A single follicular unit or a small piece of scalp tissue that carries harvested hair. To have a healthy hair graft, you need to have a healthy scalp and a healthy integumentary system. If you don’t have enough conditions to support your hair follicles and nourish your dermal layer, you will have unhealthy hair and they may lose often. A healthy person has 2-4 hair strands in one graft (follicular unit) [1], [2].
Anatomy of Hair Graft
The physiology of hair graft is divided into 7 basic parts. Let’s analyze these parts closely to better understand hair transplant procedures.
Definition of a Healthy Hair Graft
To understand the components of a hair transplant, let’s start by exploring what a healthy hair graft is. Whether you are undergoing a DHI or FUE hair transplant procedure, the number and health of available hair grafts will directly determine the success of your hair transplant surgery. The number of hair grafts in the donor area is the first signal of hair graft health. A healthy hair graft should contain at least one healthy hair follicle and must show good vitality.
Hair Shaft
Each hair strand consists of 2 structures. These are
- the hair shaft, which forms the visible part outside the skin,
- the hair follicle located beneath the skin surface.
In short, the visible part of the hair strand is called the hair shaft, it also has three layers:
- cuticle,
- cortex,
- medulla [3].
Bulb of Telogen Hair
Telogen is the name given to the ‘resting’ phase of the hair growth cycle. In the telogen phase, when the hair follicle is inactive, there is a white keratin bulb at the root. Club hairs are grown at this stage.
Sebaceous Gland
The component responsible for sebum production is called the sebaceous gland. Sebum is very important for moisturising the scalp and nourishing the hair.
Outer Root Sheath
ORS, a layer of tissue, surrounding the hair follicle, providing structural support and helping hair growth. During a hair transplant surgery, preserving the integrity of the ORS is crucial as it contains stem cells responsible for regenerating new hair follicles and supporting graft viability, it facilitates a successful hair replacement and long-term hair growth.
Dermal Fat
Subcutaneous fat (dermal fat) provides support in blood vessels and stem cells; so, it promotes graft survival and facilitates the growth of transplanted hair follicles. Moreover, dermal fat helps to achieve natural-looking hair results because it provides volume and contour to the recipient area.
Dermal Papillae
The dermal papilla plays a major role in the hair transplant process due to its ability to stimulate bulge stem cells, essential for hair follicle regeneration and growth. Growth factors produced by the dermal papilla promote the proliferation of these stem cells, influencing the duration of the hair growth cycle.
Bulb of Terminal Hair
The layer containing the dermal papilla and the hair matrix is called the bulb of terminal hair. It is important for the dermal papilla to develop newly transplanted hairs, which promotes hair growth.
Types of Hair Grafts
The number of hair follicles in a single hair graft affects the type of hair transplantation procedure and the duration of treatment. The number of hair follicles in a graft is not stable, but hair transplant specialists state that, on average, a hair graft usually contains 2 hair follicles [4].
Single Hair Graft
It is a graft containing a single hair follicle. It can be used in bald areas that require a natural-looking hairline. If you are in the advanced baldness stage on the Norwood Hair Loss Scale and have mostly single grafts, you may not be able to achieve a dense hair appearance.
Double Hair Graft
A follicular unit contains two hair follicles and is usually used to add density to areas with moderate hair loss, to cover patchy bald spots or to blend with existing hair.
Triple Hair Graft
A follicular unit (graft) contains 3 hair follicles. It is a very good number for a patient with healthy grafts. It can even help to treat male-pattern hair loss at Norwood stage 6 or 7, even in a single transplant session.
Quadruple Hair Graft
A group of hair tissue that contains 4 hair follicles and is reserved for areas requiring maximum coverage and density, such as the crown (vertex), temples, and mid frontal scalp.
Role of Hair Graft in Hair Transplant Process
Minimally invasive graft harvesting techniques have become the first choice of modern surgeons. Skillful surgeons prefer these up-to-date methods:
- Follicular Unit Extraction (FUE): Surgeons remove individual follicular units (hair grafts) from the donor site directly using a tube-like punch tool.
- Direct Hair Implantation (DHI): With the help of Choi implanter pen, surgeons first extract and then transplant the follicles.
