FUE Donor Management (Donor Miniaturisation)
Miniaturisation is the shrinking of the hair shaft; it can be caused by natural hair loss or trauma. Widespread miniaturisation can affect the hair in the donor area and the long term result the patient receives. FUE maybe minimally invasive in respect to punch size used but that invasiveness is only determined by the size of the procedure and the harvesting protocol.
Punch size is simple; it’s not the smallest or the largest that is best, it is one that can remove only one intact FU at a time causing minimal transection or peripheral damage; multiple incisions can have a “ripple” effect on the surrounding skin and the healing, and the closer the extraction points are will have a larger effect.
This can result is miniaturising the surrounding hairs due to trauma, impair the healing and increase laxity changes; miniaturising of the hair can in extreme cases make any future harvesting difficult and reduce the numbers that can be removed.
Although the donor area is wide, care must be taken to spread the extractions and not limit to a specific area or remove adjacent FU´s – for the sake of the long term best interests of the patient. The higher the % of hair (FU´s) removed makes it harder to control the extraction pattern employed and not remove adjacent follicular units and increase the possibility of miniaturisation.
An educated FUE donor management protocol is vital to the success of result. Long term donor management, preserving the integrity of the donor hair is vital as hair loss progresses.
When deciding on the technique to best use; remember: The harvesting method is not a matter of taste but a matter of necessity. Every patient has different characteristics and these should be taken into account when deciding on the best technique that should be employed*