Hair transplant and donor area: everything you need to know
A hair transplant in Turkey is a commonly performed operation to treat the effects of androgenetic alopecia in men and women. This procedure involves two areas: the donor area, where the grafts are extracted, and the recipient area, which will then receive hair follicles taken from the donor area. The management of the donor area is a major element to benefit of a safe and successful hair transplant. Find out everything you need to know about the donor area, its preservation, its evaluation, and its impact on the outcome of the procedure.
What is a hair transplant donor area?
The hair transplant donor area is the area in the occipital region at the back of the head. This term refers to the area from which the grafts are taken for the hair transplant. The grafts are small fragments of tissue containing follicular units. A follicular unit commonly contains one to four hair follicles.
The donor area is selected because of its high hair density. Hair in parts of the back and sides of the scalp is generally more resistant to androgenetic hair loss. However, the extent and long-term stability of this area vary from person to person and require assessment (Mysore et al., 2021).
People who wish to have a hair transplant procedure will have a portion of their hair removed from the donor area and implanted into the bald area. Transplanted hair usually retains the characteristics of its donor site, but long-term survival is not guaranteed. However, for a hair transplant to be successful, several precautions must be taken. The samples must be taken correctly, the follicles taken are well preserved and the transplantation is carried out with great care.
Why is it necessary to preserve the donor area?
The preservation of the donor area is an essential condition for the success of the hair transplant. Contrary to popular belief, the donor area is not inexhaustible. When a hair transplant is performed, the grafts taken from the donor area will not grow back there. Therefore, to preserve the aesthetics of this area, and to prevent the donor area from being thinned out, it is essential to take the greatest care of it.
In addition, if a second hair transplant is to be performed, it is important to have the necessary grafts available. A second hair transplant can be performed in several cases. It may be required in the case of a failed hair transplant, in the case where the area to be covered requires many grafts, or in the case of the evolution of alopecia several years after the first hair transplant.
Assessing the donor area: a prerequisite before a hair transplant
The healthier hair follicles in the donor area, the easier it will be to transplant hair. The evaluation of the donor area is essential before considering any hair transplant. A poor evaluation of the donor area is a major factor in the failure of the hair transplant. This step must be performed by an experienced surgeon who has real expertise in the field of hair transplantation. It allows to take note of all the characteristics of the donor area and to highlight potential obstacles to the success of the hair transplant. The preliminary study of the donor area will allow us to know:
- If the donor area has enough grafts: to plan an appropriate result, the donor area must have the necessary number of grafts to cover the recipient area. If not, the patient may end up with insufficient coverage in the recipient area, or an overused and unsightly donor area.
- If the donor area has good quality grafts: quantity is not the only factor involved in the success rate or the success of the hair transplant. Indeed, to obtain an excellent result, it is also essential to have good-quality grafts. The preliminary study will allow us to assess hair shaft thickness and the number of hairs in each follicular unit.
A preliminary study of the donor area also helps determine the right method of extraction and implantation. Moreover, it is recommended to go to a hair transplant clinic that has mastered the extraction and implantation of hair follicles in order not to damage them and compromise the success of the hair transplant.
What will my donor area look like after surgery?
After a hair transplant, the donor area has fewer follicles and small extraction wounds. Careful harvesting aims to preserve an acceptable appearance, but redness, scabs and later small scars can occur.
An experienced surgeon plans the distribution and number of extractions to reduce visible thinning. The appearance also depends on baseline density, hair calibre, healing and hairstyle.
What is the specific postoperative care for the donor area after a hair transplant?
After a hair transplant, the surgeon applies a bandage to the donor area to protect it. The dressing and the timing of its removal depend on the surgeon’s protocol. To reduce the risk of infection, it is recommended not to remove the dressing without the surgeon’s permission. Small scabs and redness may also appear in the donor area. Scabs after a hair transplant are normal and common. To treat them properly, it is advisable to follow the surgeon’s recommendations.
Finally, it is possible that itching and pain may appear at the back of the head after the procedure. This pain in the donor area is usually transitory and can be mitigated by taking painkillers, under medical prescription.
Does hair in the donor area grow back?
Follicular units that have been completely removed do not grow back in the donor area. The remaining hair continues to grow, and temporary shedding of surrounding hairs may recover. Careful harvesting reduces the risk of visible thinning but cannot guarantee an imperceptible result.
Does the harvesting of the grafts leave scars on the donor area?
In FUE, grafts are collected individually using a circular punch. This leaves small wounds that heal with small scars. The absence of a linear scar does not mean that the procedure is scar-free (Garg & Garg, 2018).
FUE hair transplant, including manual FUE hair transplant, leaves small donor-site scars. DHI hair transplant describes an implantation approach and may use the same FUE harvesting process. The same donor-site considerations apply to women’s hair transplant. Regenera Activa is a different micrograft treatment involving tissue sampling; it should not be described as a scar-free hair transplant.
My donor area is sparse: what are the implications?
A donor area of low density may represent a hindrance to the hair transplant. Low donor density or poor hair quality can limit the coverage achievable or make surgery unsuitable. The decision depends on the diagnosis, donor reserve and expectations (True, 2021).
If too many grafts are harvested from an unsuitable donor area, visible thinning and scarring may result, while the recipient area may still have inadequate coverage. Therefore it is essential to contact a hair transplant clinic that has the necessary expertise to accompany you from the evaluation of the donor area to the post-operative care.
Sources
Mysore, V., Kumaresan, M., Garg, A., Dua, A., Venkatram, A., Dua, K., Singh, M., Madura, C., Chandran, R., Rajput, R. S., Sattur, S., & Singh, S. (2021). Hair transplant practice guidelines. Journal of Cutaneous and Aesthetic Surgery, 14(3), 265–284. https://doi.org/10.4103/JCAS.JCAS_104_20
True, R. H. (2021). Is every patient of hair loss a candidate for hair transplant?—Deciding surgical candidacy in pattern hair loss. Indian Journal of Plastic Surgery, 54(4), 435–440. https://doi.org/10.1055/s-0041-1739247
Garg, A. K., & Garg, S. (2018). Donor harvesting: Follicular unit excision. Journal of Cutaneous and Aesthetic Surgery, 11(4), 195–201. https://doi.org/10.4103/JCAS.JCAS_123_18