Donor On Demand

The donor supply area will vary dependent on the eventual pattern of hair loss across the top of the scalp; the wider the pattern of hair loss will reduce the size of the safe donor zone as hair loss progresses down the sides and back of the head

Measuring the quality of the donor supply can be listed into aspects, size or surface area, skin laxity, hair characteristics, hair or follicular unit density and the percentage of miniaturisation within the donor area

An average density is around 75 FUcm², the density will later dependent on ethnicity and hair characteristics. Too low a density makes treating progressive hair loss impossible and over harvesting the donor will impair the look and possibly increase visible scarring

The size or surface area of the donor supply; this varies between the technique of choice. FUT harvesting is localised to a thin strip generally well within the safe donor zone but still the position has to be safely calculated, especially with very advanced hair loss, or individuals with retrograde alopecia

Follicular unit hair density; FU´s are naturally growing groups of hairs, normally 1 to 4 hairs with the highest density generally around the back of the scalp. Donor hair density will determine how much can be removed safely

FUE relies on removing follicular units individually and over a wide non-specific area, caution needs to be taken not to venture out of the safe zone when extracting. On lower hair loss stages it can be impossible to predict the size of the safe zone and a conservative approach is advised when measuring the safe area

To measure the safe zone is easier on higher hair loss stages as there is a clear demarcation line between the donor zone and the recipient area; not taking the area directly from the start of where the hair begins, such as directly above the ears or the nape of the neck, but keeping around 1-2cm in case of future hair loss or miniaturisation

The length and width of the strip with FUT will be calculated dependent on the number of grafts required, can range from around 10 to 30 cms in length and 1 to 2 cm in width; better laxity attributes allows for 6000 plus grafts to be harvested on a good candidate

Skin laxity affects the FUT hair transplant technique generally more than the FUE technique; FUT relies on removing a hair bearing strip and the width of the strip is largely determined by the skin laxity. Safe donor management needs to be employed to not make the strip too wide and increase the potential of poor healing

Laxity can affect FUE also but in a different way; if the skin physiology is very lax it can impair the punching of the follicular units, the skin can break away and damage the grafts, making them useless to transplant

If the % of miniaturised hair in the donor is high it will reduce the chances of being a hair transplant candidate

Hair shaft diameter; miniaturisation is the progressive thinning of the hair shaft, becoming finer and weaker than the surrounding good quality hair. Miniaturised hair should not be transplanted because it will impair the result and potentially will not regrow due to the trauma of the procedure

Hair characteristics covers aspects such as hair calibre, hair curl, variant in skin to hair colour; if the characteristics are poor even with a high FU density can produce poor hair transplant results

Using all these aspects will help determine how much hair can be safely harvested, what density will be required when placed and the coverage that can be achieved over the surface area. Correct donor management of the supply of hair can restore even advanced hair loss; utilising the correct harvesting technique will maximise the graft numbers in one or over multiple sessions

Ultimately a good or bad hair transplant candidate can be determined by the quality of hair around the back and sides of the head, known as the donor area; the hair is genetically strong and does not suffer the same symptoms of male pattern baldness

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