The term “mega session” is often thrown around in the hair transplant field. It is something patients ask for and cite as a reason for visiting our clinic, but what does it really mean? What does it take for a clinic to perform “mega sessions?” Can it be done as both an FUE (follicular unit extraction) and FUT (follicular unit transplant) procedure? Is a mega session right for you? And what do the results of a mega session look like?
What is a “mega session?”
Technically, a mega session simply refers to a hair transplant procedure where 2,500 or more grafts (follicular unit grafts) are moved in one sitting. As time goes on and techniques refine, the number that truly constitutes a mega session seems to change, but it really is still 2,500 grafts or greater. But there is one other important aspect to consider with a mega session: dense packing. This is another term frequently used in the industry, and it refers to a clinic’s ability to transplant with a high number of follicular units per square centimeter of scalp. In other words, it refers to placing a lot of grafts into a small area in order to recreate a truly dense, thick, natural result. Now, there is a right and a wrong way to dense pack, and you need to make sure your clinic isn’t trying to place too many grafts into an area and creating a risky situation; however, in order to truly achieve an acceptable result with a large number of grafts, clinics must be able to densely pack these grafts in areas where it is appropriate. Taking 2,500 grafts and spreading them throughout an entire scalp will not provide an acceptable look. But taking 2,500, dense packing in crucial areas, and using lighter coverage strategically in others creates truly good “mega session” results.
What does it take for a clinic to perform mega sessions?
Simply put, a clinic needs two things to perform mega sessions safely and effectively: a very large, highly trained staff and experience doing large cases. It is not possible for one doctor to perform a mega session alone. It would take days for a single doctor to remove 2,500 grafts from the scalp, treat them under microscopes, create 2,500 incisions for the grafts, and place the 2,500 grafts back in to the balding areas. Even if the doctor and patient had the stamina, the grafts would never survive and grow! In order to make these mega sessions work, the doctor must operate with an army of highly trained “super technicians.” These “super technicians” are medical/surgical assistants who have been trained to properly handle, dissect, and place grafts. They must be trained by the doctor performing the procedure, and they must know how to work with the doctor and with each other. Think of a mega session as a highly choreographed performance or a well-oiled machine. Each small part must work perfectly in-and-of-itself and with the other parts. If it doesn’t, the procedure doesn’t work. And each technician is a crucial part of this performance. What’s more, a mega session calls for a lot of them. In order to produce the highest quality grafts and ensure the safest and most efficient placement, a clinic should have 1 technician for every 450 grafts. This means that for a 2,500 graft mega session, you need at least 4-5 technicians. For a 4,000 graft case, you’d want around 7-9 technicians. If a clinic is recommending a mega session and they do not have the staff, walk away.
Another crucial aspect is the clinic’s experience with mega sessions. A clinic simply cannot go from performing 500 or 800 graft cases with 1 or 2 technicians to mega sessions surgeries overnight. It takes a lot of time, training, and man power to do this. The more of these procedures the clinic has done and the more experience the entire team has with mega sessions, the better your grafts will be handled, the less time they will sit out, and the better the results will be. Any patient considering a mega session should ask to see dozens of examples of the clinic’s mega session results. Again, if they can’t show you these and ensure you that they still have a team capable of handling these cases, walk away.
Can a mega session be done as both an FUE or an FUT?
Sure, anything “can” be done. The real question is: should a mega session be done as an FUE or an FUT? The answer, is no. The FUT process lends itself to mega sessions; the FUE technique simply does not. In an FUT mega session, a very large number of grafts can be removed without damage, dissected microscopically into perfect grafts, and placed back into incisions all within a number of hours. The “out of body” time is low, the stress for the patient is low, and the grafts are positioned for optimal growth. What’s more, the damage in the donor is minimal and the donor is left in the best shape for future procedures. The FUT procedure only creates 1 linear scar in the donor region. This means there is only one small area of damaged tissue, the rest is untouched and available for future surgeries. And the size of the scar does not differ based upon the number of grafts removed. You can take 5,000 grafts or 500 grafts, you still only have one linear scar with untouched tissue all around it. This means you can do multiple mega sessions as an FUT and transplant sometimes tens of thousands of grafts if necessary.
The same cannot be said for an FUE mega session. If done properly, the time required for a doctor to safely extract thousands of grafts via FUE is massive. So this leaves a clinic claiming to perform FUE mega sessions with only a few options: 1) keep the patient at the clinic for 14 or 16 hours extracting grafts; 2) split the graft extraction phase up into several days; 3) look for ways to speed up the graft extraction process by doing things like using automated or robotic devices or allowing multiple non-doctor technicians to extract grafts at the same time. All of these methods result in the same thing: lower graft quality, more out of body time for the grafts (which leads to drying out and graft death), and poorer results with massive donor damage. Think of the hair follicle as a fragile organ — which it actually is. Now imagine that you must remove that organ using a small, circular tool and forceps (tweezers). In order to remove that organ with minimal damage, you would need to carefully cut around it without cutting through it or removing too much of its surrounding tissue, and you would then need to gently pull it from the connective structures without causing too much ripping or tearing damage. This describes a gentle, responsible FUE process. However, this also describes a process that takes a lot of time, focus, and attention to detail. And it is not possible to put this much time and effort into graft extraction if you must remove 2,500 grafts. So clinics must resort to tactics that cause more damage and less growth. What’s more, an FUE mega session wreaks havoc on the donor region. Unlike the FUT procedure, which leaves only one small line of scarred, damaged tissue, the FUE procedure causes massive, widespread scarring in the donor region. This scarring changes the entire dynamic of the skin and makes future procedures less certain and less predictable.
So with higher graft damage, lower growth, increased donor damage, and uncertainty of future procedures, single surgery mega sessions should only be done as FUT.
Is a mega session right for you?
This is something you need to discuss with a qualified hair transplant specialist. Not everyone needs a mega session. You may have less loss and require less grafts. Based upon your type of hair loss, transplanting a lot of grafts now may actually cause some damage; and you may want to try other methods (such as preventive medications) for some areas of the scalp now and focus on a smaller transplant. But in general, mega sessions are an excellent solution for patients with moderate to aggressive hair loss, and most patients are good candidates. However, a thorough discussion with a qualified doctor must take place before settling on a mega session.
What does a mega session look like?
Here are the results of some recent mega session cases. At Feller & Bloxham, we utilize a very large staff for these mega session procedures, and have been consistently performing very large sessions for many, many years. If this type of transformation is something you are interested in, come see us for a consultation and we’ll determine if you are indeed a candidate:
4,000 graft Mega Session:
3,300 graft Mega Session:
3,100 graft Mega Session:
Dr. Blake Bloxham and Dr. Alan Feller
Feller & Bloxham Medical, PC