Article Update:
In a new publication, Dr. Umar is featured as the lead author of the new Sanusi FUE Score Scale, AKA the SFS Scale, which is a new and revolutionary method of gauging the difficulty of hair transplant for prospective patients. Before the publication, the FUE hair transplant industry had always judged the relative difficulty of hair transplantation depending on the curliness or how coiled the patient’s hair is. Using this previous method, many patients of African descent have been rejected as they were deemed too difficult to operate on. Yet, the new findings that this new paper suggests is that hair transplant difficulty is based on two factors: hair type but also the thickness of the patient’s skin.
If you are considering getting a doctor’s helping hand to restore your hair, determining your hair transplant graft count is probably a very high priority on your list of questions. After all, most clinics charge on a price per graft basis. A preliminary estimate can give you a general range of what to expect. But the actual graft number will depend on several factors and vary from clinic to clinic. As you embark on the road towards surgical hair restoration, it will help you understand the Norwood scale, how doctors calculate your hair transplant graft count, and the concept of graft quality.
DIY uGraft Calculator Tutorial: How to Find Your Graft Count for Hair Transplant
Try the DIY uGraft Calculator: https://dru.com/diy-hair-transplant-graft-calculator/ Watch the tutorial above to learn how to use the DIY uGraft Calculator t…
Hair Transplant Graft Count For Conventional Head Donor Surgeries
Traditional hair restoration is performed using hair follicles surgically removed from the head to become hair grafts. These hair follicles are then transplanted to the recipient area through insertion into carefully crafted slits.
The average Caucasian male will have a scalp donor supply of about 8,000 grafts. However, many people will also deviate from the norm. Ome will have as few as 4000 grafts or as many as 10,000 grafts.
6000 grafts are usually enough to restore the front hairline and crown for Norwood 2-4. At Norwood 5 stage, this quantity would only accomplish a sparse or partial coverage for the entire area of hair loss. Often, the crown is given less priority.
The Issue of Density
Conventional hair transplant clinics must often consider the issue of density when calculating graft count figures. Many anticipate about 6000-8000 available donor grafts from the scalp. Surgeons also have to decide on how closely packed the hairs should be in terms of FU (follicular units) per square centimeter (FU/cm2) [1].
In many cases, using the same (i.e., constant) density figure for the entire balding region will produce a sparse and thin result. Instead, they must consider a thicker density count in the front. And the back would be achieved using a smaller density. This would create a fuller appearance in the front and a thinner appearance in the back. Most patients prefer a more youthful-looking coverage for their hairline and frontal scalp, with the back and crown area more hidden at first glance.
What About the Severely Bald? (Norwood 6-7)
Norwood 6-7 individuals are considered severely bald. At this point, the hair remaining on the scalp donor cannot conceivably provide credible-looking coverage. Thus conventional hair transplant procedures which rely on head donor supply would not be suitable.
Patient Examples and Estimating Your Donor Supply
One way to obtain a rough idea of how many grafts you might need is to look at other patient hair transplant cases. Sites like YouTube and hair transplant forums have many real-life images and videos where the graft count is openly disclosed.
When you look at these cases, it would be essential to find individuals with similar hair loss presentations as yours. This would include details like:
- areas of baldness and thinning
- comparative hair type, in terms of thickness, texture, and color
- similar hair to skin color contrast
- ethnic background
Finding closely matching examples to your situation would help you understand how many grafts might be needed to accomplish your goals.
How to Estimate Your Hair Transplant Graft Count Using the Norwood Scale
A hair restoration surgeon will provide a more accurate hair transplant graft count based on your particular case. However, before making consultation appointments with hair transplant providers, you may be interested in getting a general idea of how many hair transplant grafts you will need.
The Norwood scale is a quick and easy way to get a rough estimate.
How Does the Norwood Scale Work?
The Norwood Scale is a standard diagram that illustrates the various stages of male pattern baldness. See which level, from 2-7, best matches where you are currently with your hair loss.
Next, multiply your Norwood level by 1000 -1500 grafts. You will need more or fewer grafts depending on several individual factors.
