2.  Giga sessions are those in which more than 4000 grafts are transplanted.

3. Changing trends  As techniques improve, the no. of grafts that can be transplanted in one session has increased.  In 2001, when Dr Venkat first learnt hair transplantation, any thing above 1000 grafts was considered as megasession. Now, only those with grafts above 2500 is considered as megasession  Any thing above 4000 is considered as Giga session.T  This has been made possible my refinement techniques, improvement in anesthesia, and skilled technicians.

4. How to maximize the no of grafts?  It is important to understand that variations occur between different individuals and the no of grafts that can be done in one session depends on quality of donor area. 

5. Factors determining the no of grafts per session  The no of grafts that can be obtained in one session depends on three factors:  1.Hair density( no of hairs and no of units per sq cm).Density varies from 70-95 per sq cm in Indian patients  2. Skin elasticity( which determines the maximum width of skin that can be removed safely). The width of skin varies from 1-1.7 cms depending on elasticity in Indian patients  3.Size of head-width of head from one ear to other. This varies from 25-32 cms in most Indian patients.

6. How to perform Gigasessions?  Patients with very good donor( Large head, loose skin,less tendency for scarring, high density): width 32cm*density 95*width 1.7cm=5,168 grafts—this is very rare in Indian patients.  However this is possible in many Caucasian( western) patients, who have large head, good density, good elasticity with less tendency for scarring.

7. Typical Indian patient  Average Indian patients have the following type of donor: smaller head, lesser density and greater tendency for scarring as compared to Caucasian patients:  Length 29cm*width 1.3cm* density 85=3200 grafts. So in Indian patients, maximum number is around 3000 grafts  Even this is difficult in many patients as they have smaller head(27cms), lesser density(75),and lesser elasticity(1 cm)=2500 grafts only

8. SO how do we perform Giga sessions in Indian patients?  This is done by combining different methods.  Over 4000-6000 grafts can be done in most Indian patients as follows:  Day 1 morning FUE about 600-800 grafts. This loosens the skin and helps us to take wider strip for FUT  Day 1 afternoon FUT 2500-3500 grafts depending on quality of donor hair on back of scalp, as explained in previous slide  Day 2 FUE scalp 600-1000 grafts from scalp  Day 3 body hair 500-1000 grafts  However this needs stamina, and a big budget and therefore is applicable for select patients only. 

9. Day 1 morning about 800 FUE has been performed, strip ready for FUT

10. Day 1 evening FUT of 3000 has been completed in addition to FUE of 800 = total 3800

11. Day 2 post lunch FUE of 600 ( below strip suture) has been completed-see how previous FUE –above strip has already healed=4400 grafts

12. Recipient area- large area covered with 4400 grafts

13. Giga sessions  Thus giga sessions help to cover large areas.This is particularly helpful for those coming from foreign countries as it helps to avoid a second travel for second session