Is 3,500 grafts too much in a single procedure? One surgeon is saying he can do this for me. Others recommended only 1,600?

Hello,Reliability of harvesting technique must be considered.  All techniques, including handheld FUE, strip technique, and ARTAS will have some transections or grafts which were damaged during harvest.  Our numbers (which we believe translates to most other hair centers) were around 35-50% transection rate with handheld FUE, 15% transection rate with strip surgery (due to location of bevel of knife along the whole periphery of strip), and less than 5% transection rate with ARTAS.  In my own transplant procedure, I had 1000 grafts harvested and 1 transection with harvest!!!  If a patient paid for 1000 grafts, does this mean they paid for 1000 harvest attempts or 1000 legitimate grafts.Best,Dr. Anil Shah

Pick the best surgeon, not the number or the price. A bad hair transplant is like herpes. You carry it for life.Don't focus on the number of grafts recommended.  A great surgeon can make you look great with half the number. (Just making a point in general.. not specific to your needs)Don't focus on the cost of the surgeon. Focus on the doctor's results.  See the doctor's patients in person. In the end, do your research, due diligence, and trust your instincts.  See the link below for a detailed view of how to pick your doctor:Selecting a doctor for any medical need has many common rules. You should look for a doctor who:Is caring and compassionate.Takes an interest in you as an individual.Takes the time to learn about your problem, listens to you and does not lecture you by imposing his/her views upon you.Is willing to educate you and bridge the gap between his/her knowledge and yours.Has excellent credentials in the specialty field you need.Has built a reputation of excellence in the field based on their results, and are recommended by family, friends, patients, or a physician that you trust.

If you are a NW 3 to 4 you can handle 3500 grafts.  Why not ask the surgeon who wants to do more to do 3100 and then see if you need more after he does 3100. The number of grafts always depends on the surface area that needs treatment and the density you place the grafts.  Of course, you must have a suitable donor area to build a lower hairline that might require 3500 or more grafts.  go with the best surgeon.  there are no great opportunities to "do over" with hair transplants.  Cost is not the issue.  Quality is the issue.  Choose the best quality and go with that.  

Assuming that you are talking of FUT, I would like to say that the
ability to take out the grafts depends on the experience and technique of the
surgeon . A well trained and experienced
can take out anywhere between 3000-4000 grafts from strip depending on the
laxity and elasticity of your scalp.



Regarding the number of grafts required to cover the area, some have
recommended 1600 to you perhaps may be they think that an adequate cover can be
achieved with this very number but the other surgeon because of his ability to
harvest more number of grafts would have recommended higher number of grafts.



You can check the videos gallery of that clinic and get an idea of how
many grafts does he normally take out.

Choosing a larger number of grafts has to do with two main factors:1. Your demand: How much hair you need2. Your supply: What is your density of hair and laxity (in strip procedures)If your supply is good you have to understand that your demand is not only determined by the bald area, but at time surgeon needs to fill the transitional areas that you will be going to lose hair in those areas.  That is to make sure you keep a full head of hair for many years to come.You need to talk to your doctor and ask the reason for the number of grafts and try to get a good understanding of which area will be covered with what kind of density.  Perfoming hair transplants with larger number of grafts (megsessions and gigasessions) are commonly done and recommended and there is no reason that we think the grafts may not take as good as when we transplant small number of grafts.

You can't decide on choosing your surgeon depending on how high a graft number he offers. Deciding on the right graft number is a very complex process that can not be explained in a few words. Patients have to make every effort in finding the most competent hair surgeon for the best price. They should leave the decision on graft numbers to the surgeon they trust. There are situations when 1500 grafts is the right number and situations when 5000 grafts could be considered.

This can be a tough call, but the important thing is for you to trust your surgeon and have a confident feeling moving forward. Otherwise, you risk paying for grafts that you don't need and may not get. You also didn't mention whether you are getting a strip or FUE procedure. Number of grafts in FUE may be limited by donor area, and over-harvesting may leave a thinned out occiput. Consider additional consultations until you feel comfortable. Good Luck!

You may want to clarify how much area and how much density you are talking about with the doctor himself.  Smaller staged procedures have benefits, especially if FUE.  However, bigger procedures also have benefits.  One thing to remember is transplants dont always work, so if it doesnt grow, would you rather take it step by step to find out or do the whole thing and find out?  The success rate is high, but not 100%

1600 could be right for Norwood III with frontal recessions only but if you are thin through the middle as well then doubling that number is not unusual if the area needing to covered includes the whole area in front of a line across the top of your scalp then 3000 is the minimum required and probably more if the doctor wants to maximize the number of grafts safely packed per square area

This depends on whether you are having the FUE or strip methods. Many experienced Surgeons will limit this to about 2500 when using the FUE method while 3500 grafts is possible with the strip method depending on your donor density and elasticity. If you calculate the 'hairless or bald' area then you can estimate the numbers you need depending on the density recommended. The size of Norwood III or IV area will determine the answer to your question.