Individual Variances That Affect Hair Transplant Graft Count
Averages and estimates offer a good starting point for understanding how many grafts you need. The result that you want is coverage and being able to restore the look of a younger head of hair. Contrary to what most people initially think, the coverage achieved through a hair transplant procedure is not necessarily based on complex, precise numbers. This is partially due to individual factors that are based on your genetics.
How Skin to Hair Color Contrast Affects Hair Transplant Graft Count
The contrast in color between the skin and hair will affect how well the appearance of coverage.
High Skin to Hair Color Contrast
Areas of the scalp peeking through the hair are highly noticeable in those with dark hair and very light-colored skin, where the color contrast is excellent. This results in relatively more grafts being required to achieve good coverage.
Low Skin to Hair Color Contrast
When hair is sparse, The scalp will be much less noticeable in individuals with low skin-to-hair color contrast. This includes:
- Dark skin with dark hair
- Light skin with light hair
In these cases, fewer grafts are required to create the look of sufficient coverage.
Hair Thickness and Hair Transplant Graft Count
Patients with thick hair naturally have fewer follicular units per square area of their scalp. Therefore, relatively fewer grafts are required for hair restoration procedures.
Likewise, individuals with thinner hair will need a more significant number of grafts to approximate their natural density and restore the appearance of coverage to the areas marked by hair loss.
Hair Curliness and Graft Count
Curly hair spreads over a wider surface area of the scalp than a straight area. Together, these hairs will create more coverage and make the underlying skin less visible.
Patients with curly hair will generally require a lower hair transplant graft count to achieve the appearance of coverage.
When it comes to patients with straighter hair textures, some doctors will maximize the look of coverage by inserting follicles at much sharper angles. The hair will, therefore, grow more parallel to the skin. However, the results must blend well with the rest of the hair. Whether or not this technique is used will depend on what these insertions will like relative to the surrounding areas.
Check Our Before & After Gallery!
The Issue of Density and Calculating Your Hair Transplant Graft Count
Patients often think restoring coverage is a matter of reproducing their original hair density in balding and thinning areas as a certain number of hairs per square area on the scalp. Why would different doctors provide different graft counts if this is the case?
Aiming for a patient’s initial density is a significant risk in surgery. In situations where hair follicles are inserted too close together, the likelihood they will survive long-term decreases.
For example, in Caucasian men, the average hair density ranges from 80-90 follicular units per square centimeter. However, the insertion of 30-35 follicular units per square centimeter is associated with a 90% survival rate. 4 -50 follicular units per square may have a relatively lower survival rate.
According to the ISHRS (International Society of Hair Restoration Surgery), 64% of patients express disappointment with their hair density after surgery. This implies a sizeable demand for density as well as grafts. Some doctors will try to meet this demand by offering much higher densities based on their developed techniques to improve survival rates. Simultaneously, other surgeons will stay within a very conservative density range.
Follicular Unit Extraction and Strip Surgery – Considerations For Your Hair Transplant Graft Count
Regarding follicular unit strip surgery FUSS, graft count will depend on hair density in the donor area and scalp skin laxity. The doctor will need to remove a narrow strip if a person has a tighter scalp. This will prevent the linear scar from stretching and head mobility issues. A narrow strip will also mean fewer grafts.
In a patient with more significant skin laxity (i.e., looser skin), a strip hair transplant surgeon can excise a much wider strip and harvest a much larger graft count. There is less chance of the scar widening or stretching over time. Individuals can move their heads freely without feeling tightness or awkward sensations on their scalp.
In theory, improving their hair transplant graft count would benefit patients by improving their skin laxity. Measures used to improve scalp laxity include:
- Scalp exercises usually involve placing both hands on each side of the scalp near the temples. Then the hands move the skin upward and back down. The recommended time is between 30 minutes to an hour a day, starting weeks or months before the surgery.
- Vitrase may be prescribed to help strip hair transplant patients improve their scalp laxity. However, like all medications, this drug may incur side effects and complications such as:
- Botox injections can relax the muscles on the scalp, which improves the laxity of the skin.
Choosing Follicular Unit Extraction
Follicular Unit Extraction (FUE) requires tiny punches to harvest individual follicular unit grafts directly from the scalp. Since there is no excision of a tissue strip, skin laxity is not an issue when acquiring more grafts. The recommended graft count for surgery would be the same whether a patient has tighter or looser skin on the scalp.
