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Physician Answered Q & As

How Does The Doctor Keep Track of The Grafts In a Hair Transplant Procedure?

I have already signed up to have a hair transplant at the end of July for 3500 follicular unit grafts and I began to wonder how do I know for sure that is the amount of grafts I will receive? Is each hair counted as it is placed in my head? ~ Hector

Dear Hector,

Thank you for taking the time to write! This is an area that causes great confusion to patients, so let me try and clarify as best I can.

Hairs grow on your head in clumps of 1, 2 or 3 hairs (and sometimes even 4 or 5 but this is more rare). These clumps are a “follicular unit” and they are what is cut into “grafts” for your hair restoration procedure. (Yes, hair surgery is the only specialty where getting more “FUs” is a good thing!) Hair surgeons often use the terms “follicular unit” and “graft” interchangeably since, ideally, they are the same thing. However, this can lead to confusion for the patient.

Here is the problem; if a two-hair graft is cut into individual hairs, it can be implanted as TWO single hair grafts – even though originally it was supposed to be one single graft with two hairs! You see how easy it is to double the number of “grafts,” you just need to cut apart each hair in the “follicular unit”, even if it existed in a clump in its natural state. This is not the best situation for the patient since they will not get as much density in their final result. Only in rare cases would a surgeon resort to this (like for a hairline where single hairs are necessary to make it look natural) and a reputable surgeon would discuss this with you ahead of time.

So here is how you know for sure how many GRAFTS you will receive: ASK! A reputable hair surgeon will keep track of exactly how many grafts (and whether they are singles, doubles, or triples) your surgery yields for you. The grafts are counted before they are placed in your head since this is how the surgeon knows how many sites (holes) to make. If we did not do that as surgeons – then you would end up “going home with a hole in your head” I always like to joke… If you want to know how many individual HAIRS there are, you would just need to do the math. For example;

100 single hair grafts = 100 hairs
100 double hair grafts = 200 hairs
100 triple hair grafts = 300 hairs
Total GRAFTS= 300
but total HAIRS = 600

So the “take-home messages” here are; 1) that follicular units=grafts (ideally), and 2) that you can simply ASK to see the documentation of how many you get. Surgeons need an accurate count in order to make the right number of sites/”holes” to put them into – so this number is routinely documented very closely and entered into your chart. I hope that helps and good luck with your surgery!


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The International Alliance of Hair Restoration Surgeons is a consumer organization that selectively screens skilled and ethical hair transplant surgeons. The IAHRS does not offer an open membership policy to doctors practicing hair transplatation, and is the only group that recognizes that all surgeons are not equal in their skill and technique. Its elite membership seeks to represent the best in the discipline, the true leaders in the field of surgical hair restoration.