Why Are Multiple Sessions Sometimes Needed For A Hair Transplant?

For some people, one session is typically sufficient to produce positive outcomes. An extra hair transplant may be necessary to get a more natural and fuller appearance to fill up the bald spots or thicken your hairline.

Multiple sessions are necessary for a few patients who have crossed Norwood 6 baldness. In this article, you will get to know about the multiple sessions of hair transplant procedures.

Reasons For Multiple Sessions

Multiple hair transplant sessions may be necessary when dealing with extensive baldness, low hair density, challenges in the transplant procedure, and the likelihood of future hair loss.

It is crucial to consult with a hair transplant surgeon to determine the best course of action based on individual circumstances.

Size of baldness

If the baldness is extensive and covers a large area, multiple hair transplant sessions may be necessary. It is especially true for androgenetic alopecia, which is the most common type of hair loss and can affect men and women differently.

The condition can occur at any time, even during the teenage years. In female pattern baldness, the hair follicles are gradually replaced by finer and thinner hair, leading to a miniaturized version of the original hair. Women may experience baldness at the top of the head or at the part.

Hair density

Hair transplants may not be as effective for people with widespread thinning and baldness. The procedure works best for individuals who are experiencing natural balding or thinning or those who have lost hair due to an injury.

If the hair density is significantly low or the baldness is extensive, multiple sessions may be necessary to achieve satisfactory results.

While hair transplant surgery has become increasingly popular and can provide a natural appearance, there are challenges that can affect the outcome. One challenge is the availability of donor’s hair, as there is a limit to the amount of hair that can be transplanted.

Another challenge is ensuring the survival of transplanted hair, as not all transplanted hair follicles may successfully grow new hair. In such cases, multiple sessions may be required to achieve the desired hair density.

Future hair loss with age

Hair loss with aging is a natural process and can vary among individuals. Some people may start experiencing signs of baldness by the age of 30, while others may not be affected until later in life.

Male pattern baldness, which is linked to the male hormone testosterone, often starts with receding hairlines or balding at the temples or the top of the head. Women can also develop a similar type of baldness known as female pattern baldness, which results in less dense hair and a visible scalp. 

If there is a likelihood of future hair loss, additional hair transplant sessions may be required to address ongoing hair loss and maintain a desired appearance.

Planning For Multiple Sessions

A Giga session in the context of a hair transplant refers to a transplant session involving 5000 or more grafts. It is important to note that single-session FUE (Follicular Unit Extraction) procedures have never achieved graft counts close to 5000.

Undertaking a Giga session is a significant endeavor that requires specific patient and procedural considerations for successful outcomes.

Patient Selection

Patient selection is the initial and crucial step in planning multiple hair transplant sessions. The ideal candidate for a Giga session should have above-average to excellent hair density and above-average scalp laxity. 

Various devices are available to assess hair density accurately. However, a physical examination is necessary to evaluate the patient’s suitability for the procedure.


Anesthesia plays a vital role in ensuring patient comfort and safety during the hair transplant process. Prior to the procedure, the overlying hair is trimmed. Anesthesia of the donor site is achieved by infiltrating 1% Xylocaine with 1:200,000 epinephrine.

Subsequently, a tumescent solution containing 1:400,000 epinephrine is infused to reduce bleeding. The donor area is then divided into two to four sections, carefully dissected, and closed using absorbable dermal sutures and surface staples.


Performing Giga sessions requires shaving the recipient site to efficiently transplant a large number of grafts. The recipient site areas are anesthetized by administering a ring block using 1% lidocaine and 1:200,000 epinephrine.

Tumescent fluid containing 1:300,000–1:400,000 epinephrine is injected into the target area to create tumescence in the subcutaneous space, minimizing bleeding during the creation of slits. The use of lower concentrations of epinephrine in the tumescent fluid is sometimes explored for potential benefits in graft survival.

The size of the slits created during the procedure depends on factors such as hair coarseness and the number of follicles per graft. 

Coarse hair or follicular units with splayed-out hairs may require larger slit sizes, typically ranging from 0.65 mm to 1.2 mm. For patients with Norwood 6 hair loss, the procedure typically involves one to two strip sessions initially to move the required 6000–8000 grafts. 

Subsequently, FUE may be performed to improve the scar if needed and for any refinement work.

ALCS Hair Transplant and Cosmetic Clinic, under the leadership of the internationally recognized Cosmetic Surgeon, Dr. Sunil Arora, specializes in hair restoration and cosmetic procedures. With a focus on quality, ALCS Clinic offers a range of Hair Transplantation and Cosmetic Surgery Services under one roof.

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