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Best graft numbers - how quotes can differ

Understanding Hair

Understanding Hair

Valued member
When planning a hair transplant, the size matters. There´s going to be leeway in the graft numbers depending on aspects such as hairline design and desired hair coverage. A clinic often gives a range, for instance, 10% +/- a stated number. Regardless, the goal is to block the reflection of light off the scalp, resulting in the look of fullness.

An alternate approach to using graft numbers is a classification of size as a “session.” For instance, a session can detail the area treated, the front, middle, and back/crown, or terming a session as small, medium, or large. Such an ambiguous way to approach a hair transplant allows the clinic to do whatever they wish without any measure of accountability. It makes it harder to argue the growth is low, with no reference to the numbers placed. It is impossible to compare to clinics that use a graft and hair count as the reference. This practice of “this is the cost and we´ll do whatever we have to” should sound alarms.

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Defining the size of the procedure using graft numbers, is likely to be the optimum estimate, for example, it will take an “x” number of grafts. Just ensure the clinics are using natural groups of follicular units, not splitting the units, as this will only increase the grafts numbers, (not though hairs), and to the detriment of the result and your pocket. Using grafts to reference the size of the procedure has advantages. The obvious being there is a numerical figure to relate to. This allows a comparison against similar hair transplants. But there needs to be the consideration how the natural hair characteristics plays a significant role. For instance, good hair characteristics can dramatically increase the achievable hair coverage, potentially by as much as 30%.

When researching it´s common for the graft numbers to vary slightly between clinics. Something in the region of a 10-15 % +/- swing is not an uncommon variant. Outside this range should raise concerns. There is by averages, a technical and common-sense range for the variant in numbers. If quoted outside the range it needs justification, be it lower or higher.

Over quoting graft numbers, candidates sometimes like the idea of having the highest quoted numbers. As if this proves they could do no more or it´s simply better. Even though, there is no basis for this to be correct way to go. Pushing up the numbers by adding hair into areas of healthy hair can significantly increase the number of grafts. The usual justification for this is hair miniaturisation within the current hair coverage. This often leads to wasted grafts distributed in areas of the head that had little to no thinning, as well as hiding potentially low yield. Notwithstanding the excess hair removed and now lost from the donor area would treat further hair loss.

A clinic underquotes the graft numbers may do so to undercut the price, or due to the ability of the medical team to only do so much. Either way, compromising the result and a false economy as there´s the need of further work at more expense, time, and hassle.

Under quoting can lead to putting the candidate in a compromised position on the day of surgery. The clinic suggests, it would be prudent to increase the graft numbers. They can still conduct the original plan you paid for, however …. The dilemma on the day of surgery puts the patient in a difficult position. Whether to stay with the original quote, with the implied risk of a lesser result, or agree to pay for more. This is different from a clinic stating they can remove more and give better hair coverage than originally discuss. That is a choice. This is putting doubt, by suggesting the original plan needs to change to meet the discussed result is different.

When judging the variation in graft numbers (intact follicular units), confirming that the plans are similar is essential. For instance, they all intend to cover comparable surface areas, with the hairlines around the same height. When a clinic is overtly different in the estimation, whether well under or over, it´s reasonable to expect it to justify its planning. Ideally, with previous results, similar hair characteristics you can judge. Always get everything in writing.
 
Bigmac

Bigmac

Administrator
Staff member
Great educational post that will help people.
 
Understanding Hair

Understanding Hair

Valued member
Previously touched on, was the relevance of using intact follicular units when measuring session size. The reason being the term “graft” in relation to hair transplantation needs defining over and above being a piece of skin tissue. The consensus is that a graft equates to an intact follicular unit. However, the terminology morphs between graft, hair unit, and follicular unit (FU); as a result, confirmation of the correct definition is necessary.


There are justifiable occasions when splitting a follicular unit is necessary. However, breaking up intact FU´s simply to increase the graft numbers is unacceptable behaviour. Firstly, it will negatively influence the graft distribution, and the expected quality of a result. Secondly, if you are paying per graft, you could potentially pay double, but because the cost per graft is low, it seems like a good deal. Dividing a four-hair unit into four singles, two doubles, or a single and three-hair unit increases the graft numbers. It also reduces the time having to carefully harvest the hair from the donor. Splitting the grafts is more efficient for the clinic, paying per graft or flat rate, time is money, and efficiency is key to a clinic.


Using natural, intact hair groups or follicular units is vital to the quality of a hair transplant result. When looking at sessions of around 2500 grafts and more, the number of hairs per follicular unit will average out at approximately 2.5 hairs per unit. In smaller cases of 1000 grafts, the average hairs per graft will drop to around 2.0 hairs per unit.

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To demonstrate how the number of hairs versus grafts impacts a hair transplant. Two cases, defined as 2,000 grafts. However, one being all single hair units and the other being a range of 2000 intact follicular units. As a result, one is 2,000 hairs, whereas the other around 5,000 hairs. The difference is striking, and in terms of what you could expect in terms of hair coverage, density, and the cosmetic look. There is no way two thousand single hairs can cover the same surface as five thousand hairs in their natural FU state and expect to achieve a similar look. You may pay a little less on paper, initially anyway, but you are getting much less in return, and the long term you will pay much more, in time, money, hassle to achieve anything like parity to a clinic using intact FU in the first place.


A comparison between two hair transplant results posted online by the clinics. This demonstrates how the graft count versus the hair count can differ.

Case 1: 3609 Grafts

Hair Breakdown: 1s - 459 (459 hairs), 2s - 1411 (2822 hairs), 3s - 1136 (3408 hairs), 4s - 603 (2412 hairs)

Total: 3609 (9101 hairs - Average of 2.52 hairs/FU



Case 2: 4536 Grafts


Hair Breakdown: 1s - 1401 (1401 hairs), 2s - 2835 (5670 hairs), 3s - 150 (450 hairs), 4s - 150 (600 hairs)

Total: 4536 (8121 hairs – Average of 1.79 hairs/FU


Conclusion: Case 1 has almost one thousand fewer grafts than Case 2 but almost one thousand more hairs.



Consequently, while graft numbers are important when researching, they only have relevance when backed up with knowing what the clinic term as a graft. Always check the definition of a graft when getting a quote. Also, always ensure you receive the graft and hair count after your procedure.
 
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