Author: Dr. William Rassman

The number of grafts depends upon two factors (1) the area that has to be covered which in your case is determined by where you wish the hairline to be placed and (2) the thickness of your hair shafts (hair bulk). The need for a second hair transplant is frequent when the hair bulk is low (fine hair) and less common as the hair shafts increase in thickness (medium or coarse hair) so it is difficult to give you an exact estimate other than to say that the range of grafts may be 1800-2500 grafts give or take a few

The donor area in the average Caucasian male has ~12,500 Follicular Units of which possibly up to 60% can be taken for hair transplants. For FUE without becoming over-harvested, about half of this amount (30% or 3,750 grafts) can be taken with FUE to be safe. The thickness of the hair shaft (fine, medium or coarse) alter this number (lowers if for fine hair and increases it for coarse hair). The question to ask, is how much hair do I have to leave behind to keep my donor area LOOKING healthy and full enough not to reveal that I was transplanted.

I am unsure if you have a Class 6 or 7 pattern balding pattern from the photo you supplied to me. Still, in any event, to set realistic expectations, you need to know the following: (1) donor density, (2) donor hair mass, (3) the capabilities of your surgical team, (4) what your Master Plan is for going forward after the hair transplant (may be more than a single hair transplant). There are many limitations for men with fine hair and low donor densities. YOU need to understand these elements, or you might be disappointed with the results.

I’m 24 and I want to get a hair transplant, so how many grafts will I need?

You need a Personalized Master Plan: https://baldingblog.com/go-why-do-we-need-a-master-plan/. You need to lay out what your worst case balding is and balance that against your available donor supply capacity before starting the hair transplant process. You will find many doctors willing to quote you 1500, 2000, 3000, 4000 grafts for your problem. Is your hair fine, medium or coarse in thickness? Could you respond to medications or other treatments such as microneedling and avoid a hair transplant and still get your hair back? How do you tell which is right and when you should tackle it?

I hear that question all of the time. The answers often vary from 1000 to as high as 6000 grafts, sometimes regardless of the balding pattern. We focus on the number of grafts because more grafts move more hair into the balding area. But the real numbers depend upon

• hair thickness,
• the balding pattern,
• the color of your skin and hair,
• the character of your hair, the thickness of the hair shafts (fine, medium or coarse)
• and most important, something about your donor supply capacity to support the balding pattern at the time the question is asked.

Note that I am putting in a time factor, because balding is a progressive process and how bald you are today, might be distinctly different than how bald you will be tomorrow.

Some young men fly to Turkey, get 5000-6000 grafts for minimal cost. Then they come home to wait and watch it grow. Assuming that the clinic did it right (not the case in many Turkey clinics that don’t have a doctor but sell grafts (like potatoes were sold to the Irish at the time of the famine in the 1800s), they may run out of grafts (or potatoes) before they finish balding.

Hair transplants need to be part of a Personalized Master Plan that incorporates how you are going to manage fixing the balding problem against a progressive balding process. If you use up all of your donor hair before the balding is complete, you may end up looking freaky for the rest of your life. I hear the young man tell me that they are not worried about their hair loss when they get to 30, or 35 or 40. I speak with many 30, 35 and 40 year old men and they ALL CARE about what their hair looks like. Poor planning is almost always a disaster for sometime down the road. All doctors are not equal. Some doctors are in it for the money, so selling more grafts means making more money. You have to identify those doctors and make sure that you don’t get one of them. I always say that a good decision today is a good decision tomorrow.

So to answer the basic question “How many grafts do I need?”, take it easy, digest what you read above and the look to some of the following links below:

• https://baldingblog.com/i-am-19-and-may-be-balding-what-do-i-do/
• https://baldingblog.com/go-why-do-we-need-a-master-plan/
• https://baldingblog.com/wp-admin/post.php?post=34268&action=edit
• https://baldingblog.com/hair-thickness-vs-density/

I have had 3 consultations and each one told me that I needed a different number of grafts. One doctor quoted 4000 grafts, another 3500 grafts and a third 3000 grafts. It is very confusing. My hair is a medium weight hair (I know you always ask) so I am asking you what you think I need for grafts.

Too many doctors or clinics push up the number of grafts well beyond what you need. With a medium weight hair, I doubt that you will need more than 2000 grafts to lower the hairline and bring the corners down. The reason that the numbers you heard were high is because too many doctor think about grafts as $$ in their pocket, more grafts more $$ for them. For the patient like you, too many grafts deplete your permanent hair supply and if you found yourself balding as you got older and did 4000 grafts for the front now, you might find yourself without any hair reserves for future balding.

If your goal is to transplant only the crown and the small area in front of it, the number of grafts will vary with the thickness of your hair (Fine, Medium or Course). Fine hair might take as many as 3000 grafts, while Coarse hair might take as few as 1800 grafts. That is not addressing your frontal recession which is suggestive in this photo

Before you go for a hair transplant, I would be sure that you maintain minoxidil and finasteride for at least a year as it may be reversed on this combination of medications in a year or so. How old are you?