Hair Transplant Overharvesting

Pete Scott, MD

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Written by Erin D. Updated on 29 Apr 2024

Hair transplantation is generally considered a safe surgery, associated with very few complications. One of the few complications of the surgery is overharvesting of the donor area. Not only does it affect the results of your hair transplant, but it can also cause alopecia in the donor areas. The guide below dives into greater detail about this complication, how it is triggered, and how to prevent it.

Most Important Findingssvg

What it looks like Over-extraction...
Cause Hair Transplant Surgeon
How to Prevent Choose a skilled surgeons
What to do Hair pigmentation...

How does Overharvesting of the Donor Area look like?

Before we get into what overharvesting looks like, let’s first discuss how hair transplants actually work. 

Most people have this misconception that the hair grafts transplanted into the balding areas of your scalp come from third-party donors. When, in fact, these hairs are actually extracted from areas of your own body, called donor areas. Examples include the back of your head and beard. 

Hair Transplant Donor Area

Overharvesting, as apparent from the name, is when too many hair follicles are extracted from the donor area. This can have disastrous effects on the area itself. A 2018 study backs up this claim by confirming that overharvesting can lead to permanent damage to the donor area, leaving it scarred, patchy, and thinning. 

What is worse, the area becomes practically useless for follow-up procedures, meaning you are left with more balding areas than when you went in for the transplant.

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How can Overharvesting Happen During a Hair Transplant?

Whether accidental or on purpose, the sole blame for overharvesting falls on your hair transplant surgeon. 

Basically, overharvesting occurs when your surgeon overestimates the number of hair grafts needed for a successful hair transplant surgery. Which leads to them making too many excisions and extracting too many follicular units (FUs). This in turn leaves the donor area thinning and patchy. 

Overharvesting can happen due to a number of reasons:

  • Your surgeon is inexperienced, or unqualified, and lacks the surgical skill and awareness required to identify the risks associated with overharvesting. 
  • They are overcompensating to meet the patient’s unrealistic expectations. 
  • They are trying to “cure” the patient’s hair loss in one go, without considering the need for future transplants. 
  • They’re not aware of how many excisions your previous surgeon made in the same donor area during your previous hair transplant. 

Which is why you must choose your surgeon after carrying out your due diligence. Also, make sure that the clinic you’re choosing has the facilities to detect the excision density, total number of excisions, and hair follicle transection rate that occurred during your previous transplant session. 

Both FUE and FUT are tricky surgeries that, if left in the hands of the unqualified or untrained, can be disastrous for both patient and surgeon. 


What Can be Done to Prevent Overharvesting?

Just now we alluded to how you can avoid overharvesting by carefully researching and choosing IAHRS and ISHRS-certified surgeons operating from a reputable clinic. But how can qualified, reputable surgeons save themselves from falling into the trap of overharvesting? 

Well, we’ve found a study that may provide the answer. Conducted to detect the total number of excisions carried out during a patient’s previous transplant session, researchers rounded up 5 transplant patients who visited their clinic after receiving their first transplant. 

All patients opted for the FUT method to increase hair density in the frontal area of their scalps. Researchers counted the number of FUs per square centimeter at multiple points along the patients’ scalps. While also calculating the average FU density at each point in areas with and without FUE scars. 

The difference between the two densities then allowed them to evaluate the overall excision density. All that was left then was to multiply the excision density with the total surface area of the donor area used in the previous FUE to calculate the total number of grafts extracted. 

This, in turn, allowed the surgeons to stop themselves from extracting more than 1 in 4 follicular units for the hair transplant. And save themselves from getting blamed for overharvesting FUs from the patients’ donor area. 

You as a patient can use this knowledge as well by scheduling an in-person consultation with your chosen clinic and gauging their expertise on the subject before confirming the surgery.

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What can you do About Overharvesting After it has Already Happened?

Hair transplants are generally considered the best way to restore or regenerate lost hair suffered from male pattern baldness. That said, even if the procedure is successful, it will not completely stop your hair loss. 

For that, you will have to stick to a proper hair loss treatment program, which entails taking medications like minoxidil and finasteride. Taking these medications can also help you recover hair in donor areas that fell victim to overharvesting during your last transplant. 

Additionally, if a previous surgeon has already overharvested follicles from one of your donor areas you could opt for an artificial hair transplant like biofibre. 



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