Download PDF
Facial Plast Surg 2024; 40(02): 195-204
DOI: 10.1055/s-0043-1777074
Original Article

Follicular Unit Excision Donor Area Management and Considerations of the Scalp

Timothy P. Carman
1   La Jolla Hair Restoration Medical Center, La Jolla, California
,
William Rassman
1   La Jolla Hair Restoration Medical Center, La Jolla, California
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Over the last several years, follicular unit excision (FUE) donor harvesting has become the predominant donor harvest method, surpassing the traditional method of linear strip excision donor harvesting. While this may offer advantages in specific clinical settings, the reality of ongoing losses with the natural evolution of male patterned hair loss places a premium on obtaining as much lifetime donor hair as possible to address this clinical reality. This lifetime demand requirement must be weighed against the possibility of a detrimental cosmetic appearance of the donor area with serial donor harvests utilizing FUE. This chapter will examine the important technical and artistic considerations critical for hair restoration surgeons to appreciate in order to maintain cosmetically high-quality donor area outcomes in patients choosing to undergo FUE harvesting for hair transplantation surgery.

Keywords

follicular unit excision - donor area outcomes - overharvesting - linear strip excision - artistic considerations - diffuse unpatterned alopecia - donor cosmesis


Publication History

Article published online:
04 December 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Keene S, Rassman W, Harris J. Determining safe excision limits in FUE: factors that affect, and a simple way to maintain, aesthetic donor density. Hair Transplant Forum Int 2018; 28 (01) 1,7-11
    CrossrefPubMedGoogle Scholar
  • 2 Bernstein RM, Rassman WR. Follicular transplantation. Patient evaluation and surgical planning. Dermatol Surg 1997; 23 (09) 771-784 , discussion 801–805
    CrossrefPubMedGoogle Scholar
  • 3 Cole J, Wolf B. Cyberspace chat: the safe donor area (SDA). Hair Transplant Forum Int 2014; 24 (02) 62-63
    CrossrefPubMedGoogle Scholar
  • 4 Jimenez F, Ruifernández JM. Distribution of human hair in follicular units. A mathematical model for estimating the donor size in follicular unit transplantation. Dermatol Surg 1999; 25 (04) 294-298
    CrossrefPubMedGoogle Scholar
  • 5 Rassman W, Pak J, Kim J. Combining follicular unit extraction and scalp micropigmentation for the cosmetic treatment of alopecias. Plast Reconstr Surg Glob Open 2017; 5 (11) e1420
    CrossrefPubMedGoogle Scholar
  • 6 Tolgyesi E, Coble D, Fang F, Kairinen E. A comparative study of beard and scalp hair. J Soc Cosmet Chem 1983; (34) 361-382
    PubMedGoogle Scholar
  • 7 Marritt E. The death of the density debate. Dermatol Surg 1999; 25 (08) 654-660
    CrossrefPubMedGoogle Scholar
  • 8 True R. New strategies for using grafts harvested from outside the safe zone. Hair Transplant Forum Int 2021; 31 (03) 81, 86-88
    CrossrefPubMedGoogle Scholar
  • 9 International Society of Hair Restoration Surgery. Practice Census Results. 2022 . Accessed 17 November 2023 at http://ishrs.org/ishrs-2022-practice-census-results
    PubMedGoogle Scholar