WRassman,M.D. BaldingBlog
    • Menu

    Does FUE Change Donor Area Planning?

    Jun 6, 2014/by William Rassman, M.D./0 /Density, FUE, Hair Loss Causes, Hair Transplantation, Megasession, Scarring

    Dr. Russell Knudsen (from Australia) wrote in informative article in this months “Hair Transplant Forum International”. Clearly, the ability to harvest the donor area with FUE will be more restrictive in individuals who have more extensive balding patterns (Class 5, 6 and 7 patterns of balding). The donor area around the sides and back of the head reflect 25% of the original total hair count on the head (I call it my 25% rule). If one targets somewhere between half or 2/3rds of the follicular units found in the donor area, as the maximum safe yield for FUE over time, then for Caucasians with average hair density (100,000 hairs on their head or 50,000 follicular units in the permanent zone) might be able to safely harvest as much as between 6,250 (half) or 8,250 (2/3rds) from the 12,500 follicular units in the permanent zone (25% rule).

    In those individuals with higher densities than 100,000 hairs on their head, the harvestable follicular unit numbers may safely go higher, while in the typical Asian, for example with lower hair densities (80,000 hairs on their head or 40,000 follicular units), the donor area would contain only 10,000 follicular units. With half of the Asian’s 10,000 follicular units harvested, that leaves 5,000 follicular units behind (this reflects a calculation of 25% of the birth hair follicular unit numbers which are permanent). I believe that extracting between one out of every two follicular units from the permanent zone may be pushing the limit on people with low density hair.

    There may be reasonable limits for a typical Asian based upon hair density (we calculate hair density on every patient undergoing hair transplant surgery). To complicate matters, Asian follicular unit hair counts average less than two hairs per follicular unit, so to get out an average of two hair FUE grafts, it takes more follicular units to yield an average of two hair FUE grafts. Asians (or Caucasians with low hair density) who have a high number of FUEs will, in my opinion, be thin looking around the back and sides of the head. I have seen some Asians with significant track marks from the punch scars created by FUE, particularly when the harvesting numbers are high and the remaining donor hair is significantly lessened.

    Many doctors are taking hair from the non-permanent area to give the patient the benefits of more hair in the transplant; however, this may spell disaster for the patient who develops more extensive balding (suggested by Dr. Knudsen). Hair taken from the non-permanent area will be lost with aging and/or advancement of the balding patterns. Over zealous FUE beyond the permanent zone, has long term consequences for some patients and they must be warned. I have seen some patients who’s balding had accelerated from multiple FUE procedures and have loss hair in areas where FUE grafts were taken while leaving visible scars.

    I want to raise blood supply issues here as I have seen one patient already who had received 6700 FUE grafts in two sessions and lost more hair in the permanent zone than was removed by the surgeon during the FUE. I actually counted the grafts and the hairs on the head and had done density studies on him before another surgeon did surgery on him. When FUE numbers are pushed, this patient’s findings suggested vascular compromise may have occurred impacting the remaining hair in the donor area. I have heard, second hand, that at the last ISHRS meeting some cases of necrosis have appeared in the donor area when too many FUEs were done, possibly too close together. I don’t believe we really understanding the complications of large FUE sessions, or that doctors are not reporting their complications out of fear of professional ridicule and/or malpractice risks, all of which may become a factor in the long term future of this surgery. As we do many FUE cases in our practice, we are not anti-FUE; however, aggressive FUE megasessions in the wrong hands could be a problem.

    In conclusion, “do FUE surgeries change donor area planning”, the answer is YES. FUE will impact long term planning and may impact strip surgery in future surgeries. Low density donor areas, resulting from FUE, make for less donor hair for a strip surgery, which will only make any scarring more visible as the hair is cut short.

    Reader Comments0

    Share this entry
    • Share on Facebook
    • Share on Twitter
    Newer Entries Older Entries

    Leave a Comment

    Want to join the discussion? Feel free to contribute! Note: We do not tolerate offensive language or personal attacks to other readers. Marketing links or commercial advertisements will be deleted.

    Leave a Reply Cancel reply

    Your email address will not be published. Required fields are marked *

    ( Will not be published )

    + =

    Videos

    Podcasts

    Ask Dr. Rassman

    * Your questions may be published (without your contact information).

    [contact-form-7 id=”27935″ title=”Sidebar Contact”]

    Over 21 million women and 35 million men in America suffer from hair loss. For many of these people, the psychological impact on their life is debilitating.

    Dr. Rassman is a world leading expert in hair loss with over 25 years of experience and over 50,000 satisfied clients.

    About

    This site exists to educate about hair loss and hair restoration.

    William R. Rassman, M.D.

