What is "Donor Zone" ?

In simple words donor zone is the area from where the tissue is being borrowed for placement in another location. In hair transplant this is a ribbon shaped area centered over a bony prominence in the skull called occipital protuberance. This area described as "Universal Safe Zone" forms the basis of hair restoration surgeries. It extends from the area around ear going back towards temples over to the occipital protuberance and is best seen in Norwood VII patients.

Norwood VII is the "Universal Safe Zone" for scalp hair.

The height of donor area is around 5-6 cm in midline and it is approximately 30-35 cm long. If we were to utilise all of it there would be no hair left in the donor zone of a class VII patient. However, it is possible to utilise around 50% of this hair without a visible reduction in hair density on the back. This means a total usable area of around 90-100 square cms. 


Assuming an average density of 100 FUs /cm square in caucasians and 80 FUs / cm square in east asians, this gives us a total of 10,000 FUs to 8000 FUs of movable follicular units having approximately 15 to 20, 000 permanent, DHT resistant scalp hair. Of course, if you have a higher density you will get more hair and vice versa.


Having 10,000 movable follicular units does not mean that all of them can be harvested at the same time. The number of units that can be taken out in one session depends upon your scalp laxity. Harvesting too narrow a strip will give smaller number of follicular units and harvesting too broad a strip may result in wide unsightly scar. So, it's a compromise between the two. A patient with high donor density and good scalp laxity will have significantly higher yield than one with low donor density and poor scalp laxity.


Remember, donor zone is the single most important factor in any hair restoration surgery. As a plastic surgeon I have learned to give utmost respect to donor zone but many a times under-qualified doctors do not give adequate attention donor zone.  If you look at the stage VII of Norwood class you will realise that hairline recedes not only from the front and top but also creeps up from the neck and temples. That is why follicular harvest from areas above or below this zone may result in visible scarring.Over harvesting from the donor zone may result in wide unsightly scars and thinned out see through look in the donor area. This is so unnatural that the whole exercise of hair transplant becomes futile. Although I am a strong proponent of large sessions, for the aforementioned reasons, larger sessions are not always better for you.

Example of  a bad strip scar.
This patient underwent follicular unit transplant by strip method
at a  clinic in New Delhi.  500 FUs were grafted.

 Every one is different and every hair restoration needs to be individualised. Do not rush to the doctor who is offering highest number of grafts for same area. You may end up losing precious donor hair in the bargain. Think, deliberate, consult and research before taking your decision for money can not bring these hair back.

Cheap Hair Transplants : What is the real cost?

Recently, there has been a flood of hair transplant clinics who are willing to do transplants at  ridiculously low prices. As a consumer, you think this is because of growing competition in the field. And like other commodities prices had to fall one day. You are happy that now the procedure is within your 'budget' and you quickly get a transplant before you lose this golden opportunity.

Few months pass by and you see some hair growing. You are overjoyed by this new growth and give yourself a pat on the back for a wise decision. Few more months pass by, and you don't really see the results you expected. You talk to your hair transplant physician ( who you now realise is just a general surgeon or not even that) and he reassures you of great results in few months time.

This patient received ' state of the art'  'No stitch No scar' transplant at a leading clinic in New Delhi.
Two years later his whole scalp is scarred, hairline is low and straight and donor area is depleted.

You wait with growing impatience and are then told to go for another procedure to increase the density. You pay again and get a second transplant. This time you see some improvement, but you are still looking 'kind of weird'. And you certainly cant afford a third session that was advised to you.

As time passes you lose some more hair and now the reality of your 'cost effective' transplant is there for all to see. And it is not a pleasant sight. Now you are really concerned  so you start looking for a good hair restoration surgeon. You do your homework, look at doctor's credentials and degrees, look at his results and then get an appointment. It is only now that you understand the full impact of damage done. Most of your donor zone is depleted and even the best plastic and hair transplant surgeon can not do much.

This is a story I hear at least once every day. The real tragedy is not the loss of money but the loss of hair for you and loss of repute for hair transplant procedure. Hair restoration procedure is delicate and highly skilled procedure. And once done, it can not be undone. Take your decision wisely the first time. You may never get a chance again.  Do not be blinded by the discounts and cheap pricing that many clinics are now offering online. Search and research about your surgeon for the success of transplant depends on the surgical team alone.

FAQs about Hair Transplant

What is Hair Transplant?

Word "Transplant" can be seen as  made of two  words, Transfer and Implant. So, hair transplant is simply transfer of living hair. These hair can be transplanted in any hairless area such as balding scalp or area of stable scar, eyebrow, moustache etc. Currently, this is the only technique that can give natural, permanent, growing hair in bald area.

Who Needs It?

Hair transplantation is used predominantly to treat the hereditary balding condition known as androgenetic alopecia ( Male pattern baldness). Patients with male pattern hair loss tend to loose hair from the front and top of their head. Since baldness is often ridiculed in society, it can undermine one's confidence and performance, especially if it comes at a young age.

Women with diffuse alopecia, selected patients with burn alopecia, eyebrow and facial hair loss patients are other candidates who can benefit from the procedure.

What Causes Hair Loss?

Although there are many causes of hair loss, the commonest cause is male pattern baldness. this is due to a combination of two factors. First, the hormonal byproduct Di Hydro Testosterone (DHT) and second your hair follicle's susceptibility to DHT, which is genetically determined. Both the factors should be present to cause hair loss.

How is Hair Transplant done?

Patients having baldness still have good density of permanent hair on the sides and back of the head. These good quality hair that naturally last a lifetime, are used to fill up the bald region. The hair are taken out from the scalp one by one (as single units called FUE)  and are implanted individually in the bald area. This highly sophisticated procedure replicates the natural hair growing pattern.

Is There Pain?

Hardly if any at all. I customise local anesthesia solution to gently numbs the area of procedure. You will not feel anything at all. even in post operative phase when anaesthesia effect wears off, only mild painkillers may be required. Some people do not require any painkiller after FUE method.

How Long Will It Take?

Hair transplant is a one day  procedure in office setting. No admission is required. An average surgery of 1500-2000 grafts takes 5-6 hours. Megasessions of 3000 or more grafts may take 8-10 hours. You can go home the same day after procedure.

Are Results Permanent?

Yes. Since transplanted hair come from permanent hair zone (the back and side of scalp) that is unaffected by DHT, these hair do not fall after implantation. They will have same texture, colour, growth and quality as your back hair and the results will last you a lifetime.

Why Shouldn't I go for Artificial Hair?

Entirely too many reasons. The biggest reason that my patients tell me is that they feel artificial. There is always that fear of losing face in public if the hair piece comes off. Then, of course, there is price for maintenance, price for replacement and price for touch ups. After some time the cost of maintaining a good hair piece crosses that of transplant and you still have nothing to show. Last but not the least is health reasons. The glue can cause allergy, the clips can cause headache,even wounds if they are too tight, weaving may pull and damage your existing hair

Can I afford it?

The initial cost of a good hair transplant may be high but it does not require any maintenance. It is a kind of investment that will keep you giving good returns for times to come. An average a transplant session costs 5-7,000 US $ for FUT and 15-20,000 US $ for FUE hair transplants, but it is much cheaper in India.