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Will hair that is extracted for hair transplantation grow back?

Hair Loss Skin, Hair & Nails

I'm a 31 year old male. I've been experiencing hair loss since my early 20s. My hairline, and the corners of my temple are very thin. I've tried on and off to control the hair loss with medication because of the side effects. As such, I am considering a hair transplant, but I am concerned about what happens after hair is removed from the donor area. Does hair on the donor area grow back? If it does not, how will a hair transplant help as it means that I will be getting a bald patch at the donor site?

DOCTOR’S ANSWER (2)

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

319 views 8 Jan 2019

Hi. 

With vast information readily available online, many patients fall prey to pseudo-medical claims of unlimited donor area. 

With successful harvesting of hair follicles from donor site during a hair transplant procedure, the entire hair follicle is being removed from the donor site. When these hair follicles are FULLY extracted from the donor area, it is unlikely for the hair to grow back again. 

Hair regrowth may be possible in the donor site when the hair follicles are not fully harvested. In which case, these hair follicles are transected.

With an experienced hair technician or hair transplant doctor, punches will be made at the right depth and angle to harvest the entire follicular unit to avoid damaging extracted hair follicles.

As a result, some hair may grow back in the donor in the donor site but likely with shorter growth phase. That is, these hair will grow to to be more fine and fall off faster than surrounding hair. Therefore, it may not be a good sign if you notice hair growing back in the donor site after your hair restoration procedure.

Would your donor site look bald? Harvesting of hair follicles are performed on an area of the scalp where the density of your hair is the highest. Therefore, the excision will not be noticeable as the remaining hair will be more than sufficient to make up for the extracted hair. 

Your hair transplant team will analyze the size of follicles and density of donor site before advising on the number of grafts that can be harvested.

Hope the above helps. All the best.

Regards

Dr Kelvin Chua

300 views 8 Jan 2019
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