Can I use the donor hairs that are just outside the “universal safe” donor zone?
That boundary zone can be treated in accordance with two philosophies: the first is the “prudent”, the most orthodox, taught everywhere and which consists in leaving one or two centimeters of untouched hair between the donor and recipient areas. There are two main reasons to act in this way: 1) To not use hair that is potentially unstable or balding. 2) To not create scars in a zone that is or will be potentially thinning in the future.
This modus operandi presents however a big inconvenience, mostly when performing a second (or further) Follicular Unit Excision (FUE) surgery. In fact, it creates a no man’s land between the donor and recipient areas having a section of original density – this is often ungraceful, especially when the patient wears his/her hair very short – this resembles a halo all around the skull, often called a fringe.
The second philosophy, which I tend to apply when the patient wears his/her hair very short and/or is about to have a second (or further) hair restoration surgery, this consists in ending the extraction pattern in a progressive way, approaching the recipient area as much as possible. Obviously, it is difficult to be certain about the boundaries between the donor and recipient areas. However, at worst, we will have transplanted a limited amount of unstable grafts. Additionally, I have never had to treat a scarring issue in that area, but if it happened, it would be simple to solve by transplanting some hairs taken from the lower (donor) area.
Dr. Jean Devorye– Member of the Coalition of Independent Hair Restoration Physicians and Recommended on the Hair Transplant Network
Melvin, Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
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