I read about megasessions of 5000 or more grafts. Particularly from a Canadian group. Yet unless the average Canadian hat size is larger, that is near impossible unless they are doing it on the graft dissection end of things. How can one doc get so much more hair then others??Larger heads, larger incisions??
Large sessions, really large ones, were defined by me in 1993-4 timeframe when I reported first breaking 2000 grafts/session, then 3000, and finally in early 1994 I reported my first of many 4000+ graft sessions. These are not typical. First, the surgical team must be trained in doing large sessions with fast, efficient cutting and placing. The following points must be available for the surgery to be successful:
- The sessions should not take more than 8 hours, for beyond that time, the grafts out of the body that are awaiting placement produces reduced graft growth.
- The surgeon must know the nuances of prolonged anesthesia without increasing the risks to the patient.
- The patient’s scalp laxity must be very loose so that a wide strip can be taken safely (often these strips measure greater than 2cm in width and 10 inches in length).
- The patient’s density must be high (50% higher than normal densities).
- And as you said, the head should be a larger size to yield wider and longer strips.
Large sessions are no more risky than smaller sessions, but the above criteria must be met or the yield would not be there. My record number of grafts in any one session to date is 5800 grafts. I remember that patient well, because had his balding pattern been more advanced, I would have gotten 10,000 grafts from him with ease. His density was twice average densities, his head was larger than normal, his scalp was loose (actually, very loose), he was young and healthy and we completed the surgery in 7 hours.
Good question and thanks for asking it.
