A hair transplant is a surgical procedure that relocates hair follicles from a dense area of the scalp, known as the donor site, to a balding or thinning area, called the recipient site. The two main techniques used for harvesting these follicles are Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT). The core question is whether the hair removed from the donor area will ever regenerate. The answer lies in the biology of the hair follicle, as the process involves the permanent transfer of hair-producing structures.
The Biological Reality of Follicle Harvesting
The hair removed from the donor site does not grow back because the entire hair follicle is permanently extracted during the procedure. Hair growth depends on the presence of the follicular unit, which includes the hair bulb and the stem cells necessary for regeneration. Once this complete unit is taken, the site can no longer produce a hair shaft.
In the FUE method, surgeons use a tiny punch tool to remove individual follicular units, creating thousands of microscopic extraction sites. Each extracted unit is a permanent loss of hair-producing capacity. FUT involves removing a thin strip of skin from the donor area; the follicles within this strip are then dissected for transplantation. Since the skin strip is removed, the hair within that linear area is permanently gone.
Surrounding, non-extracted hairs may experience temporary shedding following the surgery due to trauma, but these hairs are still anchored by their follicles and will regrow. This temporary phenomenon is distinct from the permanent removal of the transplanted follicles. The extracted hair will continue to grow permanently in the recipient area where it was implanted.
Visual Outcomes for the Donor Area
The long-term visual appearance of the donor area is dictated by the harvesting technique and the individual’s healing response. Both FUE and FUT leave permanent marks, but their characteristics are different. The FUE technique results in numerous small, circular, depigmented scars, often referred to as dots, scattered across the back and sides of the scalp.
These FUE micro-scars typically measure between 0.7 to 0.9 millimeters in diameter and are generally not noticeable if the surrounding hair is kept at a moderate length. If the hair is shaved down very short, such as a buzz cut, these tiny white dots may become visible upon close inspection. Visibility is also dependent on the number of extractions and whether the surgeon properly spaced them out to avoid clustering.
The FUT method leaves a single, linear scar where the strip of skin was removed, which is then closed with sutures. This scar’s width and visibility depend on the scalp’s laxity and the tension of the closure. It is typically located in the back of the head where it can be concealed by the hair above it. Because this is a continuous line of scar tissue, it restricts the ability to wear very short hairstyles without the scar becoming apparent. Although FUE creates a larger total surface area of scarring, the distributed nature of the tiny dots often makes it easier to camouflage than the concentrated linear scar of FUT.
Strategies for Maintaining Donor Area Density
Surgical planning is essential to ensuring that the permanent hair loss in the donor area does not become aesthetically obvious. Surgeons strictly define a “safe donor zone,” which is the area on the back and sides of the head where hair follicles are naturally resistant to hormones. Harvesting only within this zone ensures the transplanted and remaining hairs are permanent.
To maintain an acceptable density and prevent a thinned-out look, surgeons carefully calculate the percentage of follicles that can be removed. Generally, they aim to extract no more than 20% to 35% of the total follicular units from the donor area in a single procedure. This conservative approach leaves enough surrounding hair to camouflage the extraction sites, ensuring that the overall density remains cosmetically adequate.
Proper spacing of extractions is another strategy, as clustering removals can create noticeable patchiness and thinning. By distributing the follicle removal evenly across the safe zone, the reduction in density is spread out, making the change difficult to detect. This meticulous planning is also essential for managing patient expectations.