What is the Maximum Number Grafts That Can Be Done in One Transplant Session?

There was a phase where surgeons were doing 2000 per session. I don't think the results were as good as when only 1000 grafts were done per session. They start to grow faster and I think the yield is better when fewer are done. I currently only do 1000 as a maximum and if it is a small area, even less. Too many at one time can shock the surrounding hair causing it to fall out temporarily.

Hello,When patients are quoted numbers of grafts a common question is how does a transplant know how many grafts they have harvested?  As you will soon learn, 1000 grafts does not always translate to 1000 grafts.1. Hand counter-  Some teams will use a hand counter when harvesting via FUE.  From our observations, this is rarely done.  Below is a picture of a hand counter.  When harvesting grafts this is often difficult to do.2. Microscope counter- There is often some trimming that is done by the microscope.  This trims the excess material around the graft and allows for the graft to be optimized for the location of implantation.  It is really important for patients to not have their grafts split. (insert hyperlink here to graft splitting blog).  Splitting is when the team harvests larger grafts (such as 4 hair grafts) and splits them down to 2-4 individual grafts to inflate graft numbers.  This way, a team can harvest only 250 grafts and split them into 1000 grafts.  The issue with splitting is that it charges patients 4x the amount they should have.  This is often why some hair centers will have artificially low pricing and patients are underwhelmed with their results.  In strip surgery, grafts can be cut into as many or little grafts along FUE show that again graft numbers can be artificially inflated.  show picture of how splitting 4 hairs into 1 can give patients same amount of hair but more grafts3. Software counters-  The most accurate method of grafting is the use of technology which counts and automates the process.  The ARTAS system has a software counter built in so it knows how many grafts are harvested.  This can be helpful for patients who want some means of verification.  A screenshot can determine how many grafts are harvested and let patient's know that 1000 grafts =1000 grafts.    Show screenshot of artas and number of grafts and maybe video.  In our office, we often harvest more than the number of grafts since even with ARTAS, there may be some grafts which have been transected (MUCH lower with ARTAS than handheld).Important considerations:In Chicago, there are some large hair centers who claim to have invented a technique to multiply grafts.  In reality, this technique involves splitting grafts to keep hair number the same but to inflate graft numbers.
 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

Maximum number of grafts in one session is dependent on the exam.  Doctor needs to determine your hair density and scalp elasticity for maximum harvest.  Every person is different and with each surgery the maximum number changes.

There have been numerous advancements in the last 15 years. In one session, I transplanted 8,000 individual hair grafts from my patient’s beard and donor areas of his head using an advanced method of follicular unit extraction (FUE). My uGraft technique for body hair transplantation (BHT) uses non-head hair and transplants it to recipient areas. BHT increases the donor supply using non-head hair harvested from other parts of the body and face. This includes other hair from the face such as the beard. It also allows for the chest, stomach, shoulders, arms and legs as potential sources.

 

You can have "mega-sessions" for hair transplant surgery.   I define mega-sessions as about 2,500 grafts in one session.  The sessions can reduce the number of stages for hair transplant, one will need at least a second session to complete coverage or increase density.

Dr. ES