Donor area ruined? (photos)

Question

Hello, this is a picture 30 days post FUE, 2500 grafts. The whole backside of the head was shaved but the square from which the grafts were taken is visibly thinner than surrounding hair. It looks as though the technicians took everything they could in a box pattern. My procedure was done in an Turkish budget clinic and I'm very worried that they've harmed the follicles at the back of my head. Will this heal or improve? Thank you

Ken Anderson, MD, FISHRS · Answer

The donor area will continue to be slightly red for the next several weeks; up to 6 months.  It appears as though your donor area may have been over-harvested, which is a non-correctable problem, as this pattern does not appear in nature, and a "moth-eaten" appearance may be permanent.This is just one of the many problems that can occur when a technician performs surgery.  They are not trained to perform surgery; surgeons are.  Technicians are not aware of the hundreds of subtleties and nuances of a complex procedure like a surgical hair restoration, and this can be one of the unfortunate results.Lastly, as we say in hair restoration: the good thing about hair restoration is that it's permanent. The bad thing is that it's permanent.  I would personally be very wary of going to a "budget clinic" for a permanent cosmetic surgery that is going to forever change your appearance.  If the results are not perfect, well, it is often not correctable, and you'll have to deal with the new issues (eg: bad scarring, over-harvesting of the donor area, unnatural hairline) for the rest of your life.  If you are considering a hair restoration procedure, make sure there is an actual qualified surgeon performing the surgery.  Technicians are not who you want doing permanent cosmetic surgery on your head.Going to budget stores is appropriate for inexpensive furniture.  It is not something you want to risk your appearance and attractiveness on.

Jae Pak, MD · Answer

If too much hair was taken as you describe, it will not grow back or improve.In the end only time will tell.The real concern is that technicians should NOT be doing surgery.  A medical doctor should be doing the surgery.

Ali Emre Karadeniz, MD · Answer

The donor area will probably look much better in 3 months.However in general, it is very risky to have a hair transplant at Turkish technician clinics.It is very unlikely that the technicians will be careful and skilled enough to both use the donor area economically and do a professional hairline design that gives a natural result.My advice for hair transplant candidates is to make sure they wait until they have enough funds to go to a professional clinic, or even give the small amount of money they have to charity, so that they make sure they lose money, but preserve their natural look and valuable donor hair!

Rashid M. Rashid, PhD, MD · Answer

It is a bit early and you should give it time to heal.  Was no doctor in the clinic?  That is concerning.

William Rassman, MD (retired) · Answer

It is hard to tell from the pictures what has been done. It is possible that too many FUE grafts were harvested in one session from a limited area. If this is the case, only time will tell. You should wait it out, then after complete healing is finished, see a doctor in your area and have the harvested area measured for follicular unit density, something that most hair transplant surgeons know how to do. If the area is over-harvested and one particular area is significantly see through and follicular unit depleted, the best solution to this problem would be to have scalp micropigmentation done to the area that is depleted. We routinely perform this technique on depleted donor areas with strip scars and on over-harvested FUE and although it does not bring the hair back, it does make the donor area look normal. See the website below for photo examples of what I am talking about.

Michael Meshkin, MD - Account Suspended · Answer

As with any other surgery, if it is not done by a experienced specialist problems can arise.  One of the problems with having surgery done in non regulated clinics is improper extraction from the donor area and non donor areas by technicians or doctors without proper experience. I have found that most of the clinics in turkey use technicians without proper training do most of the work specially in FUE technique.  As a result,  Donor depletion and scaring can happen , in addition your transplanted hair may not grow as well. It is very important to do research of the surgeons and clinics before committing to the surgery and not let the cost be the only factor in choosing a clinic.

Brian Goertz, MD (retired) · Answer

Follicular unit extraction can be safely done in the safe donor area. The safe donor dimensions are approximately 1 inch above and below the bony notch in the back of the head and spreads laterally in an arc over the ears on both sides. If someone has a family history of class 7 balding then the safe donor area is smaller. It appears in your case that the donor area has exceeded what I consider a safe donor extraction area. That is something for you to discuss with the surgeon. As far as hair thinning after FUE, that is a complaint with FUE especially if too many extractions were performed in the area. I have strict guidelines for safe extraction numbers/centimeter squared.

Donor area ruined? (photos)

Answers (7)