- Robotic Hair Transplantation: Surgeons use robotic systems to assist in the precise and consistent removal of hair grafts instead of manual follicular unit extraction.
- Sapphire FUE: The surgeon uses a special sapphire blade to make the incision during the FUE procedure. It is a good choice for smaller incisions and fast recovery [5].
Hair Graft Transplant Process
The hair transplant procedure requires precision. Each stage is important to ensure the health of your hair follicles. In order to have full and healthy hair, your surgeon will follow some steps. Please keep in mind that these steps may vary slightly depending on the hair transplant method.
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Preparation before Graft Transplantation
In preparation for hair graft transplantation, your surgeon performs a comprehensive evaluation to minimise the risk of surgery and help you achieve the results you desire. The evaluation includes
- assessment of whether you are a suitable candidate for graft transplantation,
- assessment of the health of your donor and recipient sites and the number of hair grafts,
- discussion of your expectations and assessment of whether the outcome of the operation meets your expectations,
- discussion of pre-operative care, such as what to do for a healthy scalp.
- informing you about the instructions you need to follow after the operation [6].
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Collecting Hair Graft from Donor area
In Follicular Unit Excision, your surgeon removes healthy grafts from the recipient area under local anaesthesia to harvest the grafts from the donor area. Generally, the recipient area is the healthy graft-filled area on the sides and back of the head. Rarely, the beard, chest or other parts of the body with strong grafts can be the recipient area [7].
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Perpetuating Hair Grafts before implant
Before the implantation step in a hair transplant procedure, permanent hair grafts are prepared. Depending on the chosen method, the permanent hair grafts are carefully collected, sorted and trimmed in preparation for implantation.
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Graft implant process
In the hair graft implant process, harvested hair follicles are implanted into the recipient area. Using specialized tools, tiny incisions are made in the recipient area, following the desired hairline or pattern.
Important details required before Hair Graft Transfer
Before hair graft transfer in a hair transplant procedure, it’s crucial to consider:
- patient suitability and overall health,
- donor hair assessment,
- evaluation of scalp condition.
Moreover, following the current developments in techniques and preparing an individualised hair loss treatment are critical stages.
The importance of a healthy donor area
For a healthy donor area, it is vital to get a successful hair transplant surgery without any complications. Here are some basic steps to protect it:
- Stay hydrated, drink water
- Avoid chemical shampoos, hair products, and hair dyes
- Follow a healthy diet
- Protect from sun damage (UV radiations)
- Use keratin protein treatments
How many hair grafts does a healthy person have?
The number of hair grafts in a healthy person can vary depending on such factors:
- genetics,
- age,
- gender,
- ethnic background.
On average, a healthy patient may have 10,000 of hair follicles available for transplantation. But, please note that the exact graft number that can be harvested and transplanted in a single session may vary because of the characteristics of the patient’s physiology and the technique used by the surgeon.
How many hair grafts can be transplanted?
Even on the last stage (7) on the Norwood scale, approximately 7000 grafts can be transplanted. Your surgeon may divide the operation into 2 sessions if deemed necessary. There will be roughly 9 to 12 months between sessions.
What is the maximum number of grafts that can be transplanted in one session?
In a single session, more than 5000 grafts are not recommended to maintain graft viability and patient’s scalp health. If you need more than 5000 grafts to cover your bald spots, it is better to complete the hair transplant procedure in multiple sessions. In doing so, it is also possible to see how the healing process progresses and where you may need to increase the hair density. Multi-session hair transplants usually give superior results.
How long does it take for transplanted hair grafts to grow?
In the treatment of male androgenetic alopecia, hair usually grows 1 to 2 cm per month after hair transplantation. To clearly see the result of the hair transplant, you need to wait a few months for the scalp to heal and be patient for 6 months to 1 year [8].
How much of the transplanted hair grafts are lost?
This depends on the success rate of the treatment, your post-operative care and genetic factors. Even though it’s rare, it’s possible to see hair grafts fall out after hair transplant. In successful hair transplant operations, approximately 5% of the transplanted hair falls out. No shock hair loss process is included in this data as it is temporary.
