Generally, the front ⅓ to ½ of a completely bald area can be completely finished in 1 – 2 sessions of grafting. Some patients may be happy with the coverage and fullness of 1 session on a bald area. However most want more density than what 1 session on a bald area will achieve and may elect to have a second session to achieve added fullness. Patients who believe they can be completed in only 1 session and have relatively dense hair are being unrealistic. One session of all single FUs, (containing 1-3 hairs), can look very natural and can stand on its own very well; however, the density or fullness is for some people less than what one would expect for reasonable density. Some hair types, (coarse, wavy, salt and pepper or light brown/blond hair) lend themselves to a very nice result with 1 session. A patient with straight, sparse and black hair would have an understandably thinner look, and unless the patient had low expectations, he would probably want the benefit of the density of 2-3 sessions. Patients should be wary of doctors that claim most of the bald area of the scalp can be completed in 1 session, unless a thin look is desired.
Transplant sessions may be done as far apart as the patient wishes; however, they are not done in any given area without a minimum 8-12 month interval between sessions. The number of grafts that should be transplanted at 1 session and the frequency of transplant sessions depend on the characteristics of each individual case; this can be planned out in advance for each patient. Additionally, larger sessions that cover both the front half of the scalp as well as the crown, in appropriate patients, can also be performed at the same time.
It is becoming more common for patients to have 1 or more “early” transplanting sessions before hair loss has reached an advanced stage. The benefit of these early sessions is threefold: the remaining hair provides natural camouflage for the initial session; the transplanted hair (once it has grown) provides additional coverage for any later sessions; and sessions can be spaced farther apart, thus spreading the inconvenience and cost over a longer period of time.
In less than 10% of patients there may be some mild thinning involving the pre-existing hair of the recipient area within the first 2 to 3 weeks after a transplant. This is called SHOCK. This thinning (if it occurs) is almost always temporary and the hair will regrow at the same time as the transplanted hair begins to sprout.
Transplanting with Only 1-2 Haired Follicular Units, Megasessions and “Dense Packing” Of Grafts
If you have relatively fine and/or light coloured hair and you feel you would be satisfied with light to moderate hair density, you may want to consider using only single 1 – 3-hair follicular unit grafts for your transplanting. There are 4 advantages to such an approach:
In fairness, it should be pointed out here that if a slightly larger graft that employs a follicular family of 2 single follicular units close together with 3-7 hairs is used behind the hair line zone of 1-3 haired grafts instead of all 1-2 haired grafts, there is virtually no damage to existing hair and with most hair types there is essentially no plugginess, either. Follicular unit families used behind the hair line and into the crown can help yield added density and coverage.