I am appealing to any experienced FUT professional (doctor or patient) for a favor. I did my surgery on last week and I cannot tell if my doctor (who is highly reputable) did as many grafts as he said. Could you kindly look at the attached photo and give me your opinion as to how many incisions/grafts this appears to you (we focused just on the frontal area)?

Many thanks to any one who gives me some guidance.

If you really want to improve your capacity to know exactly how many recipient sites were made, you should insist that your physician use the Counting Incision Device from Device For Hair. You can see this at Counting Incision Device (C-ID) . This device will cost your physician only 22.00 to use and he can give it to you at the end of the case. This device allows you to know precisely the number of incision sites filled with grafts and it is the only way you can know for certain how many incision sites were made. Of course, if you have a site that is not filled with a graft, then you should not be charged for the graft.

We have found that most physicians are not willing to spend the extra 22.00 to be accurate with their incision site count. While the Physician is making thousands of dollars on your procedure, he appears to be less concerned with accuracy and more concerned with the extra expense. Therefore, you might want to purchase one for your physician and insist that he use it and then give it to you at the end of the case. This way you can be certain what was done.

Don”t rely on the surgery staff to count your grafts or your incision sites. They have no real interest in being accurate and they are often more concerned with what they are going to have for dinner than an accurate graft count. Try sitting at a counter and cutting grafts day in and day out. It becomes routine and monotonous. Over time, the surgery tech”s mind begins to wander and they next thing you know, they have lost count.
Insist that your physician use the Counting Incision Device (CID) so that you can be certain what the exact graft count is.

One important point to consider with the CID is that it is disposable. There is no way to properly sterilize it once it has been used. Insist that the physician use a new one on you and not one that he used on someone else the day before. It really is up to you to insure that you get what you pay for and that your physician use properly sterilized single use CID instruments on your case.

Getting back on the subject of your grafts, there is some elongation noted and many of the hairs appear to be falling over to the side suggestive that they are about to be expelled from the skin and lost in your shower drain. This would not happen one day after a procedure.

Many times when the scabs come off, they bring the transplanted, non-growing hairs with them. It is less common for scabs to contain non-growing hairs when you use Hair Cycle Biotin spray as this helps to get rid of the scabs faster and often leaves the non-growing hairs behind on the surface of the scalp. Use of Hair Cycle products can dramatically accelerate your post surgical healing.

Of course when the scabs take hairs with them, it is more difficult to determine how many grafts you had. It is only possible at this point to suggest how many remain. The overall density does not appear great so I would expect that you currently have somewhere between 1000 and 1500 grafts just based on the surface area treated and the remaining lower density as it appears in this photograph.

patient with unknon graft count

Also note that your hair transplant photograph appears to be older than one day. It is very unusual for the scabs to be shed in one day and most of your scabs are gone. The hairs in many of the grafts appear to have elongated beyond the length you would expect after only one day. When you transplant grafts, the hairs will continue to elongate for up to 11 days after a procedure. Some misinterpret this for growth of the grafts when in fact it is perhaps some growth, but it is also due to a shortening of the dermal sheath that tends to push the hair externally as the sheath shortens following the transplant. After a couple of weeks this lengthening ceases unless indeed the hairs are continuing to grow, which is uncommon. Generally, you will see only a handful of grafts continue to produce hair following a hair transplant. Many of these hairs will be puhl pinkus hairs meaning they will have a thin lighter color below a darker thicker colored hair. The thinner area usually signifies a retarded growth subsequent to the trauma experience by the growing hair following surgical trauma to the hair shaft.