How many hair 1000 grafts include?
Considering that there are an average of 2 hair follicles in a graft, it is approximately 1700 to 2300 hair strands.
How many hair 2000 grafts include?
2000 grafts are about 3700 to 4300 hair strands. The 2000 graft hair transplant procedure (at Norwood Stage 3) can be performed under general or local anaesthesia. The procedure can take between 4-6 hours.
How many hair 3000 grafts include?
3000 grafts would contain a total of 5,400 to 6,600 hairs (at Norwood Stage 4).
How many hair 4000 grafts include?
As the number of grafts increases, the probability of survival during surgery may decrease. Therefore, between 7000 and 8200 viable hairs can be transplanted.
How many hair 5000 grafts include?
Realistically, between 8500 and 9000 hairs can be estimated.
How many hair 6000 grafts include?
That’s over 10,000 hairs. It may be sufficient to treat frontal balding. It can also give great results for receding hairline.
How many hair 7000 grafts include?
It can reach up to 15,000 hairs. It is enough to cover the head of a fully bald person.
Graft cost based on the numbers you need
Take a look at the Cost and Details regarding the number of Grafts:
FAQs about Hair Graft
How many grafts are needed for a full head of hair?
Depending on the person’s head size, the thickness of the hair follicles, the number of grafts, this figure may vary, ranging from 7000 to 10,000 grafts.
How long does hair grafting last?
Hair transplant surgery lasts between 4 and 8 hours, more or less based on the graft number. The results of hair transplantation can last a lifetime if good care is taken in the 2 months following a successful operation.
Understanding the Coverage of Hair Grafts
How many grafts per cm2?
The number of grafts required per square centimeter (cm²) in a hair transplant varies based on desired hair density. Generally, 25 to 40 grafts per cm² provide a natural density. For denser results or severe hair loss, 40 to 60 grafts per cm² or more may be necessary.
Grafts Coverage for Crown Area
Crown hair transplantation is a very common procedure. It is the process of removing individual hair follicles from donor areas on the back and sides of the head with pen-like tools. The follicles are then implanted into the crown area, creating a denser appearance there. Within one to one-and-a-half years, the implanted follicles grow and cover the crown area.
Some men might be more bothered by the thinned or balding hair at the crown area as opposed to hair loss around the frontal hairline. In this case, the number of hair grafts needed for the crown can vary between 500 and 2500 grafts depending on the size of the area. The number of healthy grafts in your donor area can also affect the quantity of hair that can be transplanted.
Not everyone with receding hairlines is worried about the frontline. Some care more about filling in that bald spot on the crown of their head. The main indicator is how big the crown area is for transplantation. If the area is small, around 500 grafts might be enough, but for some, up to 2500 grafts may be needed. However, the availability of a healthy donor area is crucial for a successful operation. Without a healthy donor area, achieving satisfactory results may not be possible.
You can contact us right now to receive excellent professional service from start to finish for crown and frontal hair transplantation.
Grafts Coverage for hairline
The hairline has a huge impact on a person’s appearance. Receding hairline can make a person look older than they really are. This is why thousands of men come to Turkey every year to get a hairline transplant.
Since factors such as one’s head size, health status, and the average number of follicles in the graft vary; therefore, the number needed for the hairline may also be different. At the same time, some variables also affect the number of grafts to be removed from the person. Number of grafts needed for the hairline may vary depending on the factors below:
- whether the donor area is healthy,
- the degree of hair loss of the person,
- the person’s dream hairline appearance
Male pattern baldness usually starts in the hairline and temples. The number of grafts needed for the hairline is about 500 to 1,800 to make the forward part of the head look fuller and more natural. The exact number may depend on those:
- how much hair loss there is
- the desired appearance.
Recovering from a receding hairline can make a great impact on your overall appearance. Similar to the vertex area, the number of required grafts for the hairline can change between 1000 to 3000 hair grafts.
Grafts Coverage for full beard
Beard transplantation is the transplantation of hair follicles taken from the back of the hair or another suitable part of the body to the beardless areas of the face. Beard transplantation is performed under local anesthesia, just like hair transplantation, and according to the number of grafts required for a full beard. It has the same steps just like hair transplantation.
