This insightful information was posted on our hair restoration forum by Dr. Alan Feller of Great Neck, NY who is a member of the Coalition of Independent Hair Restoration Physicians.
Much of the hair transplant industry has been cleaned up since the advent of hair loss forums and websites like the Hair Transplant Network. However, there are still areas of hair restoration that remain largely unaddressed such as the proper “absolute” position of donor incisions.
This is why I scanned and posted the textbook definition as to how a proper donor incision should be planned and executed. I doubt any doctor will publicly contradict the text, and they shouldn’t since it is one of the few things in medicine that is objectively and demonstrably correct.
On the hair loss forum, a particular physician ignored the basics of “Hair Transplant 101” by harvesting a donor strip that was obviously too low and led to a needlessly greater chance of large scar formation. Was this just an isolated “once in a while” incident, or was this “less than optimal” approach to donor harvesting a more pervasive problem?
I think it is not only a prevalent problem, but epidemic.
By coincidence I had a patient in my office only a few days before Allan posted his results from a UK hair transplant doctor. What I found in the donor area was appalling. It demonstrated an utter and complete lack of understanding of basic scalp physiology and an almost purposeful desire to disfigure.
Most of the time, these awful results come from the “hit and run” hair restoration physicians who may perform one hair transplant per month. To them, the donor area is not a part of the body to be respected – and it shows in their results.
In the photos you can see an upper scar and a lower scar. The first doctor produced the lower scar. It is located below the occipital bump and predictably looks worse than it otherwise might have. The second doctor went way high in the donor area (in an effort to avoid the first scar no doubt), but because this scar is located well above the occipital bump the size of the scar is much smaller.
The problem with both scars is that both surgeons totally missed the very prime donor real estate. I was thankful for this because it made my job that much easier, but one must wonder why such amateur mistakes were made by hair loss doctors who have not only been in practice for years, but claim publicly to be “experts” and “leaders” in the field.
Here are a couple of other goofy scar results produced by self proclaimed “experts” in the field of hair replacement surgery.
In the photo on the left, the doctor had excised the donor strip well below the occipital bump, and that scar is smaller than one would normally expect for such an inappropriately low scar. We can only imagine how good his donor scar would have looked had it been excised on or above the occipital bump.
In any surgery the outcome is never 100% guaranteed, but the odds can be slanted in favor of the surgeon and patient by simply understanding some basics and applying them every single day. Why this has not been done is beyond me. Thankfully, such results can be reported on the internet for the world to see.
Dr. Alan Feller, D.O.