My Experience with Hair Transplants
I began performing hair transplants in the 1970s because of so many requests from patients. At that time the only option was what was called “plugs,” and each plug was 5 mm (millimeters) in diameter and contained from 8 to 10 hair follicles.
The plug grafts did take, but they looked very unnatural and this was because a 5 mm space had to be left between the grafts to assure that the entire graft could get blood supply. At a later date, another plug could be placed between the original one, making it look much better, but still not completely natural.
Then came the “flaps.” A flap is like a peninsula of the hair-bearing scalp usually rotated from just above the ear and rotated across half of the hairline from each side. The donor area from where the flap was taken is simply sutured up. This did bring hair to the hairline, but it too looked so unnatural and much like a carpet and not a natural hairline, which is not perfectly straight, plus the hair was pointing in the wrong direction. Also, the hair is too thick for the hairline to look natural. Clearly, that was not the answer to creating natural appearing transplantation.
Finally, after years of efforts from hair transplant specialists, the FUE (follicular unit extraction) was developed and refined. This is basically taking a 1 mm graft with a small hand-held circular “punch.” These 1 mm grafts of follicles with a small amount of skin contain from 1 to 4 hair follicles, thus from 1 to 4 hairs. These grafts are so small that once healed, cannot be detected as grafts, and the only thing that can be seen is the hairs growing with a natural appearance. For a natural hairline, single follicle grafts are used, and for the rest of the scalp, multiple follicle grafts are preferred for maximum density.
Generally, one can transplant about 750 grafts if the procedure is done manually. This is where the NeoGraft comes in. This is basically an automated FUE, and up to 2500 grafts can be performed at one sitting. Another advantage to the NeoGraft is that the instrument can be held more steadily reducing the risk of cutting across and damaging the follicle. This, of course, relies upon the person’s expertise doing the procedure, and like most things:
- The skill with a hair transplant is important for several reasons: Assessment to assure the patients is a good candidate for hair transplantation:
- Taking the grafts so that there are enough follicles in the donor site to still look natural and taking them from an area that will not become bald in the next few decades;
- Placing the grafts in the recipient area in a natural fashion including the proper direction for that specific area;
- Being fast enough so there is the shortest time between taking the graft and placing it back in so there is minimal time “out of the scalp” without a blood supply.
- Using a special solution to put the grafts in between harvesting them and placing them. This should be a solution similar to what is used for kidney and heart transplants and not saline to assure graft health.
Our Hair Restoration Team specializes in creating natural results, whether it is with the strip method or the Neograft FUE method.
Pricing is usually per graft, e.g. which is approximately 2-4 hairs per graft. At 4.25 dollars per graft 1000 grafts would cost $4,250. This would result in about 2,500-3000 new hairs, obviously resulting in thicker hair and a much more desirable outcome. People often get stuck on the cost per graft when it comes to shopping hair transplants and various methods. Most do not know that you can have a hair transplant with 1000 grafts that can turn out better than another with more grafts. Why? Because the method used to harvest and implant the grafts, as well as the final graft survival rate play a big role in the outcome.
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