Hi Dr. Rassman,
Excellent blog. I read it every day and would love to add my question to the plethora of information available.
I have a question about donor supply. I of course understand that when it comes to strip harvesting, you can only cut out so much of the skin, and that only some of the hair at the back, below a certain line, is permanent. But I’d like to know why after using up all the available donor hair with reference to what you can get with the strip-cup method, you can’t go in and take more grafts via the FUE method. There is still plenty more permanent hair at the back and although it might be too low to cut into because of the nerves and muscles, using tiny punches to get it out I’m guess wouldn’t have negative affects.
Thinning out the sides too would I think also have the advantage of not only providing more donor hair, but it would also make the transplanted area not look as thin in comparison since you’re making this “thick” permanent zone thinner.
With doctors performing FUE where ever there is hair, even body hair, I’d like to know why you can’t just go after more permanent hair that you still have in the back of your head and on the sides.
Doing a strip harvest for the first hair transplant surgery and a follicular unit extraction (FUE) at a later time is generally not advisable, as you limit the donor density with the FUE. Essentially, you’re asking why doctors don’t try to thin the donor area as much as possible, but for many people having the sides and back of the head looking sparse would also be a problem. Then again, everyone is different and I would rather not make a rule without knowing your situation. If you start with strip harvesting, you should finish with strip harvesting if you go for another procedure.