Donor Site Preservation and Long-Term Management in Follicular Unit Extraction (FUE): A Structured Clinical Framework for Surgical Planning and Complication Prevention

This review highlights the critical importance of donor site preservation in Follicular Unit Extraction (FUE) hair transplantation for long-term success and patient satisfaction. It emphasizes the risks of suboptimal donor selection and aggressive extraction, which can lead to irreversible donor depletion, visible thinning, and scarring. A structured clinical framework is advocated, focusing on individualized donor mapping, conservative extraction planning, and comprehensive preoperative assessments. Key strategies include minimizing repeated punctures, using smaller punch sizes, and maintaining even extraction distribution. The framework also stresses the need for lifetime donor budgeting, phased planning, and reassessment before additional procedures to prevent complications and ensure sustainable practice. Techniques like long-hair FUE and scalp micropigmentation are suggested for better visualization and camouflage of donor morbidity. Overall, disciplined planning and technique are essential for managing donor site complications in FUE.