dec 26th, 2008
Location: Minnesota USA
Posts: 2058
Status: 
Offline
User Gallery
Hi TBF,

From my experience, the patients with highest NW levels tend to have less density and have less than the average donor supply.  Personally, I don't believe a person with NW7 is a good candidate for strip or FUE unless they are going to be satisfied with a light coverage to the frontal half. 



____________________
Clinical Operations Manager for Shapiro Medical Group.
janna@shapiromedical.com

http://www.shapiromedical.com/
http://www.facebook.com/pages/Shapiro-Medical-Group/323838379464
http://www.youtube.com/user/jannasmg?ob=video-mustangbase
Back To Top PM Quote Reply

 Posted: Wed Dec 31st, 2008 12:29 pm
  PM Quote Reply
7th Post
Philb
Member
 

Joined: Thu Dec 25th, 2008
Location:  
Posts: 95
Status: 
Offline
User Gallery
FUE in the pure form is the extraction of a single FU at a time, each FU containing natural 1 hair or multiple hair groupings, normally up to 4 hairs. The punch tool can vary in size greatly and have a significant effect on the donor area as well as the result in the recipient. Donor management for FUE is very different from FUT, although the surface area may be larger does not indicate that more FU can be removed. The safety zone for FUE can be measured and sectioned in to three areas; simply both sides and the back, and then the total surface area calculated.  The density is then measured in each area and the approximate average number of hairs per FU and any miniaturisation. From this a calculation can then be determined what is available to harvest depending on the person’s hair loss stage and hair characteristics.
 
Taking into consideration to not over harvest, Dr. Bisanga believes this figure is approximately 25-30% per cm2 and any more will lead to potential complications in the donor as the person becomes older and for future procedures. This educated protocol is not just to minimise visible scarring although that is a factor but also to preserve the donor and make it easier for any further extractions be it with FUE or FUT.  The 30% rule is also not the harvestable amount in one procedure, but over multiple procedures. Dr. Bisanga has researched and feels that over 3000 FUE extracted in one procedure can potentially impair the healing in the donor because so many extraction wounds all trying to heal at the same time, and possibly even the yield in the recipient could be impaired.
 
The punch size used will affect the number of FU that can be safely removed; incorrect punch size can increase transection of the removed FU, damage surrounding FU and cause larger and more visible scarring and peripheral trauma to the skin.  With a small punch there is a risk of transecting the FU being removed if the group is too large to be encompassed by the diameter punch, therefore cutting the FU causing the loss of a hair from that FU and reduce the total hair numbers placed. A larger punch may mean taking two genetic groups at the same time or splitting and transecting one of them, for example two 2 hair FU or maybe a 3 hair and a 1 hair in the same punch OR maybe taking an intact 3 hair FU and dissecting another and a likely conclusion is killing a hair and traumatising the surrounding hairs. More hair maybe removed possibly but then greater “hair less” areas are created and less harvestable area in the future. Dr. Bisanga has long used 0.75-0.8mm punch as his preferred sizes and finds that only in extreme cases he uses larger, maybe 0.85 for very large spread groups or high calibre hair characteristics.
 
Back to the actual harvesting protocol and how many can be removed, if we take an example:
 
Average density of 80 throughout the entire donor safety zone (much higher than average) and the surface area is measured to 30 x 7cm (a generous calculation) gives you the optimum FU numbers in that area; 16,800 approx FU (assuming there is no miniaturisation). Then an educated extraction pattern has to be used so as not to over harvest in a particular area; as most of the finer and small groupings are on the sides and generally the density is naturally lower less FU per cm2 will probably be removed, opposed to the areas of the back where the groupings and density is generally higher.  

Using this better than average example of a man’s donor if we were able to extract 30% in the best possible conditions, all FU aligned well, characteristics allowing etc that gives us 5000 intact natural genetic follicular units removed. This is considering very favourable conditions of donor and harvesting and by any means does not represent the average person, no miniaturisation or transection included in this calculation. 5000 FU, at 30%, any more will impair the donor and a man who started with an above average donor has potentially no more to harvest, with FUE.  If this same man had undergone FUT there is a very good chance he could reach 5000 in one procedure, certainly close to it, and certainly a second procedure would have taken him close to 7000 grafts, then he still would have the choice of FUE to harvest outside the linear strip area.
The point being, with higher Norwood cases and for those solely looking to ever use FUE it may not be possible because without seriously over harvesting the donor the numbers just cannot be reached. If a person is emphatic that they do not want a linear scar then they need to think long and hard before starting with FUE because if the hair loss progresses the inevitable maybe to have FUT.  Follicular Unit Extraction when the limitations are adhered to can be an excellent form of hair transplant. The limitations are the use of the correct punch size, not to extract a combination of FU in one punch; not to over harvest the donor to extract more FU and leave the donor thinned and importantly to assess the long term potential for future loss and plan accordingly.
 
