Friday, December 8, 2023
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One of the questions that are commonly asked is ‘How many surgeries can a person potentially have?’ In this article, we have discussed all of the implications of having multiple surgeries. Here Dr Manas S N, a well-known Trichologist, who performs hair transplant in Mysore explains the topic in detail.


How many hair transplants can you have? 


There is a multitude of factors, really it comes down to you. When do you start the process. It’s not about the number of surgeries. When you’re having a hair transplant your major limitation is the amount of donor hair that you have.


Hair Transplant in essence, is taking hair from one part of the scalp and moving it into another part of the scalp. This part of the scalp is different, as the hair act differently and don’t respond as much to the DHT levels, so they will continue to grow. 


When hair is moved, we change the geography of the hair from one part of the scalp to another. If you are doing small operations, then you can have a multitude of surgeries. But if you are doing larger procedures, then you’re limited by the number of grafts that you have available. 


How many grafts do you have?


Usually, the cost of hair transplant majorly depends on the number of grafts. Currently, there is no proven technology for hair multiplication. It is not possible to increase the number of donor hair you have. In fact, the reverse is true. The number of donor hair that you can see in a 25-year-old will usually be less than the number of donor hairs you can see in a 50-year-old. As balder you are, the less the remaining hair that you can be used as donor hair. 


So, there is an area versus density trade-off situation. It is difficult to treat everything in a satisfactory manner because it is such a big area and there is not much donor. There are situations where hair transplant surgeons actually turn patients away from surgery because the extent of the baldness is so great and the amount of remaining hair that you can safely use as the donor is too small. That it is just inappropriate to offer surgery at all.

This is not common, but it exists. So, you’ve got to understand it is about the degree of balding. It will determine the number of grafts that can be harvested. 

What is a typical lifetime supply for most patients? 


It might be in the 6000 – 9000 graft ranges. If you’re having 500 – 1000 grafts treatment, then you can do multiple operations before you’re even going to get close to exhausting it. 


You have a donor bank and that bank has to last for your lifetime. So, a 60-year-old coming in requesting a Hair Transplant is a different patient, than a 25-year-old coming in for a Hair Transplant. As it’s a different philosophy of what a lifetime supply is going to be, to keep the patient happy if they keep progressing their hair loss. 6000 – 9000 is probably about an average and there are exceptions as some have less hair and some have more. 


There are many clinics around the world that offer more grafts per session and make it a more attractive proposition. So for example, there are thousands of ads for 5000 grafts in a single session. 


Suppose if you have 6000 grafts available to you in your lifetime and you’re 25 years of age, you’ve gone to a clinic. They offers you 5000 grafts treatment. They are not thinking about the long-term consequences of that. They are not interested in you as a long-term partner, in your hair loss journey. They are just focusing on the present and will charge you for it.

You have only got a thousand grafts left for the rest of your life and they have wasted 5000. When you didn’t need that at the age of 25. This is a problem that is difficult to solve. 

The lifetime supply declines with age because your hair is declining with age as part of ageing and it declines as your baldness progresses.

So, think about conservative planning. The younger the patient, the more conservative you have got to be because you don’t know what the future is going to hold.

Do not be obsessed with numbers, because they are going for visual density. So if you think about the consequence of the area versus density trade-off. The bigger the bald area, the less hair the doctor has to play with it. That means less overall density can be achieved if they are trying to get an even spread. 


What the doctor is looking for is a visual density that is the minimum density that the patient would find acceptable in their life. They could put more in but then they are wasting a valuable resource in case you need it later on. So the doctor does what is the minimum amount that will get the patient to the visual density that makes them happy and that doesn’t have to be a specific number. It has to be about the looks until the patient grows new hair, they cannot do 100% density over entire scalps.