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Sunday, September 16, 2007

MEGASESSION & HOW MANY GRAFTS CAN BE DONE IN ADAY?

Well with the evolution of Hair Transplant procedure there came more enterprising surgeons and patients who demanded more grafts in one session. In 80s and 90s where most surgeons used to offer 500 to 1000 graft every session and would ask the patient to take multiple sessions. Meaning of Mega session varies from centre to centre; but over 1000 grafts is usually considered as mega session. The limit of mega session depends on many factors:
  1. Willingness of surgeon and patient
  2. Well trained and well equipped team for taking the endeavour efficiently and quickly. It is well organised effort by a well experienced team only this can be delivered successfully.
  3. Donor capacity or density. Every individual’s donor site I different. There are some Asians with the donor density of only 50- 60 Follicular Units per sq. cm where as there are some Caucasians with about 150 FU per sq. cm. density. So there can be vast difference in the number of harvest from the same size of area in both these individuals. Most Asian heads are shorter that the longer heads of the Caucasian and the same may be true for the height of the donor area too. So Caucasians can donate larger area of skin and therefore larger number of grafts too.
  4. Donor Laxity: Well tight scalp can not mobilise large strip of skin and therefore laxity of scalp is one very important feature to determine for the mega session.

With all these factors considered there are number of times where over 4000 grafts have been grafted in a day by us.

The main benefits of the Mega session are:

1. Goals accomplished quickly

2. Fewer traumas and damage to donor hair and less donor scars considering multiple scars of smaller sessions

3. More graft harvest than multiple small sessions. Smalller sessions have higher likely damage to the donor follicles while strip removal and also dut to scarring

4. Comparatively less expensive for patient in terms of travel, surgical and off the work time.

Usually it is safe in the hands of experienced surgeon there can be some potential Downsides of Mega session:

  1. Necrosis of the skin if it is done without taking in to consideration of the skin laxity.
  2. Poor growth: The grafts after harvesting have to be well preserved and should be placed back in the body within 8 to 12 hours otherwise their survival rate goes down. Some times Mega session is done for dense packing of the limited recipient area. The dense packing over the 35- 40 graft per sq.cm. would lead to lower survival rate.
  3. Stretched Donor scar if the donor area is closed under too much tension
  4. Slightly higher Anaesthesia risk: due to larger dose of Local Anaesthetic agent is consumed in larger area and for longer period of surgery

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