Hi,
1. The Donor Area
Depending on the individual, a typical donor area contains 30-40 thousand hair follicles. An FUE technique hair transplant procedure can harvest 2500-3000 follicular grafts (note: there is a difference between follicles and follicular grafts, per session. This is less than 10% of the typical donor area. Properly harvested grafts are checked by an experienced team under suitable microscopy before being implanted into a pre-determined area of baldness.
2. The Transplant
These grafts, once harvested and dissected from the donor area are TRANSPLANTED, i.e. moved and live in a new area of scalp. The transplanted follicles take on the characteristics of the donor area (largely resistant to DHT balding, are coarse and hair shaft appearance takes on that of the donor area too - wavy, straight, curly etc).
3. Will they grow back?
As mentioned by Dr Chua, transected follicle units may leave 1 or more follicles remaining in the donor area and hair may grow from those partially damaged multiple grafts. These sometimes result in ingrown hairs and occasional 'pimples' forming on the donor area, which may last up to 6 months. To directly answer your question, YES they follicles will grow back at a rate of 90% and up - in their new homes - the recipient area of scalp.
4. Will it affect the appearance of the back of your scalp?
In a typical conservative FUE harvest, considering your young age, a combination of medications, regenerative medicine and surgical hair restoration might be employed to achieve good long term outcomes. This also depends on the hair density of your donor area. As you can imagine, if one removes 1 in 9 or 1 in 10 follicle grafts, the mass of hair lost a in the donor area is a mere 10%. It is widely quoted that by the time you notice hair thinning, you have lost 50% of hair mass. Hence, post-FUE transplant, if done correctly, will not leave you with bald spots.
The doctor should be assessing the suitability of you undergoing an FUE procedure either as first line, or after medical optimization. Alternatively, there may be the role of a strip (FUT) harvesting method if your donor area is limited, e.g. in advanced stages of balding.
5. Incorrect Harvesting procedure and administration of medication
It is important to note that any medications administered and surgical incisions performed at the donor area for harvesting must be done by a doctor. I have had to treat patients who have had shock loss due to indiscriminate administration of vasoconstricting tumescence (to reduce bleeding) due to it being administered by non-medically trained personnel. This can result in a moth-eaten appearance of the donor area and can last many months and will have to be treated medically.
6. Planning the procedure
Being only 31 and having male patterned balding since your 20s, it is likely that you have strong disposition to androgeneic alopecia. Seek out advice as to how to achieve the 3 targets that I set for my patients - 1: STOP hair loss, 2: OPTIMIZE the remaining viable hairs, 3: RESTORE what has been lost. In addition, your doctor should be realistic about the prognosis of your condition, with thorough history taking including that of your family history of balding.
I hope this helps.
Warmest Regards,
Dr Joshua Chong
