Depleted Donor Area

A hair transplant relies greatly on the capacity of the donor area to supply enough hair to cover the surface area of hair loss; the more times the donor is entered or harvested the quality of the area will be impaired

Also known as an “open donor” when the area has been depleted of grafts, either due to excessive scarring by previous operations or the donor hair quality not being adequate to be used, either miniaturised or simply a low density, possibly signs of DUPA

Obvious donor scarring will deplete the resources available

Obvious donor scarring will deplete the resources available

Donor management is vital to a successful hair transplant; older techniques practised in the past such as punch grafting would leave large cylindrical scarring across the donor area and greatly reduce the amount of hair that can be safely harvested

If the scarring is too extensive it can become visible and the hair length needs to be kept long to hide. The harvesting more hair becomes problematic as it may expose the scarring further, so an educated harvesting protocol has to be administered

In cases where the donor is open with punch scarring, and assuming the skin laxity still allows it can be possible to excise the scarring using the FUT technique, or strip method; this allows for the strip to be taken and then sutured leaving a single line, opposed to multiple scarring

From the strip the scar tissue can be removed and the remaining follicular units used to repair areas of the recipient area; this is a time consuming and technically challenging and should only be controlled under magnification

When dealing with a depleted donor it is important to prioritise how the hair that can be harvested can then be used in the recipient area; very often a depleted donor also means a less than successful recipient hair result and this will require planning to get the most from the donor to give a cosmetically pleasing result in the recipient

Planning is critical, both from the donor and recipient, to prioritise on what supply is available to what the demand is in the recipient area; as the number of follicular units available is a finite resource they need to be distributed in optimum approach

A depleted donor can also occur prior to any hair transplant being performed; if the area has a high % of miniaturised hair, or a low density or hair count. If the case a hair transplant is very possibly not the answer, short or long term it is unlikely a successful result can be achieved

Research is important, having the donor area checked and examined, especially with repair hair transplant surgery so a master plan can be made and both the candidate and doctor understand the goals, priorities and limitations



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