Judging the donor safe zone can be difficult in the early stages of hair loss, in fact only an educated guess can be made taking into account genetic family history, which is only a guide and cannot be taken that an individual will follow the same pattern
Hair Transplant Donor Area Safe Zone
Even with advanced patterns of hair loss when the demarcation line seems apparent between the recipient surface area and the donor area, the safe zone can reduce in size due to miniaturisation around the peripheral lines, the edges of the lateral humps, the edges of the crown and rising up from above the ears and nape of the neck, retrograde alopecia
The lateral humps are the areas of the scalp that fall on the sides of the head, joining the sides to the top of the head from the hair line temple back; they become important in cases of progressive hair loss when the hair in this area begins to part from the mid scalp.
Lateral humps may still appear to be intact in some cases but the quality of the hair is weak and miniaturised; in this case it is important the area is treated otherwise an island of hair over the top of the scalp is created
The same treating the crown, as the crown can open on all sides and drop down the back of the head; this can greatly reduce the surface area of the donor safe zone; especially when using the FUE technique
FUE relies on a wide donor surface to extract the required number of grafts otherwise over harvesting can occur leaving a moth eaten appearance to the donor area. This also hinders treating higher NW cases if the donor is not strong
Retrograde alopecia generally affects the hair just above the ears and nape of the neck rising up into the traditional safe donor zone; hair may still be apparent but miniaturised and not fit to transplant as it may not grow due to the trauma of the procedure
When designing the hair line it is important to take into consideration these areas and how much needs to be rebuilt behind the hair line to achieve a natural cosmetic result; a balanced coverage of hair over the scalp
The larger the recipient surface area drives the distribution of grafts and not result in an unnatural front loaded hair transplant with a large area of hair loss behind that could be half the scalp
With advanced hair loss where the lateral humps need rebuilding, the crown has dropped and retrograde alopecia is apparent a hair transplant may not be suitable; the quality of the donor safe zone must be measures, hair density, quality of the hair characteristics and then a plan made to achieve a natural coverage and density
This can be a compromise between the individual’s goals and what can be realised; total restoration may not always be possible and the priority is to achieve a natural balance of hair with adequate fullness or hair density
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