 

Back To Top PM Quote Reply  

 Posted: Sat Jan 3rd, 2009 12:18 am
  PM Quote Reply
8th Post
bullitnut
4 awesome repairs with SMG


Joined: Wed Dec 24th, 2008
Location: United Kingdom
Posts: 3787
Status: 
Offline
User Gallery
thanks J and
phil for your replies much appreciated

Last edited on Sat Jan 3rd, 2009 12:22 am by bullitnut



____________________
1.http://www.hairlosstips.co.uk/html/my_repair_with_smg.html
2.http://www.hairlosstips.co.uk/html/my_repair_stage_2.html
3.http://www.hairlosstips.co.uk/html/my_repair_stage_3.html
4.http://www.hairlosstips.co.uk/stage4/
Back To Top PM Quote Reply

 Posted: Sat Jan 3rd, 2009 01:45 am
  PM Quote Reply
9th Post
lost_youth
Valued member


Joined: Sat Dec 27th, 2008
Location: Melbourne, Australia
Posts: 34
Status: 
Offline
User Gallery
A question for the clinics:

Given that someone is going to maximise their donor supply by utilising both strip and FUE, does it make any difference which method is used first? (assuming they are both done properly)

Back To Top PM Quote Reply  

 Posted: Sat Jan 3rd, 2009 12:02 pm
  PM Quote Reply
10th Post
Philb
Member
 

Joined: Thu Dec 25th, 2008
Location:  
Posts: 95
Status: 
Offline
User Gallery
lost_youth wrote: A question for the clinics:

Given that someone is going to maximise their donor supply by utilising both strip and FUE, does it make any difference which method is used first? (assuming they are both done properly)


Hi LY,

There are many factors to take into consideration with the point you make, donor hair density and extent of current thinning and the potential for future loss and the design and aggressiveness of the hair line. We are not big on doing smaller strip procedures, in fact we do very few between 2-2500 grafts, the vast majority of our strip work is 3500 plus grafts with FUE work around 1500-3000 grafts. If the density in the donor is average to good, the size of the safe donor is the same then the extraction pattern can be spread enough so the impact on the overall density is minimal and it will not greatly compromise a strip procedure in the future. Relatively minimal loss, NW2.5-3 can be treated with FUE and still leave a good donor without a linear scar. If the hair loss is more progressive then a large strip would be better advised, to extract so many in one session with FUE will compromise the donor and leave larger hair less areas making the strip density lower and harder to cut around all the scarring. There is also the directional changes of the hairs, we know it happens a little around the scar line with strip but it can happen to a large extent with these large FUE sessions that some perform; the closer the extraction pattern will have an impact on the peripheral FU thus making it harder to harvest in the future.

So, I would say our stance would be that using FUE to treat a relatively small hair loss pattern is ideal and doesn't have to compromise the density in a big way when performed well, but any higher level of hair loss strip should be a consideration, and when looking at NW5 above FUE is very unlikely to be a consideration if anything like full coverage is required. Under those circumstances and depending on donor density a combination of techniques could be used, strip first, maybe another strip or a combination of the two and then probably a smaller FUE later to make any refinements.

and potentially lower the yield. So,

Back To Top PM Quote Reply

 Posted: Sat Jan 3rd, 2009 03:30 pm
  PM Quote Reply
11th Post
lost_youth
Valued member


Joined: Sat Dec 27th, 2008
Location: Melbourne, Australia
Posts: 34
Status: 
Offline
User Gallery
Thanks for the info Philb.

So from your last post would it be correct to say that performing strip on a previous FUE patient shouldn't be a problem - assuming the FUE was carried out properly and the donor area was not overharvested?

