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Hair Graft Ratio in FUE

By Dr Raghu Reddy

One of the common questions I get asked during my consultations is the difference in graft counts between a FUT and FUE Hair Transplant. It is a well documented fact that FUE yields grafts with more hair than FUT as the surgeon has access to a wider choice of grafts in FUE and hence can pick and choose the grafts necessary to achieve good surgical outcomes.

 

Examples of chunky grafts:

 

On average, the yield of FUT grafts is 1.5 to 2.3 hair per graft. Whereas the yield with FUE can vary between 1.7 – 3.2 hair per graft.

Whilst it is accepted that there is a fair amount of standardization with FUT grafts, FUE graft yield can swing wildly, based on the experience of the surgeon and also the difficulty involved in extraction.

In my experience, during my early years of performing FUE Hair Restoration, my average yield was between 1.9 to 2.4 hair per graft. However, more recently, my average graft yield has been 2.6 to 3.2 hair per graft. I would like to consider that the increase in the yield has been partly to improve my technique, whereby the partial transection of grafts has been minimized significantly. However I believe my patient qualification has improved significantly, leading to improvement in quality of grafts being extracted.

 

Examples of good quality extraction:

Advantages of extracting a significant proportion of chunky grafts (Grafts with multiple hair follicles)

One commonly used example in hair restoration surgery is associating hair restoration surgery to gardening. Lets imagine a scenario whereby we are populating the recipient area with plants from the donor area. One could use a lot of twigs to populate the recipient area or use a few twigs and a lot of trees to create the illusion of a thicker garden.

There are numerous advantages of having grafts with a higher yield both for the patient and the surgeon:

  • There is less chance of thinning of the donor area
  • Less chance of necrosis of neighboring follicles
  • Less chance of significant scarring
  • More donor hair available for future use
  • The chunky grafts can be divided into finer ones for use in the hairline
  • Less surgical time for the surgeon during extraction, thereby minimizing fatigue associated with FUE extraction
  • More density can be achieved with less grafts
  • Less chance of poor uptake as grafts are spaced out reasonably
  • Less chances of complications in the recipient area due to transfer of a large amount of grafts, needing a lot of incisions
  • Less surgical time required to replace the grafts, hence minimising the amount of time the grafts are outside the body

The Disadvantage is that the dissection of the chunky grafts into finer grafts is entirely dependent on the skill of the technicians and hence the surgical outcomes are dependent on the skills of the technicians involved, much like FUT surgery.

Though I have tried to jot down a list of things, I firmly believe the future of FUE lies away from automation and I am convinced that with a bit of experience and a lot of application, most surgeons will be able to extract grafts averaging around 3 hair per graft, thereby offering a significant advantage to the patients.

Examples of grafts with higher yield

Hair graft ratio of Follicular units in FUT (Strip Surgery) for 1000 grafts

FUE Size Percent (%) Number of Hairs
1 Hair 20% 200
2 Hair 40% 400
3 Hair 30% 900
4 Hair 10% 400

For every thousand grafts, a client can expect 1900 hair, yielding an average of 1.9 hair per graft

Hair graft ratio of Follicular units in FUE for 1000 grafts

FUE Size Percent (%) Number of Hairs
1 Hair 10% 100
2 Hair 10% 200
3 Hair 30% 900
4 Hair 30% 1200
5 Hair 20% 1000

For every thousand grafts, a client can expect 3200 hair, yielding 3.2 hair per graft.

I believe high yield is only possible in the most experienced of surgeons and the yield of grafts in inexperienced hands can be significantly lower and the transection and wastage of grafts can be significantly lower.

By glancing at the above examples, it is imperative that surgical outcomes are dependent on the experience and skills of the surgeon. Hence, any potential client should exercise due diligence before selecting a surgeon for performing their FUE.

 

Below are numerous examples of good quality extraction, yielding high number of multiple hair grafts:

 

Examples of grafts with higher yield

 

Examples of grafts with higher yield

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