Is it possible to achieve 80–90 grafts/cm² with multiple hair transplants?

Question

Would it be possible to fill the temples of someone who naturally has hair in that area (despite no history of hair loss) to the same density as the surrounding non-bald regions? I understand that transplanting a high density of grafts (e.g., 80–90 grafts/cm²) in a single session is generally not recommended due to concerns about graft survivability. But what if the procedure is split into two sessions: first placing around 50 grafts/cm², then following up with an additional 30–40 grafts/cm² in a second session to reach the target density? Would this staged approach be feasible and safe? Additionally, could medications like Cialis or Viagra during the recovery period help improve graft survival by enhancing blood flow to the scalp?

Anna Chacon, MD, FAAD · Answer

Achieving a high density of 80–90 grafts/cm² through hair transplantation is indeed a challenging goal, but it can be approached with a staged plan, as you suggested. Here's a breakdown of the considerations:

Staged Transplant Approach:

Initial Session: Transplanting around 50 grafts/cm² initially is a common strategy. This density allows for optimal placement and healing, reducing the risk of compromising graft survival due to limited blood supply in the recipient area.

Second Session: After allowing adequate time for healing and vascularization (typically several months), a second session can be used to add an additional 30–40 grafts/cm². This approach helps achieve the desired density while minimizing the risk of graft loss.

Considerations and Feasibility:

Graft Survival: The key to high-density grafting is ensuring sufficient blood supply to support the transplanted follicles. A staged approach allows for better vascular integration, potentially improving overall graft survival.
Spacing and Technique: Both the spacing of grafts and the surgical technique play critical roles in achieving high-density results. Skilled surgeons use specific techniques to maximize density without compromising graft viability.
Medications and Blood Flow:

While medications like Cialis or Viagra can theoretically increase blood flow, their use for improving graft survival is not standard practice and lacks substantial clinical evidence. Instead, focusing on post-operative care, such as avoiding smoking and following your surgeon’s recovery guidelines, is crucial for optimal outcomes.

Overall, achieving high-density results requires careful planning and execution by a skilled surgeon. It is essential to discuss your goals and expectations thoroughly with your hair restoration specialist to understand the possibilities and limitations of the procedure.

Sujeev Bains, MD · Answer

Hello,
It is not uncommon to perform 2 stage surgeries. There needs to be adequate time for full follicular growth before the 2nd stage is performed. Generally overtaxing the recipent area can have certain complications so an evaluation after the 1st stage is paramount to determine how many additional grafts are required without overtaxing the area potentially affecting graft survivability.

Jeff Donovan, MD, PhD · Answer

High densities are possible but it’s hard to predict what’s possible in your case without more information. Certainly, 50 cm 2 is possible for many. Whether 80-90 is possible is not always possible to predict and density that high is not often achieved.it depends on a) your scalp b) your hair type and quality c) your surgeon d) your surgeon’s team. There is no convincing evidence that viagra/cialis affect things in the long run.

Is it possible to achieve 80–90 grafts/cm² with multiple hair transplants?

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Is it possible to achieve 80–90 grafts/cm² with multiple hair transplants?

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