This podcast episode addresses the question:" how many hair grafts do I need?"

Transcript:

Dr. Joffrey:     Hello everybody! This is Dr. Joffrey with Chicago Hair Clinic and you are listening to our podcast. Today, I'm going to talk about a topic, I think, that will be of interest to pretty much just about anybody who's considering having a hair restoration procedure, and that's the question, "How much hair do I need?"

Obviously, that's important because, frankly, most hair restoration, hair transplant procedures are charged per graft. The question is, "How many grafts do I need, Doctor?" Here is how you figure it out.

Now, these are some very general principles and I don't want you to feel like I told you something that's not true if you get quoted something else because I'm giving some very broad stroke principles, so you can, at least, get a handle on what you might be up against.

Let's take the general premise that 2,000 grafts covers an area on your scalp of about a size of a compact disc, a CD. So, that's a good place to start. Now, there's a lot of considerations that go into this when you start playing around with those numbers.

Now, first of all, what the heck is a graft anyway? What is a hair graft? We use the word "graft" to describe each follicular unit that we take out. When we say graft, we're not talking about individual hairs. We're talking about what's called a follicular unit. A follicular unit is, on the scalp, will have somewhere between one and four hairs on it. What you're doing is taking out each graft and each graft has either one, two, three, or four hairs in it. It's going to average out between two and three. I mean, that's generally how it works.

Now, obviously there are some genetic factors and some people might have more single hair follicular units and some people might have more, but that's a pretty good general rule. The CD that I said is based on that whole premise, the CD size. Now, what else matters? The number of grafts will change depending on where you need hair.

As a general rule, the further forward you move the more hair you need; the more hair grafts you need. That's because it needs to be more dense in the areas where people are going to look at you directly, specifically, in the hairline. The hairline requires a lot of hair. If you need a complete reconstruction of your hairline, it's going to really take quite a bit of hair. It might just take 2,000 grafts just to do that. Then if you have a good hairline and you've got the size of a CD that's behind it, say, closer to the crown area, it may just take that 2,000 grafts we talked about.

Another consideration is what kind of procedure are you having and where are you having it? I say that because it's just a reality, okay? If you have a strip procedure, that's the gold standard in hair restoration right now. Generally speaking, if you go to a reputable hair clinic, probably about 85 percent of the hair follicles that are placed are going to live. In other words, if you have a thousand grafts placed, 850 of those grafts will probably survive. I mean, that's in a quality hair clinic.

Now, if you use something like automated follicular unit transfer which we love using in our office, that number may be 97 to 99 percent, so you’re getting virtually all of the hair that you had taken from the donor area survive and become part of your scalp, your balding scalp. That obviously affects the number of grafts you need as well.

Manual FUE, the type of follicular unit extraction that's done by hand has a very, very poor grafts survival rate. It might be as low as 50 percent. That's another consideration. You might have 2,000 grafts placed over time with manual FUE and only end up with a 1,000 grafts, so you can't use that CD to judge how much hair you need there.

Another situation that's a little unusual that we've talked about in previous episodes is body hair.

In this 4th episode of the Chicago Hair Clinic and Hair Restoration podcast, the topic of body hair transfer to the scalp is discussed. Body hair transfer is a relatively rare procedure.

The primary reason for doing body hair transfer rather then using the hair at the back of the scalp is a shortage of donor hair follicles in this area. Most frequently, this is because a person has had multiple previous hair transplants or hair restoration procedures using a strip procedure. A strip procedure is the classic technique for hair transplant that requires removing a strip of scalp from the back of the head and transferring it to the balding areas on the top and front of the scalp.

When there is inadequate amount of donor hair in the back of the head, one option is to use body hair. Because taking a strip of skin from the body is not desirable, this has been done in the past with traditional manual FUE where one hair follicle at a time is dissected out and then transferred to the head.

Because of the tedious nature of this procedure (usually no more than 300-500 follicles in an entire day), and the frequent damage to follicles resulting in poor survival of hair follicles, this procedure has not been terribly successful for the vast majority of patients.

We have implemented the use of automated follicular unit extraction with a suction-extraction "no touch technique" which has resulted in tremendous game changing results for body hair transfer (BHT). Individual hair follicles can now be harvested at a much higher speed (up to 3000 hair follicles per day) and nearly 100 percent survival and take of follicles. In the United States, automated follicular unit extraction is done by a machine called neograft.

We have used this machine widely in body hair transfer and in traditional back of the scalp transfers with tremendous success.

The limitations of body hair transfer are the hair follicles themselves. That is to say that hair, as always, maintains the characteristics from where it came. So, if body hair is straight and 1.5 inches long, when that hair is transferred to the scalp, it will remain straight and grow no longer than 1.5 inches in length. However, for most men, this is not a major drawback as having any hair is a far more desirable endpoint than no hair at all.

Body hair transfer with automated follicular unit extraction (neograft) has given many men the opportunity to achieve results which were not previously possible!

Our office provides free consultations including phone consultations for those living out of state or out of country. Call 847-995-9000 to make your appointment today!

In this episode #3 of the Chicago Hair Clinic podcast, Dr. Joffrey discusses surgical hair restoration, otherwise known as hair transplant surgery. After a review of the basic fundamentals behind hair surgery such as patterns of male pattern baldness and the role of DHT, Dr. Joffrey discusses the most common procedure performed around the world today, the so called "strip procedure". He then compares the strip procedure with automated FUE or neograft. Dr. Joffrey also distinguishes between neograft and manuel FUE which is done by hand.

The various advantages of automated FUE compared to both the strip procedure and manuel FUE are discussed. Dr. Joffrey concludes that the current procedure of choice for qualified candidates is the automated FUE procedure because of minimal scar, minimal complications, and maximal speed and survival of hair grafts.

In episode 2 of the Chicago Hair Clinic Podcast, Dr. Joffrey discusses the various medications for hair loss.

Specifically, Dr. Joffrey discusses the role of minoxidil and finasteride in hair loss as these are the only medications to show any effectiveness in male pattern balding.

In this first episode of the Chicago Hair Clinic Podcast, Dr. Joffrey gives some introductory comments about what to expect from this podcast and the reason for it's inception. After that, the question "why do only some men go bald" is addressed. Dr. Joffrey discusses male pattern baldness and its physiology, specifically the role of dihydrotestosterone otherwise known as DHT. A basic understanding of DHT pattern in hair loss is used to explain, in very simple terms, the concepts behind successful hair restoration and hair transplant surgery.