Exploring Safe Donor Follicle Harvesting in Follicular Unit Excision: A Comprehensive Review

ABSTRACT

Follicular unit excision (FUE) is a safe procedure provided it is done by an ethical, experienced surgeon; when not, inadequate procedures may have detrimental effects on both the donor and the recipient areas. FUE requires a long learning curve and a thorough understanding of procedure mechanics, the vaso-elastic properties of skin, and proper donor area assessment including considering the concepts of the safe donor area, safe excision density, and residual density. Donor follicles harvested crossing the safe excision limit, beyond the safe donor area boundaries, and using a relatively large-size, poor-quality punch may produce various donor area aesthetic defects. In order to improve graft longevity, avoid compromising the donor aesthetic, and achieve optimal results with FUE, the surgeon must have high-quality instruments, adequate training, and an understanding of the concept of safe donor follicle harvesting (SDFH). Other important considerations in donor harvesting include ensuring the extraction of healthy hair follicles, selecting suitable punch sizes, taking patient factors and expectations into account, and considering the pattern of harvesting.