Key takeaways:

• What is a Hair Graft? A hair graft is a segment of tissue containing usually one or more hair follicles. Grafts are the building blocks of hair transplant surgery.
  
• What Role do grafts have in Hair Transplantation? Each graft is transplanted from the donor site to the recipient site, in order to treat hair thinning or balding areas. Careful handling of hair grafts during extraction, sorting and implantation is essential for graft survival to achieve optimal results.
  
• How many grafts will I need? It depends on your hair loss requirements. We have published our own clinic graft calculator to help you estimate the number of grafts you may need based on your age, gender, hair type, and area of hair loss.
  
• Why should I learn about hair grafts? Understanding what hair grafts are and the role they play in hair transplantation can help you make a more informed choice. You will also have a greater understanding of how graft numbers translate to actual hair amounts.

What is a Hair Graft in a Hair Transplant?

Hair loss can be a distressing experience, leading many individuals to seek effective treatments to restore their hair and confidence. One of the most popular and successful treatments for hair loss is hair transplantation. At the heart of this procedure is the concept of the hair graft. In this article, we will delve into what a hair graft is, its role in hair transplantation, and what patients should know in order to make informed decisions.

What are hair grafts?

A hair graft is a small piece of tissue that contains hair follicles. In hair transplant surgery, a graft is equivalent to a follicular unit. Each graft is taken from one area of the scalp (donor site), and moved to another (recipient site), where hair is thinning or balding. A single graft, contains anywhere between 1 to 4 hair follicles ¹.

If you examine the hair on your body, you will see that they cluster together in groups. Each of these clustered groups is a “graft” or “follicular unit”.

Other than the hair follicle, a hair graft also includes the first and second layers of your skin (epidermis and dermis). It may sometimes contain the third layer, which is made up of fatty subcutaneous tissue ².

While hair grafts can theoretically be taken from anywhere on your body for a hair transplant, they are usually taken from the back of the head, where the hair more closely resembles those on the rest of the scalp. The size of an extracted hair graft will depend on the surgical technique used, and the tools and technology involved.

Hair Follicle Vs. Hair Root

“Hair follicle” and “hair root” are terms that are sometimes used interchangeably, which can lead to some confusion. The hair follicle acts as the anchor for the hair shaft, and contains the root and several other tissue components that play a vital role in hair growth. 

The hair root is the part of the hair itself that is beneath the skin. At the bottom of the root is where the hair is actively dividing, causing the hair to grow longer and push out over the skin.

The Role of Grafts in Hair Transplantation and Factors Influencing Graft Survival

Think of hair grafts as the core building blocks of a hair transplant. In order for the procedure to be successful, it is vital that these hair grafts are taken out, handled and replaced in their new position correctly. Ultimately, we want to achieve a natural-looking hairline that blends seamlessly with existing hairs.

Hair grafts are the building blocks of hair transplantation. Their proper extraction, handling, and placement are crucial to the success of the procedure. The goal is to achieve a natural-looking hairline and density that blends seamlessly with the existing hairs.

“Careful and appropriate handling of the grafts, together with minimising the time they spend outside the body, are among the most important factors in helping to maximise graft survival. We keep grafts appropriately hydrated and cool, and use implanter pens to minimise unnecessary handling during implantation. After surgery, the patient also plays an important role in supporting graft survival. Protecting the newly transplanted grafts during the early stages of healing are just as crucial as the surgical aspects of the procedure.”

Dr Roshan Vara, Co-Founder and Hair Transplant Surgeon at The Treatment Rooms London

The main steps of FUE hair transplant surgery are summarised below:

• Extraction: Grafts are individually harvested from areas of dense hair growth, which is usually the back or sides of the scalp. 

• Sorting and counting: Once removed from the donor area, the grafts must be handled with care to prevent them from being damaged. They can also dry out easily if they are not kept hydrated. For this reason, we keep them in a saline solution, at a temperature between 8°-14° C5.

With the use of a high-resolution microscope, our technicians can clearly visualise each graft under magnification and prepare them for implantation. They carefully trim away any excess tissue and fatty layers from each follicular unit using a scalpel.

