How many grafts do I need? (photos)

I was wondering how many grafts I need. I have been told anywhere from 1200-3000 from various doctors. Thank you

Doctor Answers 10

Grafts needed for hairline

Usually in patients such as yourself, I estimate about 1,500 grafts are needed to reconstruct the hairline and the angles as well as reinforcing it. This can change based on how much the patient wants to advance the hairlineetc.  The best way to know is to meet with an experienced hair surgeon but 1,500 grafts is about reasonable.


Irvine Hair Restoration Surgeon
5.0 out of 5 stars 20 reviews

How many grafts do I need

The best way to determine how many grafts might work for you is to look at our gallery of over 1000 patients withe before and after pictures below, and then pick someone out like you with your hair loss, and see how many grafts it took to get the results shown

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

Estimate the number of grafts

From looking at your pictures you are a grade two in the Norwood scale of hair loss and you need about 1500 grafts to lower your hair line and the temples.

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
4.8 out of 5 stars 27 reviews

1200-1300

Are you looking for a better answer than what other doctors told you?  Are you looking for a confirmation?

Your photos show early genetic male pattern balding. You may eventually end up with a completely bald head (You can't tell without an exam). If you are trying to cover your entire head, you may need 6000+ grafts over your life time. You may need much less for an improvement.  Maybe 1200 to 1300 will do it for now (but what if you lose more hair in 1 year?). What a doctor considers an improvement may not be what you consider an improvement. The result will depend on how you style your hair and what your ultimate expectations are. This may sound extreme, but that is the reason why you need to see a doctor in person for a personalized understanding of the treatment plan.

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

A non-surgical solution may stop your progressive hair loss, and thicken hair with better volume and density than a transplant

What you appear to have is male pattern hair loss. We first need to know the age of onset or how old you were when you started losing hair. We also ask about family history to see if there are family members with a similar pattern so that we can get an idea of what the rate of progression is. Hair loss is not a single event, it is a process of hair thinning eventually leading to hair loss. This is an important factor to think about when you’re thinking about surgical hair restoration.

We also ask about the medications that you are taking. In the United States, there are two FDA-approved drugs for hair loss in men, one is finasteride which is a pill you take daily. Finasteride works by inhibiting an enzyme called 5-alpha reductase. This is the enzyme that converts testosterone to dihydrotestosterone (DHT). DHT is responsible for causing thinning of DHT-sensitive hair follicles. If you diminish the DHT, you diminish the triggering factor that causes the hair to thin. Minoxidil is the other drug that is used topically which prolongs the hair growth cycle so that you appear to have more hair in the scalp. Currently, there is a lot of concern about finasteride because of its possible sexual side effects.

Before considering a hair transplant, you have to understand that you don’t stop losing hair especially if you are not able to take any medication like finasteride. Regardless of the number of grafts that are placed, you’ll continue to lose hair. Another thing to consider is that you only have a limited area to transplant hair from. Currently, it’s very popular to look at follicular unit extractions as “scar-less surgery”. However, in order to do follicular unit extraction, you have to go way outside of the true donor area or the genetically resistant area where hair is taken from for hair transplant. Unfortunately, this area only has limited number of hairs available and is not enough to cover a lot of area in the bare scalp. You also need a lot of hairs to achieve density. During a hair transplant, you have to place grafts as close as possible and a certain amount of hairs will not survive. You would need more than one transplant to fill in those corners to get the volume that you want in the face of progressing hair loss.

In our practice, we have developed a non-surgical method of restoring hair called Hair Regeneration. In male pattern hair loss, the hair is going through progressive hair loss, but with a microscope, we can see a lot of potential hair. In Hair Regeneration, we are using extracellular matrix which was originally used for wound healing and is combined with platelet-rich plasma derived from your own blood. Through a formulation and method of technique of delivery, it treats the thinning hair and reverses hair thinning so that hairs start to become thicker. We have hundreds of patients to prove the validity of this procedure. We have been able to demonstrate this exceeds the results of almost any transplant. For younger people, without surgery, they can have an injection that results in significant correction of volume and area of coverage and halting of the hair thinning progression. We have patients who come from all over the world and we have tremendous data to support its benefit.