    Categories

    • ACell
    • African American
    • Age
    • April Fools
    • Density
    • Diseases
    • Drugs
    • Drugs (Cause Hair Loss)
    • Favorites
    • Female Hair Loss
    • FUE
    • Hair Cloning
    • Hair Loss Causes
    • Hair Pieces / Systems
    • Hair Products
    • Hair Transplantation
    • Hairlines
    • Megasession
    • Other
    • Other Surgical Procedures
    • Personal Stories
    • Photos
    • Pigments
    • Podcasts
    • Post-Operative
    • Repair
    • Repost
    • Scalp MicroPigmentation
    • Scarring
    • Thinning
    • Tidbits
    • Training
    • Videos

    Archives

    • September 2023
    • August 2023
    • July 2023
    • June 2023
    • May 2023
    • April 2023
    • March 2023
    • February 2023
    • January 2023
    • December 2022
    • November 2022
    • October 2022
    • September 2022
    • August 2022
    • July 2022
    • June 2022
    • May 2022
    • April 2022
    • March 2022
    • February 2022
    • January 2022
    • December 2021
    • November 2021
    • October 2021
    • September 2021
    • August 2021
    • July 2021
    • June 2021
    • May 2021
    • April 2021
    • March 2021
    • February 2021
    • January 2021
    • December 2020
    • November 2020
    • October 2020
    • September 2020
    • August 2020
    • July 2020
    • June 2020
    • May 2020
    • April 2020
    • March 2020
    • February 2020
    • January 2020
    • December 2019
    • November 2019
    • October 2019
    • September 2019
    • August 2019
    • July 2019
    • June 2019
    • May 2019
    • April 2019
    • March 2019
    • February 2019
    • January 2019
    • December 2018
    • November 2018
    • October 2018
    • September 2018
    • August 2018
    • July 2018
    • June 2018
    • May 2018
    • April 2018
    • March 2018
    • February 2018
    • January 2018
    • December 2017
    • November 2017
    • October 2017
    • September 2017
    • August 2017
    • July 2017
    • June 2017
    • May 2017
    • April 2017
    • March 2017
    • February 2017
    • January 2017
    • December 2016
    • November 2016
    • October 2016
    • June 2016
    • May 2016
    • April 2016
    • March 2016
    • February 2016
    • January 2016
    • December 2015
    • November 2015
    • October 2015
    • September 2015
    • August 2015
    • July 2015
    • June 2015
    • May 2015
    • April 2015
    • March 2015
    • February 2015
    • January 2015
    • December 2014
    • November 2014
    • October 2014
    • September 2014
    • August 2014
    • July 2014
    • June 2014
    • May 2014
    • April 2014
    • March 2014
    • February 2014
    • January 2014
    • December 2013
    • November 2013
    • October 2013
    • September 2013
    • August 2013
    • July 2013
    • June 2013
    • May 2013
    • April 2013
    • March 2013
    • February 2013
    • January 2013
    • December 2012
    • November 2012
    • October 2012
    • September 2012
    • August 2012
    • July 2012
    • June 2012
    • May 2012
    • April 2012
    • March 2012
    • February 2012
    • January 2012
    • December 2011
    • November 2011
    • October 2011
    • September 2011
    • August 2011
    • July 2011
    • June 2011
    • May 2011
    • April 2011
    • March 2011
    • February 2011
    • January 2011
    • December 2010
    • November 2010
    • October 2010
    • September 2010
    • August 2010
    • July 2010
    • June 2010
    • May 2010
    • April 2010
    • March 2010
    • February 2010
    • January 2010
    • December 2009
    • November 2009
    • October 2009
    • September 2009
    • August 2009
    • July 2009
    • June 2009
    • May 2009
    • April 2009
    • March 2009
    • February 2009
    • January 2009
    • December 2008
    • November 2008
    • October 2008
    • September 2008
    • August 2008
    • July 2008
    • June 2008
    • May 2008
    • April 2008
    • March 2008
    • February 2008
    • January 2008
    • December 2007
    • November 2007
    • October 2007
    • September 2007
    • August 2007
    • July 2007
    • June 2007
    • May 2007
    • April 2007
    • March 2007
    • February 2007
    • January 2007
    • December 2006
    • November 2006
    • October 2006
    • September 2006
    • August 2006
    • July 2006
    • June 2006
    • May 2006
    • April 2006
    • March 2006
    • February 2006
    • January 2006
    • December 2005
    • November 2005
    • October 2005
    • September 2005
    • August 2005
    • July 2005
    • June 2005
    • May 2005
    • April 2005
    • June 202
    • May 202

    Links

    Disclaimer

    This site is intended to educate the public on hair loss topics based on personal experience and opinions from Dr. William Rassman and contributing physician editors. Information provided on BaldingBlog.com should not be used for the purpose of medical diagnosis or treatment.

    Scroll to top