Megasession vs Multiple Smaller Sessions?

Dr Rassman

Let’s assume someone’s donor area may yield, say, 5000 grafts using the strip technique. Is it better to have 1 mega session or 3 smaller ones? Is the yield better when cutting the skin only once (or twice) with megasessions compared to 3 or 4 times with in smaller operations?

I have always believed that less surgery is better than more surgery in people with more extensive balding patterns. If you can get 6,000 grafts in two sessions, why go for 6 sessions of 1000 grafts each? If the density and laxity allow for it, most of my patients prefer to have one larger session and hopefully just be done with the surgical process quicker. This means in a practical sense that 6-7 months after the first session of 3000 grafts, you can see results which will impact your ability to style your hair.

Alternatively, I can make an argument against the large session. Multiple FUE procedures or smaller strip sessions have a relatively short recovery time, but for FUE, the shaving of the donor area can be a problem unless you elect to keep your hair short, so regrowth of the donor area usually occurs in about 10 days. Smaller strip cases will have their donor scar covered by the existing donor hair.

Incremental surgeries have really no downside other than the length of time from the point you start to the time you finish. It is possible that more surgeries could give you wider scars, but this has never been studied with any direct comparison. Few patients approach me with a desire for multiple smaller surgeries and prolonged benefits, as they want the benefits quickly and would like to say goodbye to me and the hair transplant process altogether. I am, however, open to performing multiple smaller surgeries.