When you come to our practice asking for hair transplant, I discuss the number of grafts and look at the area of hair loss to estimate the number of grafts that you would need to fulfill that requirement. However, before doing the surgery, I would actually insist that you would first do the Hair Regeneration procedure so that you would benefit from the reversal of hair thinning and thickening of the existing hairs. At the end of 18 months, you get the full benefit. If you want more hair, then we can be more secure in the strategy of doing a transplant because we know that your progression of hair loss won't continue. We can also be more strategic where we place the hairs.

The typical approach is letting patients understand their limitations and avoiding surgery because they might end up having a short-term benefit. With surgery amidst the progressive thinning, you might end up having only the grafts left. That’s why a lot of people are dissatisfied with hair transplant. Hair Regeneration has become the treatment of choice for people who are thinning and are having existing hair before moving to a hair transplant. Fortunately, more than 90% of our patients, once they have Hair Regeneration, they don’t feel that they need a hair transplant. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Recession of Corners

If your hair loss is only limited to the receding areas on the corner, you may only need 800 to 1500 grafts.  Of course another factor that should be considered is the level of thinning of your existing hair behind the current hairline where we have to extend the transplantation.  That may add to the numbers.  A visit to a good hair transplant surgeon can help you find out the number with more accuracy.

Parsa Mohebi, MD
Beverly Hills Hair Restoration Surgeon
5.0 out of 5 stars 28 reviews

All depends on your expectation

Your expectations will dictate the number of the grafts. You can have 1500 at first session and if needed do the second session. Robotic hair restoration has the advantage of harvesting hair from same donor site more than once without scar and shorter recovery. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 113 reviews

Number of grafts needed, it's a good question

Determining the number of grafts or follicular units can only be determined by working with you to design a hairline that you are happy with. If you would like a hairline above your temple points more anterior or slightly less anterior this will play into the amount of donor material needed to meet your desires. It also depends on where you are in your stage of hair loss and looking at your family history of hair loss, this would help me to determine how much donor material needs to be kept in reserve as well as meet your current cosmetic needs. I have seen many patients that tell me a doctor "eyeballed" the bald area and came up with a number. This is almost always a mistake. If you have thinning behind the frontal forelock of hair you may need grafting in that area as well as above the temple points, which would also effect the numbers. However, for an approximation discussion, 3000 grafts is definitely not an appropriate number and may cause tissue damage in the recipient area. Also, few may want you to look at a flap procedure, these procedures in  my opinion always look unnatural both for scarring and hair angle. Have said this "me eyeballing your needs" it appears you will likely need approximately 1200 to 1700 follicular unit grafts. Results are important. Do your research! There are approximately 100 hair transplant surgeons in the USA that exclusively devote their practice to hair restoration. It takes artistic talent and repeated, devoted, clock work precision to obtain great results. My advice: 1. Seek out a full time hair transplant surgeon who is devoted only to hair restoration. 2. Examine their website for before and after pictures and ask yourself, "Do the results look natural?" Not all results are created equal. 3. Meet with the doctor not a sales consultant and view before and after pictures of "their" work. 4. Do not be pressured into hair restoration it is a cosmetic optional procedure. 5. After all your investigation, assess the results and information and "listen to your gut"! Are you comfortable with your decision and choice of surgeon? Thanks for the question, I hope this will help you in your search.

Brian Goertz, MD
Seattle Hair Restoration Surgeon
5.0 out of 5 stars 23 reviews

Number of grafts needed for density?

You will not match the density of your forelock! You will need at least 4000 and remember that it is not over until the fat lady sings! You could need thousands in the future. You should look into the Fleming-Mayer Flap which gives the most density and has many advantages grafts do not have. We have done both grafts and The FM Flap for 35 years and give our patients the pros and cons of each and let them decide which is better for THEIR GOALS and not just the surgeon"s.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Determining # of grafts for hair transplant

I see that you have quite thick forelock hair in the center.  If you desire to match that density in the frontal peaks, I would recommend 2000 grafts at least to come closer to the density.  1200 may still look pretty good but is less likely to match the density.  While 3000 would almost guarantee achieving the same density with some room for error of graft failure.  Though there is never a guarantee with transplants because their are other metabolic factors involved in how well the graft will take.  I wish you the best of luck in your decision.

Karen Stolman, MD
Sandy Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

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