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What Are Grafts?

What Are Grafts?

Medical Director Dr. Hans-Georg Dauer

10 min

March 24, 2022

Have you ever consulted the internet on hair loss? Then you probably stumbled upon the term “graft” and were left puzzled, scratching your head. You may have wondered what a graft is supposed to be. Why don’t we have a look through the hair loss encyclopedia together?

First, let’s get to linguistics. “Graft” is just a fancy word for “transplant”. By graft we mean the transplantation of organic parts of the body for beneficial purposes.

We encounter a transplant in the most diverse forms – ranging from tissue and cells to organs and entire organ systems (e.g. hands, feet).

“So what you’re saying is, that a single hair can also be used for a transplant?” Yes, that’s exactly what is done in a hair transplant.

But be careful: we are not talking about a single hair here. We are talking about hair follicles. One graft can actually consist of several hair follicles.

If this is the case, we are dealing with a so-called follicular unit.

To summarize: If a graft consists of only one hair, we call it a single graft. However, if a graft consists of several hairs, the term is called multi-graft.

A multi-graft’s number of hair follicles is a matter of chance. While one graft may suffice with two hair follicles, another one may enjoy five hair follicles.

The exact number of hair follicles is very important in the transplantation process. Not every graft fits into every region of the head.

On the contrary: for the hairline, a good surgeon usually only uses single grafts, i.e. a single hair follicle. This is the only way to achieve an impressively natural result.

If, on the other hand, the hairline were to be filled with a large number of multi-grafts, this would be disadvantageous in terms of the natural appearance of the hair. The result would have a great resemblance to a broomstick.

To achieve a fuller center of the head, however, the doctor uses more multi-grafts than single grafts. The reason: with the help of multi-grafts, bald patches and light areas on the scalp can be filled noticeably faster and more effectively.

Would you like a quick example?

If the surgeon were to transplant 3,000 single grafts, your head would be enriched by exactly 3,000 hairs. The same result is achieved with about 1,000 multi-grafts with three hair follicles each. That way, they also transplant 3,000 fresh hair, but with significantly fewer steps.

Phew, grafts can be quite confusing. How about a little summary for a better understanding?

  • Graft = transplant
  • Single graft = hair follicle
  • Multi-graft = 1 follicular unit
  • Hair follicle = 1 single hair
  • Follicular unit = 2 to 5 individual hairs

Graft, Single Graft vs. Multi Graft – Who Needs to Know?

But why do we talk in such detail about the differences between grafts? It’s simple: anyone who is seriously considering a hair transplant should have this knowledge at hand. Unfortunately, the market for hair transplantations is full of bad apples that try to rip you off with every trick in the book.

Usually, the price of the treatment is calculated per graft or according to a certain number of grafts. And this is where the problem arises: because we now know that 5,000 grafts sometimes mean more hair and sometimes less. It all depends.

The big trick of the clinics: Follicular units can be divided, so some clinics appreciate this division. This enables them to transplant significantly fewer grafts. In other words, you get less fullness in the donor area for your money.

Another problem: Some clinics lack expertise, which means that they endow the patient’s hairline with many multi-grafts. And in the end, the patient wonders about the unnatural, broom-like result. This is probably not how he had envisioned his ideal hairstyle.

Let’s keep in mind: It is best to intensively research the topic of grafting before the procedure – no matter if it is the FUE method (hollow needle method) or the DHI technique.

Next, ask the clinic of your choice for a consultation and test out the experts a little. Do they explain the difference between single graft and multi-graft? And do they know what kind of grafts belong in the hairline? Feel free to ask them a few questions.

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Grafts – The Protagonist in Hair Transplantations

We now know what a graft is and how they can be distinguished into single graft and multi-graft. Well, why don’t we talk a little bit more about the importance and effect of grafts in hair transplantation?

Grafts are basically the key players in hair transplantation. Without them, nothing works – no matter whether it is the FUE hair transplant or the DHI method. In every transplant technique, grafts are the focus of attention.

How Exactly Does the Extraction and Transplantation of the Grafts Work With the FUE Method?

The first step is to anesthetize the donor area. No need to worry: a local anesthetic is sufficient for hair transplantation. The gentle anesthetic is administered to the scalp with the help of very fine injection needles.

The big advantage: the patient is completely awake during the entire procedure. Even reading, listening to music, watching television or going to the toilet are possible without any problems.

Once the local anesthetic has taken effect, the treating doctor starts working on the donor area.

Most of the time, they focus on the back of the head – for good reason. After all, the back of the head is usually overgrown – with robust hair follicles that are mostly immune to hair loss. These are ideal candidates for successful hair transplants.

The surgeon extracts the required number of grafts with the help of a fine hollow needle with a diameter of 0.65 mm to 1.0 mm. Step by step, they are detached from the crown of hair.

The individual hair is plucked out of the scalp, one might say. This technique is called plucking technique for a reason.

Immediately after removal, the grafts to be transplanted are first placed in a cooled nutrient solution. In this rich liquid, the sensitive grafts are ultimately protected from mechanical damage or from drying out. The shorter the transplants are cut off from the nutrient supply, the higher are their chances of survival later on.