The issue I have in my mind is contingency, and retaining the ability to buzzcut should the HT results be disappointing, and/or the patient cannot have further transplants for financial or other personal reasons.
That's not to say I'd expect a bad result from BHR or any other reputable clinic - but I can see hundreds of documented cases and still be concerned about my own head - at least until I've had the personal experience of a HT myself.

I've discussed this point on the old forum but I'll do so again here since that's gone now.

Using my own case/desires as an example:

I'm 27 years old.
Been on 1/4 proscar daily for about 4 months.
My frontal area is mostly gone, midscalp and crown holding up ok until now.
Given my family history, I'm working on the assumption I'll ultimately hit something around NW5/6 like my dad/uncle.

If I go through with a HT, I'm planning to stay on the meds (no sides so far) and restore the front with a mature, conservative hairline. The question is whether to do this first procedure with strip or FUE.

Assuming I went with FUE:

Case 1:
I get a HT to address the front, and the yield is poor/nonexistent. I can buzz my head and move on and go bald, after cursing the clinic or my physiology or whatever.

Case 2:
I get a HT to address the front and I'm happy with the results, but the meds don't work for me, and after a year or two my midscalp/crown get very thin. This might look odd/unnatural, so I could buzz short at least until I'm able to schedule another procedure to address the midscalp.

Case 3:
Perhaps continuing from case 2, a number of years down the road I get to a point where I have sufficient frontal/mid coverage, and a bald crown. At this point I may well be content to leave the crown and not to have any more procedures, but if I really do want to do something about it, then I could look at strip, or using some body hair (I have loads), or whatever else is available by then.

The concern I have with strip is that I may be 'locked in' after the first HT. I've seen some really thin tricho scars, and I'd probably be happy if I got something similar to the better ones I've seen - but no clinic can guarantee what my scar will be like, so there's always an element of risk there.


Anyway - sorry if I've hijacked this thread a bit, but I think these issues are relevant when discussing how many grafts can be extracted by various methods.




Last edited on Sat Jan 3rd, 2009 03:31 pm by lost_youth

Back To Top PM Quote Reply  

 Posted: Sat Jan 3rd, 2009 05:01 pm
  PM Quote Reply
12th Post
Philb
Member
 

Joined: Thu Dec 25th, 2008
Location:  
Posts: 95
Status: 
Offline
User Gallery
lost_youth wrote: Thanks for the info Philb.

So from your last post would it be correct to say that performing strip on a previous FUE patient shouldn't be a problem - assuming the FUE was carried out properly and the donor area was not overharvested?

The issue I have in my mind is contingency, and retaining the ability to buzzcut should the HT results be disappointing, and/or the patient cannot have further transplants for financial or other personal reasons.
That's not to say I'd expect a bad result from BHR or any other reputable clinic - but I can see hundreds of documented cases and still be concerned about my own head - at least until I've had the personal experience of a HT myself.

I've discussed this point on the old forum but I'll do so again here since that's gone now.

Using my own case/desires as an example:

I'm 27 years old.
Been on 1/4 proscar daily for about 4 months.
My frontal area is mostly gone, midscalp and crown holding up ok until now.
Given my family history, I'm working on the assumption I'll ultimately hit something around NW5/6 like my dad/uncle.

If I go through with a HT, I'm planning to stay on the meds (no sides so far) and restore the front with a mature, conservative hairline. The question is whether to do this first procedure with strip or FUE.

Assuming I went with FUE:

Case 1:
I get a HT to address the front, and the yield is poor/nonexistent. I can buzz my head and move on and go bald, after cursing the clinic or my physiology or whatever.

Case 2:
I get a HT to address the front and I'm happy with the results, but the meds don't work for me, and after a year or two my midscalp/crown get very thin. This might look odd/unnatural, so I could buzz short at least until I'm able to schedule another procedure to address the midscalp.

Case 3:
Perhaps continuing from case 2, a number of years down the road I get to a point where I have sufficient frontal/mid coverage, and a bald crown. At this point I may well be content to leave the crown and not to have any more procedures, but if I really do want to do something about it, then I could look at strip, or using some body hair (I have loads), or whatever else is available by then.

The concern I have with strip is that I may be 'locked in' after the first HT. I've seen some really thin tricho scars, and I'd probably be happy if I got something similar to the better ones I've seen - but no clinic can guarantee what my scar will be like, so there's always an element of risk there.


Anyway - sorry if I've hijacked this thread a bit, but I think these issues are relevant when discussing how many grafts can be extracted by various methods.





