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Hair Grafts – What Are They Actually?

If you are considering a hair transplant, you may already know that you will need a specific number of hair grafts transplanted into the bald or thin areas of your scalp. The number of grafts needed varies in each individual case, but is based on the size of the area to be treated. But do you actually know what a hair graft is?

What is a hair graft?

A hair graft is a piece of skin, in others words, a skin graft, that happens to contain hair follicles. It is composed of a follicular unit and its surrounding tissue. Follicular units are bundles of hair that grow together in clumps of 1 to 4 hairs. The grafts also contain sebaceous (oil) glands and some fat.

Back in the bad old days of “hair plugs” a graft could literally be the size of a pencil eraser and contain 5-8 follicular units. That is why they looked unnatural and looked like…well, like plugs. Now they are extremely small and natural, so they  are undetectable as a “transplant.”

Hair Grafts – What Are They Actually?

How are hair grafts harvested?

Although technically a graft can be harvested from anywhere on the body, grafts are usually selected from the back of the scalp, due to the fact that the hair is robust in that area and not susceptible to DHT, the hormone that causes hair loss in men. Furthermore, grafts from body hair tend to have characteristics that are not similar to scalp hair, such as curl and orientation.

At RESTORE, FUE grafts are harvested manually using the Harris S.A.F.E™ System—invented and patented by me and now used throughout the world—or by utilizing the ARTAS® robot, which also employs the Harris S.A.F.E™ System technology. In the case of the ARTAS robot excision, The hair in the donor area is shaved to the length of a military cut (a clipper with no guard). In the case where a patient does not want to shave the donor area short, I offer a no-shave FUE which means only the hairs that are targeted for excision are cut short, then covered by the remaining hair.

Once the grafts are harvested technicians utilizing microscopes sort the follicular units into groups containing 1 to 4 individual hairs.

How are the hair grafts placed?

The next step involves the physician making incisions in the bald or thin region known as the recipient area. These incisions are exactly the same size as the individual grafts. The grafts are then handled by the cuff of dermal fat in which they are encased. They are inserted one-by-one into the scalp, fitting precisely into their new home in terms of depth, width and angle, like perfectly planted mini seeds. The graft must not be plunged in too deeply, but rather the top of the graft must reside just above the scalp surface to avoid what is known as “pitting.” The natural characteristics of the hair, such as wave, length and diameter, mimic existing hair. The goal is to replicate nature. 

How do the hair grafts survive the process?

Your follicles are precious—the last thing you want is to lose them in transition. The following factors are monitored:

  • Temperature. Follicles cannot withstand heat, and chilling them can have a dramatic effect on their survival rate.
  • Oxygen. The follicular units cannot be deprived of oxygen for prolonged periods.
  • Hydration. The grafts can easily become dehydrated, which in the worst case can cause them to die. The grafts are always kept out of the holding solution for the shortest amount of time possible.
  • Durable donor follicles. Only follicles that are not susceptible to the hormone DHT are considered for transplantation.

How many grafts will I need?
It’s impossible to say how many grafts an individual will need without an assessment of your unique situation. The short answer is between 800 and 3,600, but many factors determine the actual graft count to be transplanted.

Contact my clinic for a consultation or ask me a question about your unique situation and how we might treat it. 

Dr. James Harris is an internationally renowned hair transplant surgeon, inventor of patented follicular unit excision technology, published author in the field of hair restoration and an advocate for patient care. He is currently at the forefront of research and development in the field of hair cloning. Learn more about Dr. Harris or read rave reviews from his patients.

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Hair Transplant & Restoration, Surgery

Publish Date:

September 11, 2018


Jim Harris

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