Maximum Width of a Second Hair Transplant Donor Strip?

This question, from a member of our Hair Restoration Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. Michael Beehner:

My understanding is that, in general, an average maximum possible hair transplant donor strip width on a virgin scalp is around 1.25-1.75 cm for a person with good laxity. What would the maximum possible average donor strip width be for this same person in their second surgery? I realize that donor strip widths are not uniform across the entire strip but I am referring to the average width along the entire strip. My guess is that it would be about 1 cm – 1.3 cm in the second surgery.

My opinion in most cases is that the second strip should be 1mm narrower than the first strip. I take a second strip exactly above the first one. In most cases the first strip’s scar is almost undetectable, usually 1mm or less in width. The flat part of the occipital part of the scalp in back can be cut wider than the rest. Once you come to the curve around the back of the head and into the area behind the ears, it is important to narrow the width of the strip taken, as this is the trouble spot for widening of the scar.

I typically take a 1.3 or 1.4 cm wide strip in that flat occipital portion of the scalp for a distance of around 10.5cm. I then narrow the strip’s width down to 1.1 cm wide as I begin the turn and keep it at that width the rest of the way laterally.

If it is necessary to do a third hair transplant, I leave a small “pillar” of intact scalp at both corners, so that I am essentially taking three separate strips – one in the back and one on each side. Leaving this small intact “pillar” anchors the scalp together and prevents the classical widening that often happens with third-time follicular unit hair transplants in that area.

For female hair loss, where oftentimes the occipital region is the only area with hair worth harvesting, I will push the limits in order to get enough hair to make the procedure worthwhile for the patient and I will push as high as 2 cm wide if I think there is enough laxity. With undermining, it is possible to easily close such a wound, as long as it isn’t taken too far laterally and around the corner at that width.

Dr. Mike Beehner, M.D.

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
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