Question – Do you mean a higher density from each graft or do you mean a higher density of growth?
Dr. Cole’s response – There are instruments that allow me to average 2.93 hairs per graft, where as strip surgery averages 2.0 hairs per graft. There are no instruments that allow for a higher density in the recipient area. Density in the recipient area is governed by yield. Studies have shown that in some individuals, the yield from grafts declines above 40 grafts per square centimeter. No one knows specifically why yields decline in some patients. It may be an accumulation of free radicals. One thing that might improve survival of the grafts is liposomal ATP. This delivers energy to the grafts while waiting for the circulation to be re-established. Circulation is reestablished over about 3 to 4 days, but in the interim the cells must derive energy aerobically. When the cells are re-exposed to oxygen, they produce free radicals. The free radicals might be the cause of cellular death or lower yields from high density because a higher density overwhelms the bodies own natural antioxidants. Adding antioxidants to the storage solutions and liposomal ATP to the grafts, helps to reduce free radicals and provide energy to the cells so that they do not have to produce ATP aerobically. The antioxidants tie up the free radicals and the liposomal ATP decreases free radical production. This may allow for a higher density of grafting, but it must be studied at some point to assess the benefits.