FUE Donor Management
Safe FUE donor management becomes harder as greater numbers are looked to be harvested to treat higher Norwood scale patients. An important aspect to remember is FUE reduces the density and the amount of hair in the donor, the actual skin surface area remains the same, just the amount of hair left in the area is reduced. It is important that long term planning starts with the 1st procedure to ensure that the goals can be met and or if hair loss progresses it can be treated effectively to maintain a natural looking result and good donor
What % can be removed?
If too much hair is removed to treat the recipient area it will impact not only on the visual look of the donor area but also potentially reduce the donor hair density to a level no future procedures can be performed; first the size of the donor area safe zone has to be mapped out. Potential future hair loss will reduce the size of the safe zone. Potential miniaturisation and retrograde alopecia will reduce the size of the safe zone.
It´s important to ensure only hair within the donor safe zone is harvested and shaving the donor hair allows for any miniaturised hair to be identified within the safe zone.
The Safe zone can then be measured, for purpose of this example.30cm from ear to ear and an average of 6cm high = 180cm² of donor surface area
Muliplied by 75 (average donor density) = a total 13,500 FU´s in the safe zone
13,500 FU´s in the safe zone, if we remove:
20% = 2700 FU/Grafts
30% = 4050 FU/Grafts
50% = 6750 FU/Grafts
60% = 8100 FU/Grafts
This does not take into account miniaturisation and changes caused by so many extractions
The higher the % of hair (FU´s) removed makes it harder to control the extraction pattern employed and not remove adjacent follicular units to leave unnatural hair-less areas between each remaining FU. With a short or shaved hair cut it could expose the lack of hair and or the man-made pattern of extraction. Although if the hair is worn long enough, each hair will lay over the next to hide the extractions; the same as FUT
Educated FUE donor management is vital to the success of result. Under the right conditions, very good hair and skin characteristics large numbers are possible although it is important that future hair loss is taken into account, especially when treating lower scales of hair loss as it is harder to predict how progressive hair loss will be in the future.
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*