The follicular units are meticulously counted and then sorted by how many hairs they each contain. They can be single, double, triple or quadruple follicular units.

• Implantation: During this stage, the surgical team places each graft into tiny incisions that were previously made in the recipient area of the scalp. The diameter of the incisions can range from 0.6-0.9 mm. The surgeon must consider the angle, direction, depth, and density of each graft to mimic natural hair growth patterns 6. Here at the Treatment Rooms London, we use implanter pens to protect the follicular bulb during implantation. 

Implanter pens in hair transplant surgery:

• Post-Operative Care: The transplanted hairs are likely to fall out at first before they gradually regrow. You can expect the final appearance to be visible at around the 12 month mark. It is really important to follow all of the post-operative care instructions to give your grafts the best chance at survival. Patients should avoid activities, for a set amount of time, that might dislodge and damage the grafts, such as vigorous washing or combing of the hair, and contact sports.

Graft calculator for a hair transplant

For an FUE hair transplant procedure, we understand how difficult it can be to determine the number of grafts required. Our interactive hair graft calculator provides a personalised tool which takes into account various factors such as your age, gender, hair colour, hair type and hair loss area, to estimate the number of grafts required.

The number of grafts required will also depend on the total area that needs to be covered and the desired hair density.

Since each patient is unique, we recommend arranging a consultation with a hair transplant specialist, as it is the best way to find out how many hair grafts you may need to achieve your desired hair goals.

To learn more about calculating the number of hair grafts you may require, visit: How Many Hair Grafts Do I Need For My FUE Hair Transplant?

“The number of grafts does not directly equate to the number of hairs transplanted, as some grafts naturally contain more hairs than others. Our aim is not simply to harvest as many grafts as possible and implant them as densely as we can, but to maximise the survival and effective use of every graft while protecting the donor area from over-harvesting. This also preserves future options, should another transplant be needed later on.”

Dr Roshan Vara, Co-Founder and Hair Transplant Surgeon at The Treatment Rooms London

Conclusion

Hair grafts are at the core of a successful hair transplantation. If carefully planned and performed with expert care, a hair transplant can achieve a natural and long-lasting result. Our patients often report a positive impact on their confidence and appearance. While hair loss can be disheartening, we strive to make our patients feel more confident about their hair and optimistic about the future. 

References

1. Bernstein, R. M., Rassman, W. R. and Seager, D. (1998) ‘Follicular transplantation’, International Journal of Dermatology, 37(11), pp. 841-842. Available at:  https://pubmed.ncbi.nlm.nih.gov/9311372/
   
2. Lin, X., Zhu, L. and He, J. (2022) ‘Morphogenesis, growth cycle and molecular regulation of hair follicles’, Frontiers in Cell and Developmental Biology, 10, 899095. Available at:  https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2022.899095/full
   
3. Rassman, W. R., Bernstein, R. M., McClellan, R., Jones, R., Worton, E. and Uyttendaele, H. (2002) ‘Follicular unit extraction: minimally invasive surgery for hair transplantation’, Dermatol Surg, 28(8), pp. 720-8. Available at:  https://pubmed.ncbi.nlm.nih.gov/12174065/
   
4. Sharma, R., & Ranjan, A. (2019) ‘Follicular Unit Extraction (FUE) hair transplant: curves ahead’, Journal of Maxillofacial and Oral Surgery, 18(4), pp. 509–517. Available at: https://link.springer.com/article/10.1007/s12663-019-01245-6?
   
5. Cole, J. P. and Reed, W. M. (2012) ‘The optimal holding solution and temperature for hair follicle grafts.’, Hair Transplant Forum International, 22(1), pp. 17-21. Available at:  https://www.ishrs-htforum.org/content/22/1/17
   
6. Park, J. H., Ho, Y. H., & Manonukul, K. (2023) ‘A practical guide to hair graft placement using the sharp implanter method’, Clinical, Cosmetic and Investigational Dermatology, 16, pp. 1777–1785. Available at:  https://doi.org/10.2147/CCID.S411488
7. Created with BioRender.com