Unger’s “Safest Donor Area (SDA)” for 80% of patients under the age of 80 years, as determined from studies of 328 men aged 65 years or older.
(a) Immediately after strip wound closure. The sutures will be easily camouflaged completely, immediately after the surgery, by combing the hair above the suture line down over it. (b) The same site 8 days after surgery when the sutures were removed. (c) The same site 6 months after surgery. Approximately 80% of our patients heal with a scar similar to this one.
(a) A donor area strip scar similar to those produced in 10% to 15% of patients. It was approximately 0.1mm to 0.2mm wide. The hair has been lifted to expose it. (b) A photo taken at the same time as that shown in Fig.8a with the hair combed as normally worn. There is no noticeable scarring despite a very short hairstyle.
Some hair restoration surgeons believe that while strip harvests can produce a very fine scar line following the first donor area excision, each subsequent excision that includes the preceding scar will lead to an increasing scar width. As the above photos before a 5th small session demonstrate, this is not necessarily the case. As long as each subsequent strip width does not create a tighter closing tension in the wound (which usually requires a narrower strip and therefore fewer grafts), subsequent scars typically remain quite narrow.
(a) 1000 FU were extracted by another physician via FUE, 3 years prior to this photo, leaving the donor area with an unnatural moth-eaten appearance with the hair worn at the length shown here. The patient had undergone FUE in the hopes of being able to shave his donor area without scar noticeability. (b & c) Punctate oval/round FUE scars are obvious with the donor area buzzed very short for an additional FUE procedure just above the original donor sites. This time the FU were harvested by me, with a smaller punch and wider site spacing than the prior surgeon had employed. The grafts obtained in the second FUE session were placed into the worst scars from the first session. FUE is not scarless.
This is a copy of a page from a promotional brochure for the Artas robot. While there is minimal noticeability of the scars 7 days post-procedure, the photo also reveals how high the grafts have been taken and very close to the border of a balding area that is destined to get larger in most patients as they age (the younger the patient, the more likely that will occur). Hairs transplanted from areas that eventually lose their hair will result in loss of those hairs in the recipient area in which they were placed, as well as donor scar noticeability. This type of harvesting unfortunately is too common when FUE is carried out, whether by hand punch, motorized punch or robotic punch.
Some FUE operators have referred to FUE harvesting as “minimal excision surgery”! Compare the above intra-operative photos showing a strip wound immediately after surgery in the left upper corner and FUE in the other photos; then decide for yourself which method is more minimal. Note also in the photos on the right hand side, how close an obviously balding area’s border is to areas that were harvested. (The photos on the right are again taken from an Artas Robot promotional brochure.)