“Splitting Hairs” about counting hairs?

No where is the expression “splitting hairs” more fitting than during a gathering of hair transplant physicians. At the international meetings I’ve attended over the years graft sizes, hair counts and hair transplant session sizes have been hotly debated.

From these debates follicular unit hair transplantation has emerged as the recognized “Gold Standard” in hair  restoration surgery. But this standard has evolved over the past few years into an even more refined procedure, which is referred to on this community as “Ultra Refined Follicular Unit Hair Transplantation“.

This ultra refined procedure involves creating smaller and more minimally invasive incisions, which enable surgeons to transplant more grafts in one session, often at greater densities.

But with grafts now ranging is size from very tiny and closely trimmed to plump, measuring a session size by “grafts” does not really provide a standard of measurement that is consistent across various techniques and hair restoration clinics.

Ultimately it is the amount of hairs moved to the top of the head, not grafts, that determine the finally result. Therefore myself and members of this community have been advocating that hair counts by graft be used rather than simple graft counts.

For example rather than a patient or physician presenting their surgical session as 3,715 grafts, we would prefer a more detailed presentation of this surgery such as:

Surgical Session #1 on 03/07/2005

1,212 one hair grafts (1,212 hairs)
1,756 two hair grafts (3,512 hairs)
567 three hair grafts (1,701 hairs)
180 four hair grafts (720 hairs)

3,715 total grafts (7,145 total hairs)

Hypothetically another clinic that cuts smaller grafts on average could have the following hair count, for a 3,715 graft session:

Surgical Session #1 on 03/07/2005
(Same hypothetical patient at  another clinic)

1,512 one hair grafts (1,212 hairs)
1,920 two hair grafts (3,840 hairs)
283 three hair grafts (849 hairs)
0 four hair grafts (0 hairs)

3,715 total grafts (5,901 total hairs)

Although the difference in total hairs is only just over 1,000 hairs, I believe this detailed presentation presents a more accurate and detailed description of the actual nature and ultimate impact of the hair restoration surgery.

Thus using hair counts by graft provides a more accurate standard of measurement that is consistent across various techniques and clinics. Presenting such info will enable potential patients to evaluate patient results in “apples to apples” comparisons, no matter what the technique or clinic.

The size and dimensions of a patient’s donor strip is also useful information as can be the patient’s hair characteristics and scalp laxity.

I have been lobbying online for the adoption of hair counts by graft. The issue of both hair counts and session sizes was recently hotly debated on our hair restoration discussion forum (see topic – What is the optimal Ultra Refined Follicular Unit procedure?).

Strong support in favor of providing and presenting hair counts by grafts has emerged. Many leading clinics have pledged to provide patients with both detailed hair counts by grafts and donor strip measurements. We will also be overhauling all our photo galleries to enable clinics to update patient photos with hair counts and donor strip measurements.

All patients sharing their hair transplant experiences are also encouraged to update their weblogs and posting signatures with hair counts and donor strip measurements.

I’m optimistic that hair counts by graft will soon become a standard expectation online.

All the best to all,

Pat, publisher

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