Avoiding scarring and donor depletion in large FUE sessions

The hair transplant industry has moved to a new dimension by offering successful results by the FUE technique. The history of the industry has evolved through the years with continuous research and innovation. Punch grafting, micro grafting are terms that belong in the past. Even the Strip Method is now considered old fashioned and in HDC we use this technique only if absolutely necessary and in very special cases.

HDC, has been a pioneer in offering cutting edge procedures that aim to give the best possible result to the patient, by taking advantage of the correct exploitation of the donor area.

The 3 basic factors that contributes in a successful hair transplant, the natural Result, the adequate coverage and not least important is the efficient use of the donor. This gets even more important in order to cover patients with extensive boldness. For this to be achieved, the surgeon needs to extract a significant percentage of existing follicular units from the donor without causing damage or depletion. To put it simple, without making the donor area look thinner.

Avoiding depletion is an art form in itself and is relevant to the surgeon’s skill and expertise. The secret is that follicular units chosen for extraction are selected in a specific pattern that will not leave gaps on the scalp hence to create obvious scarring. The extraction points should not be too close and the surgeon must take into account the overall density of the donor area. There are some basic variables that the surgeon can apply to calculate the ratio of grafts available to harvest, in proportion to the availability of the donor area. The surgeons aim should be to maximize harvesting by managing to extract the maximum number of hair per graft (Minimize transection) and at the same time ensure that the area does not look visibly thinner. This is down to skill, experience and also artistry, and not just being good in math!

The photo below demonstrates the donor area of a patient just after extraction of 3500 FUE grafts from HDC. Click on the photo to enlarge to observe the pattern of extraction with less than 1mm punch and that the donor is not depleted.

The photos below, shows another patient after extraction of 4249 FUE grafts who came in for his 3rd session. You can see the whole story and result of this patient on This Link. Again, demonstrating the health of donor after Proper FUE surgery offered by HDC. Click photos to enlarge.

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Many doctors in their effort to increase the number of grafts that can be extracted in a single FUE session and to reach high numbers such as 4000 or 5000, end up performing procedures in the expense of causing damage to the donor area. The correct way that graft harvesting should be planned, is to extract 3000-3500 FUE grafts, according to the patients donor density, in a pattern that will not make apparent that these follicular units have been removed.

If the patient requires a higher number of grafts to cover his boldness, then a similar amount can be extracted at a 2nd session which will bring the total to what is required for the desired coverage. If for example the patient needs 5500 grafts, this should be done over two sessions with at least 8 months interval. Methodical extracting will minimize transection rate and at the same time will not deplete the donor area safeguarding it for possible future use. Any number well exceeding 3500 grafts should be done in two sessions.

Below, the first photo demonstrates the depleted donor area after extracting only 3000 grafts. The second photo shows the depleted area after extracting 5.000 grafts. These are patients who came to HDC for repairing their case. On both of these patients donor areas are scarred and depleted and further FUE extraction is not recommended.


 Depleted donor after 3000 FUE grafts                   


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Depleted donor after 5.000 FUE grafts

Going to Clinics that offer one day surgery for 4000 – 5000 grafts must be avoided. The danger of a rushed extraction of a large number of grafts in a short period of time results in overharvesting, damage of the donor and no possibility for future procedures.

Avoid non skilled surgeons who attempts to extract 4000 grafts or more in one day, usually using mechanized FUE extraction devises. Many times the punching is let to unskilled technicians that bear no responsibility for the damage they will cause. It is often the case that the surgeon needs to punch up 6000 grafts to end up with 4000 non transected grafts which will result in huge wastage of the donor and high depletion.

Transection rate can be kept to a minimum, only with planned and careful extraction. HDC Hair Clinic has a celebrated history of over 10 years of publishing state of the art Hair Transplant Results in highly reputable hair transplant forums and changing patient’s lives. We pride ourselves treating each patient as an individual and offering honest advice. This is a once in a lifetime decision and HDC wants to ensure you make the right one. Press here to get started.


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