Can Nape Hair be Used in Follicular Unit Extraction (FUE) Hair Transplantation?

This common question was recently asked by a member of our Hair Restoration Social Community and Discussion Forums:

I’m looking to undergo a large follicular unit extraction (FUE) procedure and was wondering if it is possible to include hairs extracted from the nape of my neck (nape hair)? I’ve heard of several hair transplant surgeons who extract hairs from the nape of the neck and implant them during the FUE procedure. Is this a viable option?

In theory, extracting and implanting hair from the nape of the neck makes sense; it’s a region where the hair is usually quite abundant, and the texture of the hair itself is soft when compared to scalp hair or hairs located in the universal donor region. Because of this, we see a growing trend in the hair transplant industry where practitioners are extracting these hairs (via follicular unit extraction) and using them to soften the frontal hairline during a hair transplant procedure (meaning hair from the nape is extracted and implanted into the balding scalp). However, there are definitely some issues to consider before committing to this technique:

First, remember that extraction of follicular unit grafts from outside the universal safe zone is not something usually recommended. The follicles in the universal harvest zone are much more resistant to dihydrotestosterone or DHT (the hormone directly responsible for hair loss), meaning they can be safely removed and implanted into balding scalp without fear of future loss. However, since the nape hairs are located outside of the safe extraction zone, there is no guarantee that these follicles will not thin and shed over time.

Additionally, there is no guarantee that extracting hairs from the nape of the neck will not create unnecessary scarring. Although extraction techniques have advanced to the point that scarring is very minimal, it is still a reality and one that could prove dangerous in an area outside the universal extraction zone.

Finally, the manner in which talented hair restoration surgeons are able to safely and artistically extract and implant thousands of follicular unit grafts (to the point where the frontal hairline is soft, natural, and resistant to future loss) truly hinders the need to venture outside of proven techniques.

Hair transplantation is an ever evolving field, and this assessment in no way means nape hair extraction has no place in modern hair restoration. Elements such as repair cases, matured patients who still have excess hair in the nape region, and hair loss sufferers who understand the risks of progressive loss all make strong arguments for further research into nape hair extraction. However, it’s probably best to keep these issues in mind, consult with several hair transplant surgeons, and conduct thorough research before deciding on integrating nape hair into a follicular unit extraction procedure.

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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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