Hi LY,

I would say your concerns are very legitimate and probably what everyone who sensibly goes into a HT thinks about, if they do not they should do.

Assuming all is equal and the FUE is performed within educated boundaries to not over harvest and a good extraction protocol then there is no reason why in the future a strip is more than feasible and can be carried out well with a trico closure also. One advantage FUE has given the patient is exactly in line with your thoughts, none of us have a crystal ball and know how far our hair loss is going to go, or what medical refinements are on the horizon or to a point what financial status we will have; being able to go FUE and being able to buzz down under the circumstances can leave you in a position that the HT is not noticeable, something that even the best strip scars cannot give as an option. Sometimes the donor is forgotten with all the attention placed on the recipient, it's funny how the donor later can actually be more of a concern than the recipient because if not managed properly can reduce your options in the future, be it your hair style or donor supply.

Back To Top PM Quote Reply

 Posted: Sun Jan 4th, 2009 02:36 am
  PM Quote Reply
13th Post
lost_youth
Valued member


Joined: Sat Dec 27th, 2008
Location: Melbourne, Australia
Posts: 34
Status: 
Offline
User Gallery
Thanks again for replying Philb, it's much appreciated.

Back To Top PM Quote Reply  

 Posted: Tue Jan 6th, 2009 09:20 pm
  PM Quote Reply
14th Post
Nervousnelly
The Coolest Member


Joined: Thu Dec 25th, 2008
Location: Michigan USA
Posts: 883
Status: 
Offline
User Gallery
Without going into too much detail, I will agree with Phil that in some cases it is certainly nice to go FUE first because if circumstances in your life change (financially, less concerned about hairloss, whatever) you always still have the option to buzz down.  In saying this however, if you are quite certain that you likely will be a NW4+ you might want to start with strip because you can get more bang for your buck and and likely you will need a 2nd surgery.  If circumstances do change you have had a rather large procedure that might give you a good look irregardless of whether you get another procedure or not.

NN



____________________
My blog
http://www.hairlossexperiences.com/gallery_view.php?user=7
Back To Top PM Quote Reply

 Posted: Wed Jan 7th, 2009 06:28 am
  PM Quote Reply
15th Post
Philb
Member
 

Joined: Thu Dec 25th, 2008
Location:  
Posts: 95
Status: 
Offline
User Gallery
Nervousnelly wrote: Without going into too much detail, I will agree with Phil that in some cases it is certainly nice to go FUE first because if circumstances in your life change (financially, less concerned about hairloss, whatever) you always still have the option to buzz down.  In saying this however, if you are quite certain that you likely will be a NW4+ you might want to start with strip because you can get more bang for your buck and and likely you will need a 2nd surgery.  If circumstances do change you have had a rather large procedure that might give you a good look irregardless of whether you get another procedure or not.

NN

Hi NN,

You make a very valid point and in many ways I totally agree with you, you look at a NW4 and they are borderline FUE and could have a big Strip to see them well.

This is when goals and expectations must also be taken into account because it can have a great effect on the outcome and the person's happiness. Many guys only want to design a very conservative hair line, almost like a NW3 would be, open temple etc and this means even a NW4 can achieve a good result with around 2500 grafts and using FUE. This way we are not breaking the bank with grafts, we can safely extract on an average to good donor across the entire donor and leave it relatively untouched in terms of density and no linear scar; and if in the future he continues to recede he has plenty of options still, even if that is to buzz it down and have no further ops in theory.

Cannot stress the importance for the patient to convey their goals and expectations to the doctor, he is not a mind reader and needs information so he can then plan around what he knows, this way doc and patient work together to achieve the result.

Back To Top PM Quote Reply  

 Posted: Wed Jan 7th, 2009 09:06 am
  PM Quote Reply
16th Post
lost_youth
Valued member


Joined: Sat Dec 27th, 2008
Location: Melbourne, Australia
Posts: 34
Status: 
Offline
User Gallery
Philb wrote
.....Many guys only want to design a very conservative hair line, almost like a NW3 would be, open temple etc and this means even a NW4 can achieve a good result with around 2500 grafts and using FUE.....

Hey Philb,

If it's not too much trouble - would you be able to link to an example of the type of case you're talking about?

