Excessive Donor Harvesting in FUE As A Common Cause For Repair Surgery

[Abbie]

There are many types of patient cases which require more grafts than what can be supplied by the donor follicles on the scalp. And this can be problematic when conventional hair transplant surgical methods are used, where the scope of expertise is limited to only performing extractions on the scalp.

 

At our clinic, many of our repair patients seek help for typical issues such as:

 

1. areas where grafts from previous procedures failed to grow

2. misplaced or awkward looking insertions that have a detrimental effect on the patient’s appearance.

 

However, another issue that we often see is the over harvesting of grafts on the back and/or sides of the head in an attempt to cover severe areas of baldness with the use of only head hair donor.

 

This results in linear areas of emptiness, or wider looking areas of missing hair in the head donor regions.

 

 

 

Excessive Donor Harvesting and the Need for More Grafts

 

In these cases, previous surgeons attempted to meet the pressing demand for improved coverage by extracting an excessive number of donor hair grafts from the scalp, creating the additional problem of barren areas in the back or sides of the head.

 

However, it is important to maintain the awareness that except in some extraordinary cases where donors are above normal; the scalp can typically only offer a maximum range of 5000-7000 grafts. For most patients with NW 6-7 hair loss level, this is inadequate to offer credible global coverage. The best that can be hoped for with head hair only surgeries in these cases would be NW 3ish hairlines with very sparse to empty crowns.

 

Patients requiring youthful hairlines with global coverage and density should be looking to supplementing their donor with body hair transplants.

 

Recently, Dr. U addressed the issue of exceeding the head donor limits in Follicular Unit Extraction surgery through this video.

 

 

 

To view more videos where Dr. U explains common phenomenon in hair restoration or provides answers to frequently asked questions visit this video playlist:

 

 

[irishsailor]

Great post by clinic. Very interesting, thanks for sharing doc.

[MAGNUMpi]

Wow, that second picture is my nightmare.

So are you basically saying that if a person is eventually going to be a NW6 he are not going to have enough donor hairs on your head and will have to result to body hair eventually?

Would the pictured patient have been looking normal if he had gone for FUT to begin with?

[Britanium]

Nice video dr! You have saved these guys from a nightmare. Its all down to planning. Some people

are just not good candidates to begin with.

[gbhscot]

Unbelievable results! Strangely reassuring for a young guy with too much chest hair and not enough on top!

[TakingThePlunge]

I'm always impressed by Dr. Umar's success with "lost cause" patients. Well done!

[Dr Blake Bloxham]

Abbie and Dr Umar,

 

Thank you for sharing. Decimating the donor area with overzealous FUE harvesting is a serious issue that is rarely discussed online. It's something we see quite a bit in consultations and it's always so distressing to evaluate a patient who experiences the unfortunate combination of poor growth AND donor depletion from over-harvesting. Options for these gentlemen are really limited. In fact, it's part of the reason why we started working on new FUE extraction methods like our mFUE technique.

 

Again, thanks for bringing this important topic up.

[Tav1]

Dang Blake - I understand you need to pump your mini-strip method at every available opportunity, but shilling in another clinic's thread? One that is no way related to anything you offer in terms of repair? Abbie's post outlined Dr. U's use of BHT to positively impact this patient's appearance. Are you guys doing body hair mini-strip now? Otherwise, what's your point? P.S. - another clever use of your typical "poor growth" references made to FUE.

 

Enough already. It's so tiring to read day in and day out in every thread you post in. Good grief.

[Abbie]

Hi MAGNUMpi! These are great questions that you posed.

 

RE: Anticipating a Norwood 6-7 level of hair loss, and considering BHT early on

 

Most patients destined for NW6 - 7 would show evidence of early signs of significant thinning that is not congruent with what their young age. Often this is evident as early as in the 20s.

 

Apart from this consideration, and family history, Dr U uses a test he calls a "Shave Test" before performing FUE. In this test shaving the donor area reveals distinctly contrasting densities between the so called safe donor areas and the non safe donor areas. In patients destined for NW 7 especially, a line of demarcation is often visible by the mid 20s. Dr U's study on this subject is about to be published in a major plastic surgery journal.

 

In such patients, Dr U recommends the appropriate integration of BHT in HT from the outset. Dr U is not a proponent of first exhausting the head donor before the use of BHT in such patients.

 

RE: Question: "Would the pictured patient have been looking normal if he had gone for FUT to begin with"

 

No. As a matter of fact, of the 3 patients shown in this video, only the first one had FUE surgeries to begin with. The later 2 patients had only FUT surgeries before running out of options and going to Dr U.

 

If you are interested in learning more about the patients shown in the two photos, here are their videos:

 

 

[Dolph1969]

Wow! :eek::eek: Incredible results.:cool:

 

Feel sorry for the guy, having to go through all that.

[HairJo]

I agree it's a shame he had to go through all of that I probably would have given up at that point but I have to say nice job using body hair he's lucky he had body hair or he would have been unhappy with those before results for the rest of his life really a nice fix.I guess if you don't have body hair to use you'd have to look like a baby bird for the rest of your life. This is my main reason why I would go with Strip you can always switch to FUE later if you choose to do so for a touch up or fill in .

[MAGNUMpi]

Dr U uses a test he calls a "Shave Test" before performing FUE. In this test shaving the donor area reveals distinctly contrasting densities between the so called safe donor areas and the non safe donor areas. In patients destined for NW 7 especially, a line of demarcation is often visible by the mid 20s. Dr U's study on this subject is about to be published in a major plastic surgery journal.

Very interesting. Thanks Abbie