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 chose to have a hair transplant at various other clinics. Since we have been hearing about 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 to have a hair transplant at a clinic in Turkey. During the assessment at the clinic, they told me that I had advanced male-pattern baldness and would need 5000 grafts transplanted. I told them that was fine if it would solve the problem, since I had felt very uncomfortable about my appearance for a long time. A year has now passed since the hair transplant, but my hair still looks very thin. What should I do? I hope you can help me! I would need another hair transplant, but I have to say that I have lost trust in the clinics that perform hair transplants.

Thank you very much."

We invited the writer of the letter to an examination and a consultation, aware that after a year the transplanted hairs had not started to grow. When we compared the patient's before-and-after photos, it was clearly visible that the coverage of the thinning areas had improved, but it appeared that 5000 grafts had not actually been transplanted.

During our analysis, it turned out that roughly 1200-1500 grafts could have been transplanted, which we shared with the patient. He insisted that he had paid for the transplantation of 5000 grafts, but with our decades of routine experience, it could be determined just by looking that there could not have been more than 1500 grafts, so we recommended 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 he was told that he had received 1500 grafts. The situation was made worse by the fact that the clinic told the patient that 1500 grafts had been transplanted, but that this meant he had received 5000 new hair follicles in his hair. This explanation was of course confusing, and our patient was baffled, because he was certain that they had talked about grafts, not hair follicles, during the consultation.

Problem: Graft or hair follicle?

The hair follicle refers to the root of the hair, the part beneath the scalp, while the graft (follicular unit) refers to a group of hairs, which can consist of 1-6 hairs.

Our experience shows that serious prospects considering a hair transplant choose the clinic that's right for them after 6-12 months of research and deliberation. Among these prospects, some conduct intensive research, visit most clinics, and learn every detail they need to know about hair transplantation. 

Most patients who do enough online research on hair transplants and prices, or who visit various hair transplant clinics, roughly understand the difference between a graft and a hair follicle. Those who rely solely on the hair transplant clinic without doing enough research of their own are often greatly disappointed after the procedure, either due to misunderstandings or because of clinics that take advantage of people's lack of knowledge.

During preliminary assessments, some hair transplant clinics suggest a relatively high number, e.g. 2000 grafts, to cover the entire area, but in reality only 700-800 grafts are transplanted, even though they tell the patient that they received 2000 grafts. Once the transplanted hair grows in, the patient realizes that there are still thin or even bald areas, and in most cases contacts the clinic that performed the transplant to raise the issue. The clinic claims that 2000-2500 hair follicles were transplanted and that this was the original number agreed upon. In reality, they are just playing with words, using various expressions to confuse patients.

Probably several hundred people are currently thinking about hair transplantation, but there are a great 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 during a personal consultation with the chosen hair transplant clinic.