Existing facial hair and personal preferences determine the number of grafts needed for a full beard. Let’s say you want a relatively thin beard. In such a case, to achieve your goal, the number of grafts you need: 1,500 to 2,000.
If you want a thicker beard, then 2,500 to 3,000 grafts may be considered. Don’t forget, it can change according to the desired style and coverage. Because beard transplantation has exactly the same techniques as hair transplantation, the steps are alike. In this application, a process path is followed in the same way. It is possible to briefly explain these procedures respectively as follows;
- Preliminary examination before beard transplantation,
- Blood collection and tests before beard transplantation,
- Providing local anesthesia with a painless anesthesia procedure,
- Determination of the area to be transplanted
- Calculation of the number of grafts,
- Hair follicles are collected from the donor area and kept in transplant solution,
- Transplantation of the collected grafts to the beardless area with sapphire percutaneous beard transplantation technique.
Grafts Coverage for half head?
Depending on your specific situation, the number of grafts required for a half-head transplant may differ. This variation comes down to two main factors:
- the extent of your hair loss
- the desired hair density in the transplanted area.
A small amount of graft is usually sufficient to provide a slight improvement in hair coverage. On the other hand, a larger area at the crown or frontal scalp may require significantly more grafts. As a further example, you can consider the greater amount of grafts needed to achieve a denser hairline.
The number of grafts needed for a half head of hair restoration vary based on the extent of hair loss. Typically, 2,000 to 2,500 grafts are suitable for moderate hair loss affecting the top or crown. Extensive hair loss in a larger area may require 3,000 to 4,000 grafts or more.
A qualified hair transplant surgeon can determine the precise number of grafts needed for your half-head transplant during a consultation. They may apply those steps in order:
- meticulously examining your scalp to assess the degree of hair loss and the quality of the donor area,
- checking the suitability of where healthy hair follicles will be extracted for transplantation,
- applying blood tests and other assessments
- sharing the final decision with you.
Ref.
- 7000 Grafts Hair Transplant Turkey – Operation and Cost. Heva Clinic. Accessed May 16, 2024. https://www.dentalhairclinicturkey.com/7000-grafts-hair-transplant-turkey/#norwood-scale
- Hoover E, Alhajj M, Flores JL. Physiology, Hair. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK499948/
- What Is the Structure of Hair and How Does It Grow? Institute for Quality and Efficiency in Health Care (IQWiG); 2019. https://www.ncbi.nlm.nih.gov/books/NBK546248/#:~:text=The%20shaft%20is%20the%20visible
- What Is a Hair Graft? – 1 Graft Equals How Many Hairs? Heva Clinic. Accessed May 23, 2024. https://www.dentalhairclinicturkey.com/blog/what-is-hair-graft/
- 8000 Grafts Hair Transplant in Turkey. Vantage Hair Restoration Istanbul. Accessed May 23, 2024. https://hairrestorationistanbul.com/hair-transplant/8000-grafts/
- Cisterne JM, Rostaing L, Durand D. [Preparation for transplantation and graft patient management]. La Revue Du Praticien. 1997;47(18 Spec No):S38-42. Accessed May 23, 2024. https://pubmed.ncbi.nlm.nih.gov/9501595/
- Garg AK, Garg S. Donor Harvesting: Follicular Unit Excision. J Cutan Aesthet Surg. 2018 Oct-Dec;11(4):195-201. doi: 10.4103/JCAS.JCAS_123_18. PMID: 30886473; PMCID: PMC6371717.
- Vasudevan B, Neema S, Ghosh K, Singh S, Khera A. Hair transplantation by follicular unit extraction for male androgenetic alopecia: A retrospective observational study from two centers. Med J Armed Forces India. 2020 Oct;76(4):430-437. doi: 10.1016/j.mjafi.2019.11.001. Epub 2020 Mar 12. PMID: 33162652; PMCID: PMC7606102.
Article Review By: Dr. Jyothi Shenoy V
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MBBS, MD – Obstetrics & Gynaecology, MRCOG(UK)
23 Years Experience Overall