With Follicular Unit Extraction, there is no need to invest sizeable amounts of time for weeks or months on daily scalp stretching exercises. Patients would not have to expose their health to the potential risks of drug side effects to achieve a higher graft count.
Skin laxity is genetically determined. Medication or manual exercises to alter this would most likely create short-term results if anything. The skin would attempt to restore its initial state of balance. And this may result in scar stretching, becoming broader and more visible over time.
Regarding optimizing graft count, Follicular Unit Extraction would be the more time-efficient and less risky choice than strip surgery.
Available Graft Count on the Scalp – Follicular Unit Extraction Versus Strip Surgery
In Follicular Unit strip surgery (FUSS), the excised strip can only be derived from the Safe Donor Area (SDA) on the back of the head. A scar in the nape and periauricular areas would be pretty disfiguring and would not heal well. So, these grafts are resilient to DHT and have a strong likelihood of lasting long term. Therefore, strip surgery is limited to the number of hair follicles available in this zone.
On the other hand, Follicular Unit Extraction offers the ability to achieve a much higher graft count since doctors can extract follicles from the head’s entire back and sides in select patients. The FUE Shave Test developed by Dr. Umar can determine who is eligible for extractions in these regions.
As the name suggests, the test requires patients to have their heads shaved. The hair distribution patterns on the head reveal reliable information about how likely these follicles will continue to grow hair long-term.
When there is an even distribution of hairs (in terms of density and hair caliber) across the head’s entire back, this indicates that these follicles can be used as grafts and are not likely to miniaturize from the progression of pattern baldness.
When there is a clear line of demarcation and a visible decline in hair density and caliber, this pattern indicates the individual is likely to progress to a Norwood 7 (severely bald) stage of hair loss. Additionally, they would not qualify as a candidate for an FUE procedure where grafts can be extracted throughout the back and sides of the head, only through advanced FUE tools such as the Dr.UPunch I, an Intelligent Punch.
FUE and Hair Graft Quality
Since Follicular Unit Extraction uses tiny punches to remove the follicular unit, many strip surgery supporters argue that this approach is more likely to remove the outer layers of the fatty tissue sheath surrounding the cluster of hair follicles. Therefore this would potentially compromise the quality of the grafts.
However, this premise is not valid. Compromised graft quality would result in minimal to no hair growth. Therefore, hair transplant doctors and patients expect better yields from strip surgery than FUE. But in truth, there are numerous patient cases where strip hair transplant patients have ended up with disappointing outcomes and continued to suffer from baldness and sparse hair areas.
Many of these patients have sought Dr. U’s help, rebuilt their coverage, and concealed their strip scarring with Follicular Unit Extraction.
Need A Higher Hair Transplant Graft Count? Why Body Hair Transplantation with Dr.UGraft ™ May Be Your Answer.
All hair transplant patients hope to achieve the best coverage possible and not settle for partial improvements that continue to fall short of their ideal outcome. This explains why there is a robust demand for high graft counts.
When the scalp cannot provide enough grafts, body regions may be considered an additional resource for expanding the donor supply. This includes areas such as:
- Sides of the face
- Neck
- Chest
- Lower abdomen
- Back
In many men, thick body hair tends to grow in large quantities. Additionally, these follicles are very robust since they do well in DHT-rich environments. Therefore, body hair grafts can be expected to survive long-term on the scalp.
Dr. Umar’s FUE Shave Test (Published by the Aesthetic Surgery Journal, Volume 35, Issue 8) enables hair transplant doctors to predict whether or not a patient will reach the severely bald Norwood 7 stage of male pattern baldness. In situations where this is the case, the anticipated use of body hair allows for an overall graft count to be determined at the onset to plan out a reliable long-term hair restoration strategy well in advance.
Watch this patient’s video where beard hair was used to achieve the successful growth and strip scar coverage this patient hoped to achieve after experiencing poor growth from past strip surgeries. He was so happy with the results and yield of his first procedure and decided to further improve upon his results with another hair transplant by Dr. Umar.
Body Hair to Head Graft Counts – Real-Life Patient Examples With Dr.UGraft™
The use of body hair may simply be a matter of choice. Some patients have reached an advanced stage of male pattern baldness and no longer have enough hair to reach their coverage goals.
