FUE Donor Density And Safe Zone

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*

Donor hair management is a vital aspect of a hair transplant procedure; ensuring the donor can sustain long term hair loss especially as hair loss progresses to an advanced stage. As hair loss is progressive the timing of a hair transplant is important

FUE reduces the density or the amount of hair over the donor area, the surface area does not change in size. The donor area can spread around the back and sides of the head and the surface area is determined by how advanced the hair loss pattern becomes

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

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. Safe FUE donor management becomes harder as greater numbers are looked to be harvested to treat higher Norwood scale patients

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

A conservative mapping of the safe zone is logical, especially when treating a low hair loss stage as it is impossible to know how progressive hair loss will become. The density should be measured over various areas around the donor area, around the sides and back

The starting follicular unit density will ultimately determine how many FU’s can be removed; an average density may be able to safely treat a lower NW scale hair loss pattern, but if the hair loss pattern progresses this may make it harder to sustain a natural coverage and density over the recipient area

An average density can be calculated and from this the potential number of grafts that can be harvested over one or multiple procedures. The amount or percentage that can be removed is debatable

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.

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

Multiplied 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

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