Is my donor area over-harvested? Can this be fixed by placing grafts into the bald patches? (photos)

I have undergone an FUE procedure of 3500 grafts. Its been 10 days now and my has began to grow a little. Im am noticing a rectangle shape in my donor area that has very thin hair. I am extremely worried that this will be permennant. My surgeon informed me that it would even out in about 4 months but Im not convinced. My question is this normal? If not is there a way that i could have a procedure to transplant hairs into the bald patches? (I don't want to do micropigmentation)

Doctor Answers 8

Donor Zone Depleted

The only way to tell is to wait about 2-3 months.  But in general, your donor zone looks very depleted and looks like there is a possibility it may be permanent.  Unfortunately this is the risk taken with FUE, especially when it is done by an unqualified clinic/doctor.  Fixing this by transplanting grafts into the depleted areas is possible but extremely difficult and labor intensive.  In the last year I have started to correct a lot of procedures such as yours by transplanting grafts into the depleted donor zone with hair taken from the beard or chest as well as micro pigmentation.  I would recommend finding a skilled surgeon in your area that could help you.

Irvine Hair Restoration Surgeon
5.0 out of 5 stars 25 reviews

Overharvesting of the donor area with FUE

At 10 days you can't tell if the area has been over harvested or not. Generally removing 12-15 % of the donor area leaves behind reasonable density. You'll know if 4 months if too many grafts were removed or not. No, transplanting hair back into the is not a practical option. SMP is an option but I understand this is not what you are looking for. 

Jeff Donovan, MD, PhD
Vancouver Dermatologist

It may or may not be patchy when it heals. Only time will tell. You cannot tell with photos alone

It may or may not be patchy when it heals. Only time will tell. You cannot tell with photos alone.
3500 graft FUE is considered a very high number of grafts harvested at one time.  It may lead to patchy looking donor area when you keep your hair buzz cut.  It may even out with time and longer hair.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 100 reviews

FUE Considerations

Here are some things to consider when considering an FUE hair transplant:

1. Finding a skilled surgeon that can extract a significant number of grafts while not wasting donor hair is very important. Technician clinics that use unlicenced technicians for FUE should be avoided.

2. Extracting very high number of grafts such as more than 3000 can cause prolonged healing and camouflage time while risking donor depletion. It also leaves little donor hair behind for future sessions. The decision should be made carefully.

3. 3500 grafts is a significant number and even if it was done by a skilled surgeon, prolonged healing and camouflage time is expected. There may also be some shock loss due to this that usually resolves in 4 months.

4. If the extractions were not done professionally, then permanent donor depletion is a risk which will prevent any future attempts for repair and improvement.

Ali Emre Karadeniz, MD
Turkey Plastic Surgeon
4.7 out of 5 stars 17 reviews

Wait for FUE 's final result

First of all I think that you have to wait because 10 days is a very short period. There is a possibility that you will have more hair to the donor area in the future.
In case you don’t see any improvement, theoretically you could do hair transplantation to the donor area but the problem is where the grafts will be taken from. Probably, there are some areas which could help as donor areas but I don’t think they will be enough for resolving completely your problem. Probably you might start considering of micro pigmentation.
Anyway don’t be pessimistic and wait for 4-5 months until you see the final result and then you can decide.

FUE risk factors

one of the risk factors associated with FUE technique specially in larger sessions is hair depletion or thinning in the donor area. This should have been discussed with you before you had done the procedure. 

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
4.8 out of 5 stars 27 reviews

3500 grafts and my donor area looks depleted

If your donor density was low in the first place, that number of FUE grafts could very well have permanently created a see through area in the back of your head. This is a problem with FUE that is exchanged for no linear scar with a strip surgery. The best treatment, once the hair has grown in and you are satisfied with the results, is a process called scalp micropigmentaiton (SMP) which is shown in the web reference below. This easily can manage both defects in the scalp hair in the back of your head and the see through look that is obvious. 

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

FUE donor harvesting

At 10 days after FUE harvesting you would usually expect to have sufficient hair coverage to hide the donor sites completely and for the donor area to blend completely and uniformly with the surrounding hair.
This does not appear to be the case from your photos. It is possible that you have experienced shock loss in the donor area. If this is the case, then you may have to wait 3-4 months for the hair to start to grow.
If, at 6 months, the hair has not recovered then you should see your surgeon for assessment.
It is unlikely that hair transplantation to the donor area would be a viable option. After all, where would the new donor hair come from?
If things don't recover one option might be to have micropigmentation tattooing.

Greg Williams, FRCS (Plast)
London Hair Restoration Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.