A 12,000 Hair Transplant Graft Count For Norwood 7 Severe Baldness
This patient had reached the Norwood 7 stage of baldness, which left him with only the lower ring of hair around his skull’s base and the sides of his head. This remaining scalp hair area was insufficient to create a sufficient hair transplant graft count for improving his coverage. Body hair was the only way he could reverse his hair loss and achieve the youthful fullness he wanted. Having been rejected as a hair transplant candidate by other clinics, he turned to Dr. U to help him acquire the correct quantity of body hair to meet his objectives.
8000 grafts of head and beard hair were used for his first surgery. Later, 4000 additional grafts were applied for his second hair transplant procedure, using the same donor sources.
Graft Failure From Previous Hair Transplant Surgeries
A more severe scenario is when most transplanted grafts do not survive. Some unfortunate clients will wait up to the 12 or 18-month point to find a disappointing yield of sparse sproutings or awkward patches of growth. The only way to fix these issues is to undergo another hair transplant to repair these results. Yet, their scalp donor supply had already been exhausted from their previous failed surgery.
Conventional clinics can offer no hope since they are only trained and equipped to extract donor grafts from the scalp.
However, the correct type of body hair can leverage new sources of hair follicles to be used in helping such patients move on with their lives, no longer having to worry about the social embarrassment caused by a poorly conducted hair restoration surgery.
This patient started his hair transplant journey at the Norwood 6 stage of baldness. To reverse his hair loss, he underwent various strip and FUE procedures. However, many of his grafts failed to survive. On top of this, these procedures depleted much of his head donor supply, leaving him with little hope of a successful repair through conventional hair transplantation.
The patient chose Dr. U for a pivotal hair transplant repair using a 6500 hair transplant graft count comprised of the following breakdown.
- 3150 beard hair grafts
- 1550 head hair grafts
- 1300 nape hair grafts
- 500 chest hair grafts
Dr. U’s surgery produced prolific hair growth, finally creating the coverage the patient hoped to achieve. Watch his video, which features commentary by Dr. U and the patient himself.
Check Our Before & After Gallery!
Increasing the Hair Transplant Graft Count For Scalp Deformity and Scar Repair
Another case where body hair is necessary is where the scalp has been permanently scarred and/or disfigured from past procedures. Older patients may have undergone hair restoration attempts using techniques that are now outdated. These include surgeries involving removing or repositioning sections of the scalp or using large punches.
Some of these patients underwent multiple surgeries to restore a normal appearance. But instead, they kept depleting their head donor supply. Harvesting body hair grafts is the only feasible way to achieve an ideal hair transplant graft count to achieve their desired coverage and hide their scalp deformities.
This patient had undergone multiple types of procedures in trying to reverse the signs of male pattern baldness. This included punch graft surgery and scalp reduction, which left him with permanent scarring, disfigurement, a depleted donor supply, and continued signs of hair loss. Dr. Umar extracted a combination of beard and head hair to produce an abundant hair transplant graft count of 6500 grafts to hide the patient’s scalp deformities and restore the desired coverage level.
Specialized Body Hair Transplant Tools – Why Dr.UGraft ™ Devices Are Essential For Improving Hair Transplant Graft Count
Extracting body hair grafts is not the same as harvesting donor follicles from the scalp. Head hair grows at angles close to being perpendicular to the skin. Before, FUE surgeons could align basic rotary cylindrical punches more easily to extract individual scalp hair follicles accurately.
On the other hand, body hair angles are sharper and acuter. Conventional punches are more likely to sever these grafts, making them unusable for transplantation.
Due to the structural differences between head and body hair, Dr. Umar designed a particular FUE device, Dr.UPunch intelligent ™, to accommodate body hair’s unique angles. Rather than aiming to surround the follicular unit within the punch’s cylindrical barrel, Dr.UPunch intelligent ™ requires an initial shallow incision around the upper part of the follicle. The rotary punch curves away from the graft as it turns. The follicle is gently pulled upward and away from the donor site. This system is powered by water irrigation that keeps the graft hydrated as it is carried into a storage vessel. Watch this video to learn more.
