Hi Guys,
Just wondering what everyone’s thoughts are on strategically taking grafts outside the traditional donor area to mainly soften the contrast between the safe zone and surrounding hair. It’s something I’m considering for my 3rd HT.
I’ve attached a pic of my donor 3-4 months after my 2nd HT shaved to #1. I personally feel the contrast has improved over time but there still is a difference in density noticeable at #1 and below. I don’t think it would be noticeable if the surrounding hair was softened to match.
I think it’s worth taking a chance and using the grafts in areas that won’t suffer if the grafts miniaturize in time eg adding density to the hairline.
My thoughts is that it would give more consistency to the sides and back of the head.
All expert opinions welcome, it’s not a topic I see often on the forums
As
@Bigmac has said, this is not a new idea and has been performed many times before. That said it does open many questions regarding donor harvesting protocols and the life expectancy of a potential hair transplant result. Including the distribution of the "non-safe hair".
Natural hair characteristics including healing will play some role in the donor contrast after the area has healed but one large aspect to minimise the contrast is having a donor harvesting extraction protocol to maximise the safe donor area. The area can be mapped out quite successfully and especially when shaved to identify areas of miniaturisation The safe area can be calculated and the FU density measured and then if the extraction is spread over the maximum safe area mapped and assuming the donor is not over-harvested then a relatively large number of grafts can be harvested and even with a short hair style there is little to no contrast.
Even with a wide extraction pattern the larger the procedure will have a greater impact on the contrast left once healed. This is especially the case if there is no educated harvesting pattern. Each Dr will have their own interpretation on how much can be taken from the donor over one or multiple procedures. The % removed and what is left, how much space should be left between each extraction and how many FU can be removed per cm2 without causing an obvious "hair-less area". This is a problem when chasing big numbers or a Dr working on a lower than average hair density donor. With an educated extraction pattern it is possible to minimise the look of "hair-less areas" so even when healed and having a short hair style the contrast is hardly if visible at all. But the closer the extraction points and taking adjacent FU or overlapping extractions will increase this contrast to make it very obvious.
Especially when treating lower NW stages and a younger hair loss sufferer it is harder to measure a potential safe zone of course. Looking into the family hair loss history is one way to gauge the potential future hair loss pattern. Taking potentially unsafe or DHT-prone follicluar units will obviously result in hair loss in the future. The distribution of these DHT-prone hairs over the recipient area can lead to an unnatural hair growth pattern being left. Especially if the hairs are used in an isolated area or an exposed area, for example the immediate front hairline. If the potentially DHT-prone FU are blended with safe or existing hair the impact if and when they minaturise or fall out will be lessened to a loss of hair density, as long as distributed over a wide area the loss could be minimal. That said the practice would involve knowingly removing and placing DHT-prone or at best potentially DHT-prone hairs that have a shelf life and therefore detrimental to the result they give their patient overtime.
