http://www.bernsteinmedical.com/hairtransplantblog/inde...ies/64-Graft-Numbers

That's pretty interesting reading. I do wonder about some of the issues he discusses though.

quote:

In “very” large sessions, the long duration of surgery, the increased time the grafts are outside the body , the increased amount of scalp wounding, risk of poor growth, wider donor scars, placing grafts where they are not needed, sub-dividing follicular units, and the decreased ability to plan for future hair loss, can all contribute to suboptimal results.

I asked my doc and was told that folicular units can live outside the body for as long as 72 hours if properly stored. I can't imagine even the largest mega session having the units "out of the body" for more than 15-17 hours max. If 72 hours is an actual account then I don't see significant risk with a competent staff taking proper care of them. I would be more worried how the grafts are being handled along the way than the time they were out.

Donor Strip ( of 5000 )

quote:

When you do the math again, it turns out that for most of the incision, the width must be almost an inch wide, an incredibly large amount of tissue to be removed in one procedure.
This large incision obviously increases the risk of having a wide donor scar – probably the most undesirable complication of a hair transplant.

I would think with a carefully chosen doc this isn't really an issue either. If the doc is experienced and ethical, he will not excise so much as to compromise a proper closure.

These issues seem to come down to the doc you choose rather than it being such a common risk about the procedure in general.

He does make good point about dividing up 3-4 hair units into 1's and therefore bumping up the total graft count. You are getting more grafts, but not more hairs. And it could cost you more for the exact same result.

I think the charge should be "per folicular units" that your donor provides. This seems the most fair way overall. You would definitely need an ethical doc for this as they could get lazy and not divide them up as much as they would if they are splitting them. Splitting them under this plan would cost the doc more in time and they may not do it because of this. It's an incentive to the doc to split them up when you are paying by the individual graft. Either way it is charged, I would expect the "splitting" be done specific for the job and not have money factor in it in any way whatsoever.

quote:

For example, I would prefer to have full growth with a properly placed 2,500 – 3,000 graft hair transplant session than partial growth in a 5,000 graft session. Of course, the 5,000 graft session will look fuller than 2,500 grafts but, in my experience, never twice as full, and never as full as two 2,500 graft sessions.

I'm not sure I agree with this. It's not worded fairly. Of course anyone would rather have a properly placed graft to on that has partial growth. He's making an implied assumption that larger sessions *WILL BE* partial growth.
Again, I think this concern also comes down to the doc you have do the larger session as for "partial" growth to be an issue.

If he's *not* inferring partial growth, (in the 2nd sentence) then how could 2 smaller procedures be better than one larger one with the same amount of total grafts?

IMO, That would not change my mind against a larger session vs a multiple smaller ones. There would be other reasons to do that but I think choice of doc, his experience, consistent results with larger sessions etc.. would alleviate most if not all of those concerns about larger sessions.

I think there are docs that are too conservative (maybe due to lack of experience in larger sessions) and docs that could be too aggressive for their experience. And there are those in the middle(ish) that have proven track records with consistent quality results with larger sessions.

Rambler
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Interesting read....I'd love to hear a "rebuttal".

I think the system in place now for charging a patient per graft, whether 1 hair or 4, is more than fair for everybody. The doctors and techs are bending over backwards to stay with the times as it is and producing great results for the most part, so let them continue to work hours on end without having to split even more hairs at their expense not to say anything of having get used to to a whole new system that surely isn't going to benefit the ones doing all the work.

I found it interesting he says he has never seen one 'mega' session of 5,000 look twice as full as a 2,500 session.

If that is true, then the only benefit to a mega session would be the comfort of not having to go through a second one. In my view, it would take the financial aspect out as there would obviously be yield issues with the 'mega' session - if that were the case.