The Dr.UPunch intelligent ™ is engineered to avoid typical mechanical damage to all types of hair follicles, whether they are from the scalp, nape, or body. Additionally, the water transport system prevents air exposure, the number one cause of follicular death in hair restoration procedures.
This instrumentation helps to ensure graft viability, health, and survival. When used to extract body hair, it also offers the means to expand the donor graft count significantly and create the flawless coverage that patients ultimately set out to achieve.
To learn more about expanding your donor graft count using non-head hair, sign up for a complimentary consultation with Dr. Umar.
SMP Via Tricopigmentation to Supplement Graft Count
Some patients do not have enough head or body hair to create the appearance of coverage they want. In these instances, scalp micro pigmentation can be used to enhance the results of their hair transplant procedure.
Dr. Umar uses a unique form of scalp micro pigmentation known as Trichopigmentation. In conventional SMP procedures, the pigment particles eventually migrate downwards to deeper layers of the skin, forming a suspension. When light interacts with the ink particles, the rays bend, giving a blue or green appearance. This is called the Tyndall effect. Therefore, what started as brown coloration can turn bluish-green over time.
Trichopigmentation requires superficial injections closer to the skin’s surface, preventing the Tyndall effect. Also, the pigment will naturally fade within two years. Wher as regular SMP is permanent, individuals who choose trichopigmentation can choose to maintain their results or stop altogether.
Trichopigmentation is not to be viewed as a substitute for a hair transplant to simply fill in areas of hairline and temple recession or crown baldness. Instead, it is best used to improve upon the final surgical outcome. Suppose a patient’s available hair transplant graft count (from the head and body) is insufficient to create the desired density level. In that case, Trichopigmentation can be applied between the hairs of the recipient area to approximate the look of a fuller coverage.
The patient below opted for this approach to further improve the appearance of his hair transplant density.
Graft Numbers and Hair Transplant Cost
Many people are interested in finding their graft count as their top priority to understand how much a hair transplant surgery will cost. Previewing the Norwood scale and similar patient cases is a great way to get a general estimate before consultations with different clinics. Of course, exact cost figures will depend on:
- how much does each clinic charge per graft
- how well the surgeon can work with factors like hair texture and hair thickness to meet your expectations
Achieving the best coverage possible would require a higher hair transplant graft count.
If managing the cost of your surgery is a concern, here are some options to consider
- finding the best financing option that will offer affordable monthly payments and interest rates
- dividing your overall procedure into separate phases
Graft numbers and hair transplant cost figures will undoubtedly vary from clinic to clinic. Since surgery results will last long term, it will be imperative to understand what you will be happy with in the end. This means:
- carefully defining a specific set of factors to discuss with your doctor (must-haves versus nice-to-haves)
- clarifying your vision and the feasibility of achieving your ideal outcome
- factoring in your emotional satisfaction
You should consider these qualitative points within your final cost and graft count.
If you are considering hair transplantation and would like to know what graft count can be achieved for your case, schedule a complimentary consultation with Dr. Umar
FAQ – Hair Transplant Graft Count
If I want to know how many grafts I need, will an online graft calculator help me?
Many online graft calculators are likely to be based on average patient scenarios. They won’t necessarily account for influential factors like ethnicity, hair curliness, hair-to-skin color contrast, or hair thickness. Pros active patients who use the DIY uGraft calculator to estimate their graft amount can benefit from more realistic estimates. Howe er, it is designed to consider such factors. This video illustrates how to use the DIY hair transplant feature better:
Can I start with a lower hair transplant graft count for my first surgery and increase it later?
It is certainly possible to start with a lower donor graft count for your first procedure and improve your results over time. This is typically done for budgetary reasons or for younger patients who can expect further hair loss as they get older. Be sure to speak to your doctor about your goals and objectives for each phase of your hair transplant process.
Have more questions about hair transplant graft counts? Ask Dr. U now using the button below:
References
- Venkataram, Aniketh, and Venkataram Mysore. “Logic of Hair Transplantation.” Journal of cutaneous and aesthetic surgery vol. 11,4 (2018): 169-172.
Further Reading
Click here to learn more about Dr. UGraft™’s no linear scar hair transplant system.
Learn more about hair transplants using beard hair to augment donor supply.
See how Dr. Umar repairs hair loss and scars with a body hair transplant using Dr.UGraft™.
