How many HAIR TRANSPLANT procedures do you need? #FUE

hey guys hi how are you welcome to another underperforming video on youtube today killian joins us to speak about the important topic of finding out how many transplants do you need to find those desirable results one, two, three? today we’re going to speak about that. hi killian! -hello juan, how are you? -good man! i hope you’re having a good day. i’m having a very good day. the weekend is just starting and well this is a topic i’ve really been looking forward to talking about. -then let’s start! are you ready? -i am, as always. -let’s do it what do joe tillman, David DiMuzio and hairliciously have all in common? is, they’re all great youtubers but also they have they have had multiple hair transplants; at least two or more such as is the case with me and killian.

i really recommend those channels; 00:50 - joe tillman, he’s an institution in the topic he’s got had, i think, about 10 and David DiMuzio and hairliciously they’re also very good channels so i recommend them highly and they have also have more than one hair transplant such as is the case with killian and me and today i would like to discuss this because 16 years ago when i walked into my first hair transplant ever, i really walked in with the false premise that one would be enough. i remember my doctor telling me that one should be enough and if i ever wanted to come back for more, then it would just get better but for some of us uh one isn’t enough. what do you think killian? -oh i i think you’d be very mistaken to think it’ll be just one, it’s not possible to achieve the density that we all have in our mind and as well hair loss is progressive so catch up is. -so you think it’s very common for us to walk in with the picture on our mind about what’s going to happen after a first transplant? -uh no. i i think we all walk in, including myself, when i was younger thinking that this would be a fix just once off. -um…

according to the international hair restoration society… what is it? the international society of hair restoration surgery, according to them, in the latest stat it says that 57.2 percent of patients get satisfactory desirable results in one transplant but then there’s a big number of 33.1 who need two procedures and then in 9.6 they need three or more. i get that question. a lot people tell me “i want to get a hair transplant” and i always tell them “be open to the possibility that you may need 2” why do you think it is killian that a desirable result is hardly achievable with one procedure even if it’s a good one? -okay, it depends on… if it’s totally bald scalp, which is nearly all of the cases or else in a few cases which are optimal you have some hair and you go in between but let’s focus with the majority normal hair per square centimeter is about 70 to 90 follicular units.

03:21 - it is impossible to transplant that amount. we can transplant, and numbers vary, but safely around 30 to 45. how come it gets a little bit more difficult after that? because you’re making so many sites in one area that the more you do, the more injury you cause that area. the tissue literally becomes injured and then devascularization is a potential risk factor which means necrosis. you have to make so many, you have to put them much closer together. all these injuries… imagine you get some coalescing of them.

04:04 - the damage is huge so then you get skin death potentially as a worst case scenario but generally what happens is if they try to transplant, you know 50, 60, 70 per square centimeter a lot just don’t survive so you take the safe one where you know you get most of them surviving and then what happens is angiogenesis occurs because new blood vessels will form over the next year in that area which means you’re safe to come back and do more in the future. -did you know that when you walked into your first hair transplant? =no i i had… you know a rough idea of, um… what i would get but i certainly didn’t know the details. i didn’t really consider having to go back and replenish until later on. -for somebody like killian… we’re different. me and killian are different because i have lower density so my guess…

remember, as a patient always as a patient, 05:08 - my idea is that if you have lower density and you walk in for a hair transplant then it’s easier to match, to get closer to the density that you have if you have lower density but in the case of killian that he’s got great density but he had a hairline that he didn’t like then with more reason, it’s going to be very hard for a doctor to match that density. so if a doctor has this artistic element when it comes to a transplant, he can make it appear like he’s got a good density. but like he says, it’s really hard to hard pack those, uh those graphs so close together that most likely you’re gonna have come, you have you’re gonna have to come back for a second one. -yeah definitely. now, there is the whole art behind this, is the illusion. so angles so less is more because it’s all about angulation you have like, i’m sorry, you have like…

let’s say this to this if you get what i’m trying to say. um it’s all about the surgeon and what he sees and what he’s going to artificially create in terms of angles that will give the illusion of more density, i’ve… so i don’t even like calling it an illusion because it is almost more density when you look at it. -can you show us what do 2 transplants look like on bare scalp? -on bare scalp? okay, well as a contrast i’m going to show you where isn’t bare scalp. so here, okay we’ll go to the bare scalp so this area here was all bare ball scalp whatever you want to call it.

and you can see the scalp on guess and reflective 06:58 - now let’s go to an area that hasn’t been touched by transplants that’s entirely natural, hopefully you can… uh see the difference. -oh yeah… different, it’s harder to get to the actual scalp. -exactly no matter how many transplants i have, it is never gonna look like that i can only get it so close. and you know, for me so far, two has been the magic number. there’s no point in doing the third back in this area… just, it won’t make a difference. i’ve kind of i’ve hit the top now with it.

07:34 - -the next question, i have for you killian is: what do you think a second procedure can bring that the first one didn’t bring? -refinement. because the first procedure ideally sets the foundation and you’ll probably notice that from your first procedure it might be a little bit more pluggy, more abrupt and then you go and you do a second procedure you create a softer look in the hairline by adding more to it if that’s usually what happens, what people do. you beef up the density a bit but you make it look more natural. -my first two procedures were rather smaller sessions and i’m going to leave you the link to the ishrs because you can find lots of information and you can see how sessions have gotten bigger. doctors are able to transplant more hair in a single session is in from 2009 to 2019 the difference is about 20 percent so the average first session is 20 percent bigger than it used to be so such was my case 1500 graphs and then a thousand graphs which is 2500 graphs and then in my latest procedure it was 2300 graphs.

so you 08:46 - can see how the two procedures from 16 years ago were rather small sessions in today’s standards. -they have better instruments now. they have sharper instruments. there’s more precision. there’s so much more control and this is why they can transplant more safely higher numbers. -there you go. and you know they keep getting better i think um i think the instruments were more limited in the past see i’m no expert but if you go to the ishrs website, it talks about how the punch sizes have gotten smaller so my guess is they’re that they’re able to put more graphs in a single session than before because those uh those those tools were bigger before so… -they can’t get any much smaller than they are now really because we’ve kind of you know we’re ultra refined at the moment you still have to keep that connective tissue, that fat on that graph for it to survive. -i think that the more informed you are by bringing in the right questions for the doctor and see what your expectations are so that when you spend your hard earned money on a first transplant be more than likely open to the possibility that you may need a second transplant. i think i want to wrap it up at this.

i hope we did a good job at answering that question how 10:03 - many transplants do you need. um i think we found a consensus between me and killian. the answer is: be open to the possibility of needing more than one. even one good hair transplant may need a follow-up procedure. right killian? -definitely! so put your money aside. if you… if you’re, if you want to… if you are, i wish i did this. i’m telling you, if if you’re going to get a transplant be prepared that as little as two three four five. i i would nearly guarantee you’ll be going for a second so you know put them on your side for two or at least one and a half. -yes. and if it was your case, please let us know in the comments let us know in the comments if you found the desired results on a first transplant or if you went for a follow-up procedure. that is it for today. i hope you find this video useful and if you did find it useful, please give it a like and also, if you haven’t done so, please subscribe to my channel and if you can think of anybody that can benefit from this material feel free to share this video with anybody. thanks for being here killian today. -absolutely it was great fun and until next time whatever our next topic may be.

11:11 - - great, awesome! thank you guys and i’ll see you next time. .