What can be achieved from a hair transplant depends wholly and solely on the donor area that you carry. The most common donor is the permanent safe zone at the back and sides of the head and varies from one person to another.
What is a donor area?
The perfect donor area is located on the two sides and at the back of the human scalp. The permanent growth of hair remains unaffected in these areas since these hair are mostly immune to the effects of DHT.
Factors like texture, caliber, color, and curl of the extracted hair follicles from the donor area play an important role in determining the final result after transplant. Even if you get your hair transplant done by the top transplant specialist, the outcomes are also determined by the quality of your hair since we are working with your hair alone- merely relocating it from the back of the head to the bald area. Hence the preop consultation before procedure needs to determine these important characteristics before advising a hair transplant.
What is a Good Donor Area for Hair Transplant?
• While choosing the donor site, doctors prefer the scalp hairs in the occipital area and the temporal adjoining zones. This is because the hair growing in these zones are permanent.
• The next preferred donor site is the beard as its hair is naturally thick and is DHT resistant. Hair transplant specialists often tend to mix scalp hair with beard hair but hair transplant artistry dictates that they should not be used in (a) isolation (b) along the hairline and, (c) in the crown area due to their nature.
• Abdomen and chest hair also can be used as donor hairs. Though thin, in a majority, in some they are thick enough to resemble scalp hairs. At our clinic Darling Buds, chest hairs are routinely used to augment graft counts in those who are extensively bald. Chest hair are also recommended to revise pluggy hairlines and at times to soften a hairline.
• Hair from extremities (upper and lower limbs) are the last resort but in most people, they are so thin that they will barely show on the scalp when used. Their growth cycle being long and unpredictable they are the lowest in preference in body hair transplants.
• Only the scalp hair grafts are used in Female hair transplants due to obvious reasons.
Hair transplant techniques
Though FUE (Follicular Unit Extraction)is the commonest and preferred method for a hair transplant, FUT (Follicular Unit Transfer) is an option in some cases. They differ only in the technique of harvesting of follicles from the same permanent zone of the scalp. Both techniques are highly effective and have high success rates in best hands. These two treatment procedures require the surgeon to extract healthy hair grafts and place them into minute incisions in the parts of the scalp affected by balding. Incisions are strategically positioned and distributed such that recipient areas when grown out, blend seamlessly with native hair and create an illusion of fullness so it seems the patient no has a ‘head full of air’.
Choosing donor sites for both the techniques
The permanent zone is the same, whether an FUE procedure is done or it is FUT the old-time/itinerant surgeon prefers. A horizontally oriented elliptical chunk of skin measuring 12-15 cms (each unch hole in FUE is of 0.7-0.85 mm in diameter by contrast) with some underlying fat with total 1.5-1.8 cms (each FUE punch incision is 2-3 mm in depth in contrast to FUT depth) is cut out with a knife. This leads to a linear visible scar given short hairstyles in vogue today among the youth. However, with the introduction of minimally invasive FUE technique, there will be barely perceptible scars after extracting hair from the donor site. In this technique, the surgeon removes and extracts the hair roots from the donor site one by one with the help of a micrometer having micro-heads. Some still do this procedure manually. Robotic extraction has neither been successful nor economically viable.
Bad donor sites for hair transplant
• It is important to realize that not everyone has a good donor site. Men suffering from DUPA or diffuse unpatterned alopecia tend to have unhealthy hair. Hence, they are not a suitable candidate for a successful hair transplant. Others may have extensive baldness miniaturization may have creeped into also the permanent zone.
• People having a diseased donor supply are also a bad choice. Such instances occur more in women than in men.
• Cicatricial alopecia due to scarring consequent to obscure not well-understood reasons.
• People with thin caliber hair are also not suitable candidates.
• Donor sites before 25 years of age can be considered a bad decision since we have no idea whether these hairs will stay. Therefore it is oftentimes advisable to tell the patient to wait till he is 25-27 years of age.
How to treat the donor site after transplant?
After the completion of the root extraction process, the surgeon sterilizes and dresses the donor site properly to prevent hemorrhage or infection. Patients are often recommended pain killers and antibiotics in case they experience some irritation or pain in the donor area. After one or two days of the operation, the surgeon removes the dressing and cleans the affected area. Any minor blood clots or crusts will disappear in a week’s time.
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