Cheers,

LY

Back To Top PM Quote Reply

 Posted: Thu Jan 8th, 2009 06:13 pm
  PM Quote Reply
17th Post
Philb
Member
 

Joined: Thu Dec 25th, 2008
Location:  
Posts: 95
Status: 
Offline
User Gallery
lost_youth wrote: Philb wrote
.....Many guys only want to design a very conservative hair line, almost like a NW3 would be, open temple etc and this means even a NW4 can achieve a good result with around 2500 grafts and using FUE.....

Hey Philb,

If it's not too much trouble - would you be able to link to an example of the type of case you're talking about?

Cheers,

LY

Hi LY,

I was thinking something like this case, potential NW5-6 in the not to distant years, he is on meds but not sure how long they would hold off aggressive thinning. He has a slightly above average donor density, and good hair groups that helped the distribution. Dr. B placed just over 2500 FUE with a conservative hair line and in some ways mirrors this discussion. He knows by dropping the line he reduces his coverage further back, would prefer to only have FUE, certainly initially anyway.

I'll post the case properly with hair groups etc in the doctors section in a few days.


BEFORE







DESIGN






PLACEMENT







11 MONTHS POST OP





 

Back To Top PM Quote Reply  

 Posted: Thu Jan 8th, 2009 09:42 pm
  PM Quote Reply
18th Post
Nervousnelly
The Coolest Member


Joined: Thu Dec 25th, 2008
Location: Michigan USA
Posts: 883
Status: 
Offline
User Gallery
Wow.  Ask and we shall receive.  Excellent case.  This guy does however have some grey hair so I am assuming he is a little older and very likely might be able to avoid the continuation towards a NW5-6.  Currently he is one of those hovering at NW4-5 I would have to guess.  He looks great with the 2500FU which could turn out to be all he needs or wants and would look great with the buzzed look as he would have an established hairline so many people would think that he opted for the look out of choice not necessity.(avoiding the bozo look)  Thanks for sharing the case Phil.

 

NN



____________________
My blog
http://www.hairlossexperiences.com/gallery_view.php?user=7
Back To Top PM Quote Reply

 Posted: Sat Jan 10th, 2009 02:56 am
  PM Quote Reply
19th Post
lost_youth
Valued member


Joined: Sat Dec 27th, 2008
Location: Melbourne, Australia
Posts: 34
Status: 
Offline
User Gallery
Hi Phil,

That's a nice example indeed - thanks for posting.
This is exactly the type of strategy that I would like to adopt.

I would happily go for this kind of hairline to preserve donor for the future.

I've got a forelock which would dictate where the centre low point of my new hairline would have to be, but I've got no intentions of filling in my temples - I'm happy with the recessed look.

I secretly snapped a pic with my phone the other day (attached), as it is an example of the kind of outline I'd like to go for. (maybe round off the V tip though - making the front of the hairline as high as I can).

I quite like the buzzed look - and really want to avoid the 'bozo' look that NN mentioned.



Attached Image (viewed 1569 times):

recessed temples.jpeg

Back To Top PM Quote Reply  

 Posted: Sat Jan 10th, 2009 03:39 am
  PM Quote Reply
20th Post
Nervousnelly
The Coolest Member


Joined: Thu Dec 25th, 2008
Location: Michigan USA
Posts: 883
Status: 
Offline
User Gallery
Lost youth,

Gotcha--had to read a couple of times as I was thinking that this was a photo of you and I was wondering why you needed to do anything.   Ya, certainly not a bad look at all.  This guy likely has some thinning and with the buzzed look he looks great since he has an established and very concrete hairline.   Nothing wrong with the recession as it saves on grafts and will always remain age appropriate.  Personally I believe everyone should be very conservative this way if it still frames the face well for them.  Going just slightly higher in the hairline can save you 1000-2000 grafts that can be used for density.  Not enough guys truly sit and think about the numbers.  Its imperative to know roughly the size of area needing coverage and your estimated donor availability and then go from there with a thought out plan.

NN



____________________
My blog
http://www.hairlossexperiences.com/gallery_view.php?user=7
Back To Top PM Quote Reply

Current time is 04:44 am Page:    1  2  Next Page Last Page    
Hairloss Experiences Hairloss Forum > Hair Transplant section > Hair Transplant-Hair Restoration Topics > How much donor does the average joe have Top



UltraBB 1.17 Copyright © 2007-2008 Data 1 Systems
Page processed in 0.1936 seconds (6% database + 94% PHP). 32 queries executed.