How many grafts will I need? (Photo)

I have been losing hairs rapidly for last 3 to 4 years. I don't know to what extent I will lose hairs. Need to know how many grafts will I need to get good density.

Doctor Answers 5

Stabilizing should be done first to slow or stop losing hair, so you're less reliant on hair transplants and limited grafts

Thank you for your question. I understand you’ve been experiencing rapid hair loss for the past 3-4 years, and you’d like to have a hair transplant to address this. You’re asking how many grafts you would need to improve your appearance.
I can certainly give you some advice on this matter. To give you a little about my background —  I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I have been performing hair transplants for that same amount of time, and I’m also the founder of TrichoStem™ Hair Regeneration Centers, where we’ve advanced a method for the non-surgical treatment of genetic pattern hair loss in both men and women.
I think the question that needs to be addressed first is how to stop your hair loss progression. Currently, the only drug that has the ability to slow down hair loss progression is finasteride, brand name Propecia. Finasteride works by blocking an enzyme called 5-alpha reductase, which is responsible for the conversion of testosterone to dihydrotestosterone or DHT. The challenge here is that only 60% of men respond to finasteride, and there are also reports that the drug can cause long-term sexual side effects in men. With your level of hair loss, however, failing to slow down hair loss progression could put you in a difficult position when it comes to getting transplant in the future.
In our practice, we make use of a treatment called Hair Regeneration to stop hair loss progression and to strengthen whatever hairs are still salvageable. Hair Regeneration consists of a combination of platelet-rich plasma and extracellular matrix that is injected into the scalp, in areas where hair thinning is apparent. It stops the progression of hair loss, reactivates hair that is not growing, and helps thinning hairs grow thicker.
This is usually a one-time treatment, but in some cases, we will do two injections separated by about a year to eighteen months. In the course of over five years of using this treatment, we have been able to sustain improvement for our patients with a 99% success rate for both men and women. Every patient is treated as an individual and we even receive patients who come to New York from all over the world specifically to undergo this treatment. One thing we have observed and learned over the many years of doing this treatment is that the earlier we catch somebody, the more hairs we have to work with, the better the results. Keep in mind that once a hair is lost, it’s usually too late to help that area of scalp because there is no hair follicle left.
When it comes to someone with advanced hair loss such as yours, compromises must be made in terms of the hair transplant procedure. Hair transplants are very limited in terms of the number of viable hair grafts that can be harvested from the donor area, so it’s important to understand you’re not going to get full coverage and density.
Usually for men, most of the grafts are placed towards the front of the scalp to develop a frontal hairline. In addition to this, achieving optimal and natural-looking density will require more than one transplant. People often think that natural-looking density can be achieved with one hair transplant, and while it can offer some improvement, ultimately a second transplant is almost always necessary. Oftentimes, we also use Hair Regeneration to improve the results of hair transplants as well.
I recommend you learn more about hair loss stabilization to prevent hair loss progression. Based on the amount of hair loss you experienced in the last 3-4 years, it appears that you could lose a lot more in the next 1-2 years. You could look into stopping or slowing down the progression of hair loss first. Perhaps you can do this with the help of finasteride and do a treatment like Hair Regeneration, so that you can at least have more hair coverage and you will depend less on the hair transplantation to try to achieve a desirable look.
I hope that was helpful and I wish you the best of luck!
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New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Photos cannot determine how many grafts you may need if your goals are not discussed.

Photos cannot determine how many grafts you may need if your goals are not discussed.  What happens if your lose more hair?  What happens if your goals is to have the original hair density (which is not likely possible).

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
4.9 out of 5 stars 85 reviews

It appears that you are a Norwood Class 4A patterned balding patient

depending upon the hair quality and your donor density, it would take between 2000-3000 grafts a decision made clearly by a competent surgeon you need to select. 

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

How many grafts will I need?

Thank you for posting your question. The total number of grafts required all depends on the amount of surface are that needs to be covered.

From looking at the picture you have posted, the first half of your scalp zone 1 and zone 2 can use anywhere from 3000 to 3500 grafts.

The second half of your scalp can also use another 3000 to 3500 grafts, as we call zone 3 and zone 4. 

You may also want to consider using Topical Minoxidil atleast 5% along with considering Finasteride to thicken up what you have. 

Hope this helps.

Matt Tahsini, MD
Pasadena Hair Restoration Surgeon
5.0 out of 5 stars 15 reviews

How many grafts

I advise you to have a FUE operation of 3000- 3500 grafts . Hair transplantation would cover all area in one session of operation that is bare and you would have a good, succesfull result .

Ilhan Serdaroglu, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.