Donor Sites for Hair Restoration Procedures

Hair transplant donor area must be a location in which the hair does not have receptors for dihydrotestosterone. The most used donor site for hair restoration is hair from the side of the scalp and back of the scalp. When used as donor for the scalp, hair form the sides and back can ensure that hair growth is natural. When used in other locations, it may require regular clipping.

The most common method for harvesting donor hair from the scalp is termed the strip harvesting method. In this method, a strip of tissue is removed from the back of the scalp, usually 1-2cm wide, starting over one ear and extending as far as above the other ear. The donor site is closed leaving a single incision line which is not seen under the natural hair.

For patients with a lack of hair on the head, hair can be taken from the chest, arms, or legs. This is not the ideal donor site as these hairs have different times in each stage of the hair cycle than scalp hair. The biggest difference is a decreased time in the anagen or growth phase resulting in shorter hair than natural scalp hair. This can produce an unnatural hairline or hair appearance.

Other Recipient Sites for Hair Transplants

Though the scalp is the most common recipient site for follicular unit grafting, other areas of the body can be transplanted as well. Follicular unit grafting can be undertaken for eyebrows, eyelashes, the beard area, and chest hair. The procedure is similar to that which is undertaken for scalp hair transplants. A word of caution though, transplanted hair will continue to grow just as if it were in its original location. If the donor site is the scalp, hair transplanted to other areas of the body may need to be cut on a regular basis to keep it the correct length.

Follicular Unit Extraction

In an effort to provide differentiation, some surgeons have begun harvesting the donor sites through a process termed follicular unit extraction. In a manner similar to previous hair plug removal, very small punches are used to remove single or double follicular unit grafts. The grafts are then transplanted similar to a traditional donor strip follicular unit grafting procedure.

The biggest advantage to this procedure is the lack of a linear scar compared to strip harvesting techniques. For patients who may one day decide to shave their heads, this can be advantageous. Because individual hairs are harvested by one person, operating times for this method are longer than strip harvesting and often more costly. Studies have shown a slightly higher follicular transection rate than with traditional strip donor site harvesting. Unfortunately no clinical studies have been done to compare the results of FUE to traditional donor site harvesting methods. Overall, a clear advantage of FUE to donor strip harvesting has not been shown to make it the preferred method for harvesting donor hair during follicular unit grafting procedures.