What is a graft? How many hairs are in one graft?

What is a graft?

In medicine, a graft is a piece of tissue that is taken from one place and transplanted to another. In a hair transplant, this piece is taken from the donor area (usually the back and sides of the head) and contains one or more hair roots. A graft usually has one to four hairs; this number depends on which natural hair group the graft was taken from.

What we move in a hair transplant is not the hairs but the follicles (hair roots) that produce them. Along with the follicles, a graft also contains a small amount of the tissue around them. For the follicle to keep producing hair in its new place, it is important that these structures are moved without damage. We describe the parts of the follicle in detail in our article on the hair follicle.

In everyday language, these words are often used interchangeably, but each one actually describes something different:

• Hair strand: The part that grows out of the skin and that we can see.
• Hair root (follicle): The structure inside the skin that produces the hair. Each root usually produces a single hair. In promotional material, the word “root” is sometimes also used to mean a graft.
• Follicular unit: A small group of roots that sit together naturally in the skin.
• Graft: The piece of tissue taken for the transplant. In FUE, one graft usually corresponds to one follicular unit.

Knowing the difference helps you understand what a number you are given is actually counting.

Follicular units: how hair grows in natural groups

When you look at the scalp through a magnifier, you can see that hairs grow out not one by one but in small groups. These groups are called follicular units (natural hair groups). Most units carry one to four hairs; units with five or more hairs are rare.

The follicles in a unit sit close together in the skin. Besides the hairs, a unit also contains oil glands, hair erector muscles and sometimes one or two fine, downy hairs (vellus hairs). A thin layer of connective tissue surrounds the unit; thanks to this natural boundary, each unit can be told apart as a separate group within the skin.

In FUE (the method in which grafts are taken one by one), we take each graft by separating it from the surrounding tissue with a fine tip; our aim is to take each follicular unit as intact as possible. Even so, a graft does not always match a unit exactly. During harvesting, part of a unit may be left behind, or two units that are very close together may come out together.

We sort grafts by the number of hairs they carry

Before the transplant, we sort the grafts into single-hair, two-hair, three-hair and larger grafts, because we use each group in a different place in the recipient area:

• Single-hair grafts create the softest transition. We use these grafts at the very front of the hairline and in the eyebrows.
• Two- and three-hair grafts add more to fullness behind the hairline and in the mid-scalp.
• Grafts with four or more hairs are less common; we usually use them in areas away from the front rows.

This arrangement aims to create a transition that resembles the way hair grows naturally. We explain how we plan the hairline in our article on hairline design.

Why is the number of grafts not the same as the number of hairs?

The number of grafts is the number of pieces of tissue that are taken and placed. The number of hairs, on the other hand, is the total number of hairs these pieces carry. Because grafts carry different numbers of hairs, the two numbers are not the same.

Here is a simple example: if ten grafts all have a single hair, a total of ten hairs are moved; if they all have three hairs, thirty hairs are moved. In a real transplant, the grafts are mixed, and the proportions in this mix vary from person to person, and even from one part of the donor area to another in the same person. That is why the average number of hairs per graft is not the same for everyone either.

How should you read “this many grafts, this many hairs” calculations?

In hair transplant advertising, you may see comparisons claiming that a certain number of grafts equals a certain number of hairs. These comparisons are not standard; there is no accepted conversion rate that applies to everyone. There are several reasons for this:

• The makeup of the units differs from person to person. The same number of grafts means a different number of hairs for someone whose units mostly contain one or two hairs than for someone whose units mostly contain three or four.
• The way grafts are counted can vary. If a multi-hair unit is split into several smaller grafts, the number of grafts goes up, but the total number of hairs does not.
• The number does not show growth. The number of grafts and hairs describes the tissue that is placed; it does not tell you in advance how these grafts will grow in their new place.

That is why, when you are given a number, we recommend asking whether it refers to grafts or hairs, and how it was calculated. It also helps to ask the same question when you compare numbers from different places.

Why is the number of grafts alone not a guide to fullness?

How full your hair looks after the transplant does not depend only on how many grafts or hairs are placed. The same number of grafts can give quite a different look in two different people. We list the main factors below:

That is why there is no single “sufficient number of grafts” for fullness that applies to everyone.

The number of follicles in the donor area is also limited; every graft taken today is one less graft available in the future. Taking more grafts than the donor area can supply may leave it looking sparse. That is why we do not think about the number of grafts in terms of “the more, the better”; we take into account both the current and the future condition of the donor area. We explain why the donor area is limited in our article on the donor area and donor dominance.

What can we not know for certain in advance?

Graft and hair numbers guide the planning; however, some things cannot be known for certain before the procedure:

• Exactly how many hairs the grafts will have. During the examination, we can get an idea of the structure of the units in the donor area; how many of the grafts will have a single hair and how many will have several, however, becomes clear during harvesting. That is why the numbers we discuss during planning are approximate.
• How the grafts will take hold. How many of the placed grafts take hold and grow hair varies from person to person and cannot be known for certain in advance.
• How the hair loss will progress. A transplant does not stop the loss of your own hair in areas that were not transplanted, so the way your hair looks today may change over time.
• When the look will become clear. It takes months for new hair to grow, and how long varies from person to person.

How do we look at the number of grafts during the examination?

We see the number of grafts not as the plan itself, but as a result of the plan we make for you. During the examination, we look at the following together:

• How densely the follicular units are spaced in the donor area, and how many hairs the units usually carry
• The thickness and curl of your hair, and the contrast between your hair color and skin tone
• The size of the recipient area, and whether there are still follicles producing hair there
• How your hair loss is progressing, and whether the donor area may need to be used again in the future

Using this information, we discuss together how densely we plan to place grafts in each area and what you can realistically expect from this. We do not give a fixed number of grafts in advance; we determine the number you need during the examination, as we make the plan. We explain which factors determine how many grafts you need in our article on how many grafts are needed, and the procedure options on the hair transplant methods page.

Whether you are suitable for a hair transplant is determined during the examination, and results vary from person to person.