Shaving The Recipient Area Prior to Transplant

Dr. Rassman:

I would appreciate your comments regarding the following: I have read of a debate or difference of opinion between hair transplant doctors on the value of shaving a patient’s hair in the recipient area prior to the transplant. Some doctors are proponents of having the patient cut the hair very short in the recipient area. These doctors claim that closely trimming the recipient area hair results in maximum density and no transection. Their contention is that when recipient areas are trimmed short, the doctor has an easier time of placing new recipient sites in the place of absent follicular units and alongside miniaturized follicular units. Also, by clipping the hair short, there is a lower risk of transection of existing hair. The final argument in support of clipping the hair short is that hair exits the scalp at an exact angle and the only way to precisely match that angle is to clip the hair short. Some doctors are so convinced of the benefits or trimming the hair in the recipient area that it is not an option for the patient. They are insisting that the patient do it.

On the other hand, other top transplant docs believe that it is not necessary for a patient to closely crop the recipient area hair and that while it may make things easier for the doc and the techs who do the graft placement, it does not lead to better density or less transection.

What is your opinion? Does closely cropping the hair in the recipient area give a better result? Is it of no value? Or, does the answer lie somewhere in-between?

There are many views and theories on this topic. Instead of making it complicated, I believe it is the doctor’s personal preference which (you may argue) may have a direct impact on the outcome. At NHI, we only cut the part of the donor area hair that we will removed just prior to surgery so that the surgery can be easily hidden after the surgery. On rare occasions, we will ask the patient to allow us to clip the recipient area hair (usually when we have complicated plugs to remove). We place a great deal of importance on the absence of detection and if a person shaves the head or cuts it short, it is an announcement that the person has had a hair transplant. I have trained many doctors on how to keep the hair long so that social disruptions are minimized and have learned to work between the longer hairs.