Why is it important to know the difference between a graft and a hair follicle?

From time to time we receive letters with strikingly similar content from patients who decided on a hair transplant at various clinics. Since we have been hearing these recurring complaints for a long time, we are sharing the content of one of the most recent emails and explaining what you need to do to avoid such problems.

"Dear Clinic, About a year ago I decided on a hair transplant at a Turkish clinic. During the assessment at the clinic they told me I have advanced male pattern baldness and that I would need 5,000 grafts transplanted. I told them that was fine if it solved the problem, since for a long time I had felt very uncomfortable about my appearance. A year has passed since the hair transplant, but the mass of my hair still looks very thin. What should I do? I hope you can help me! I would need another hair transplant, but I must say I have lost trust in clinics performing hair transplants.

Thank you very much."

We invited the author of the letter for an examination and a consultation, knowing that after a year the transplanted hairs had not started to grow. When we compared the patient's before-and-after photos, it was visible that the coverage of the thin areas had improved, but it seemed that 5,000 grafts had not been transplanted.

Our analysis showed that roughly 1,200-1,500 grafts may have been transplanted, which we shared with the patient. He insisted that he had paid for 5,000 grafts, but with our decades of routine it was possible to tell at a glance that it could not be more than 1,500 grafts, so we suggested that he contact the Turkish clinic that performed the hair transplant.

The next day he called us back angrily after speaking with the Turkish clinic, where they told him he had received 1,500 grafts. To make matters worse, the clinic told the patient that 1,500 grafts had been transplanted, but that this meant he had received 5,000 new hair follicles in his hair. This explanation was of course confusing and our patient was baffled, because he was sure they had talked about grafts, not hair follicles, during the consultation.

The problem: graft or hair follicle?

A hair follicle refers to the root of the hair, the part below the scalp, while a graft (follicular unit) refers to a group of hairs, which may consist of 1 to 6 hairs.

Our experience shows that serious candidates who are considering a hair transplant choose the clinic that suits them after 6-12 months of research and deliberation. Some of these candidates do intensive research and visit most clinics, learning every detail they need to know about hair transplantation.

Most patients who do enough online research on hair transplantation, prices, or visit various hair transplant clinics roughly know the difference between the meaning of graft and hair follicle. Candidates who rely on the hair transplant clinic without doing enough research are often greatly disappointed after the procedure because of misunderstandings, or because of clinics that exploit people's lack of knowledge.

During preliminary assessments some hair transplant clinics suggest a relatively high number, e.g. 2,000 grafts, to cover the whole area, but in reality they transplant only 700-800 grafts, although they tell the patient he received 2,000 grafts. Once the transplanted hair grows out, the patient realizes that he still has thin or perhaps bald areas, and then most often contacts the clinic that performed the transplant to raise the issue. The clinic claims that 2,000-2,500 hair follicles were transplanted and that this was the original number agreed on. In reality they are only playing with words and use different terms to confuse patients.

Probably hundreds of people are thinking about a hair transplant right now, but there are very many who have experienced similar problems. To avoid such disappointments, we recommend that everyone learn about the differences between the terms used in hair transplantation and clarify everything before the procedure in a personal consultation with the chosen hair transplant clinic.