How many grafts do I still have available on the back of head? (Photos)

It looks like your donor area has experienced some degree of depletion from the two prior transplant sessions, though there’s still a moderate amount of density remaining. Based on your photos, the central occipital area (back of the head) still appears to have viable follicles, but the safe donor zone has definitely been reduced compared to before.

On average, a typical donor area can safely yield 5,000–7,000 grafts over a lifetime without causing visible thinning. Since you’ve already had two procedures, you may have around 1,000–2,000 grafts left that can be harvested conservatively from the mid and lower occipital region. However, this estimate can only be confirmed through a detailed in-person assessment using magnification tools and donor density mapping, as factors like hair caliber, scalp laxity, and previous extraction pattern significantly affect the count.

If you plan another small session just to refine the frontal area, focusing on strategic placement and density blending may provide a noticeable improvement without overharvesting the donor zone.

You’re being thoughtful about avoiding overuse of the sides — that’s a wise approach to maintaining long-term scalp health and natural appearance.

Based on the photos, the central donor area shows signs of thinning and miniaturization, especially near the crown. Due to the two hair transplant surgeries, density is lower than an untouched donor, which is expected.
A physical examination is always needed to make an accurate donor calculation, but here is an estimate based on what can be seen.
Since the sides behind the ears are excluded, we are considering only the mid-occipital zone.
- Around 1,000 grafts is safe and would have minimal impact on the donor
- Around 1,500 grafts is possible with careful extraction
- Around 2200 grafts can be risky but possible depending on the expectation

It appears that your donor area still retains a moderate amount of density, though there are some signs of previous extraction. The grafts visible in your donor zone seem to include a good proportion of double and triple follicular units, which is an excellent indicator for achieving natural thickness and coverage in future sessions.
The remaining safe donor capacity can only be accurately determined through an in-person assessment with density mapping and magnification, as factors like hair caliber, direction, and prior extraction pattern affect the total available grafts.
To form a complete treatment plan, it would be important to evaluate the frontal and mid-scalp zones as well, as these areas determine the most strategic use of the remaining grafts for visible improvement.
Your donor’s characteristics especially the higher number of multi-hair grafts are a positive sign, as they can provide good density even with a conservative extraction approach.