The retrieved grafts are then checked – with a microscope or a special magnifying glass. The doctor carefully examines the individual donor hair and immediately sorts out damaged samples.

Only the strongest have earned a place in the hair coat. Afterwards, they divide the “good grafts” into groups according to their number of hairs, in order to be able to distinguish them better during the transplantation.

At this point, nothing else is standing in the way of the hair transplant. The recipient’s area on the scalp is anesthetized.

In the next step, the doctor uses very fine special needles to open up tiny channels for the hair roots. In doing so, they always take into account the respective size of the hair follicle groups.

Exposing the recipient channels requires the highest surgical skill and a great wealth of experience.

Not only do the distances between the individual hair follicles have to be right, but also the angles at which the grafts are implanted into the scalp. This is the only way to ensure that the result later looks impressively natural, without any strange effect.

Next, the surgeon refills the channels in the scalp that have just been opened with strong donor hair.

This is performed manually and with a fine pair of tweezers. It allows the surgeon to maintain full control during the transplantation. They place the individual grafts at precise angles along the direction of growth.

Almost done: Once all the grafts are in place, the quality control follows. The doctor carefully checks all the transplanted hairs for density, insertion angle and placement. This way, small inconsistencies can be corrected in time.

If everything has worked out well, the doctor finalizes the transplantation. Time has come for the freshly transplanted grafts to regenerate. Over the next weeks and months, the hair follicles will gradually fill in the bald spots, bald patches and receding hairline.

When Can I Expect Results After the Hair Transplant?

In the first five days after the procedure, the freshly transplanted hairs establish roots to the scalp. Unfortunately, this first growth spurt is short-lived. Around 95 percent of the grafts fall out again within the first two to three weeks after the treatment.

There is even a name for this phenomenon. We call it shock loss. Because the hair roots were cut off from their natural nutrient supply for a short time during the operation, they were exposed to severe stress. The result: we lose them.

But don’t panic: After the shock loss, things start to really take off. Once the hair roots have recovered from the stress of the operation, around three months after the operation, they start to grow again.

At first, a fine fuzz grows back. Over the course of weeks and months, however, it becomes increasingly longer, fuller and stronger.

The time when the final result can be expected varies from patient to patient. Generally, we distinguish between two groups of patients:

  • Fast grower: More than 80 percent of patients are fast growers. They are lucky: the final result is already visible after a total of twelve months.
  • Slow grower: The remaining 20 percent of patients are slow growers. They have to be a little more patient. But no later than after 18 months, their youthful freshness can also be seen.

How Many Grafts do I Need?

The number of grafts the patient needs for a full and strong hair coat is completely individual. A range of 500 to 6,000 grafts is possible.

For small bald patches or receding hairline, a modest amount of grafts is often sufficient for a noticeably fresher look. For larger bald patches as well as half and full bald heads, a larger amount of grafts is usually needed for a youthful glow.

Let’s check out this example together:

If you want to fill in the tonsure, i.e. the area at the back of the head, with your own hair, you have to find a good middle ground. There should not be too little grafts. Otherwise, the scalp will still visibly shimmer through the transplants and rob us of vitality.

But there should not be too many grafts either. After all, the natural hair should blend in with the existing hair as naturally and inconspicuously as possible.

For an ideal result at the back of the head, experts generally recommend 70 grafts per square centimeter. However, this general guideline should be used with precaution. In most cases, there is not enough space at the tonsure for such a high density of hair.

It’s best to get detailed advice on the ideal number of grafts from the doctor you trust before the transplant. Together you will find a solution that will make your very own hair dream come true.

How Much Does a Hair Transplant Cost?

The price of a hair transplant always depends on the number of grafts required. And since this varies from patient to patient, so does the price.

To find out how many grafts you need for a perfect result and how much you will have to pay, it is best to talk to your doctor in advance.

The prices on our HAIR & SKIN website can give you an idea. Take your time to browse through it and get a realistic idea of the costs of your hair transplant.

Looking for a Professional Hair Transplant? HAIR & SKIN is the Right Choice

Are you looking for an experienced transplant specialist who can advise you honestly and competently on the ideal amount of grafts? Then HAIR & SKIN is the right place for you. Our team of specialists impresses with professional expertise, medical perspective and interpersonal skills. With us, you get an offer that is 100 percent right for you.

And this is how your hair transplantation with us works:

  • Step 1: Get a free consultation with our experts at a location near you – whether in Aarau, Basel, Bern, Lausanne, Lucerne, St. Gallen, Winterthur, or Zurich.

  • Step 2: Our experienced team of doctors performs a hair analysis with you and works out your own personal treatment plan.

  • Step 3: Look forward to an individual and discrete treatment in our modern clinics. And don’t worry: at HAIR & SKIN you’re not just one out of many. For us, you are very special. After all, an empathetic and personal treatment is all part of feeling good.

  • Step 4: Visit us for a follow-up and final check-up. By the way: Our consultation and check-up appointments are free of charge.

Is this how you’ve always imagined your treatment? Well then, we are looking forward to getting to know you soon.