Understanding Recipient Dominance in Hair Transplantation
The principle of modern hair restoration is predicated on “donor dominance.” Donor dominance refers to the concept that hair transplanted from the donor area (back of the head) and placed into the front (recipient area) will never be lost despite ongoing hair loss due to the fact that the transplanted donor hair retains its native characteristics that preclude it from hair loss.
Recipient dominance implies the exact opposite, i.e., the recipient area has influence to some degree over the transplanted hair. Fortunately, recipient dominance is not the prevalent condition otherwise transplanted hairs would be lost over time. Instead, recipient dominance expresses itself in unique and subtle ways. For example, in eyebrow hair transplants, the eyebrow region hairs that otherwise grow very fast when transplanted can be influenced by the native skin in the eyebrow region so that over time the hairs start to grow more slowly and grow even finer than originally transplanted. Similarly, hairs transplanted from the body such as from the chest can start to grow faster and finer when moved from the body to the scalp. These curious conditions can be leveraged to advantage in the above circumstances.
This gentleman underwent a corrective eyebrow hair transplant. Hairs can become softer and grow more slowly after an eyebrow hair transplant due to a principle known as “recipient dominance.”
Another example of donor influences (but that is not formally entitled donor dominance) refers to the effect that transplanted hairs can have on the recipient skin. For example, hairs transplanted into an area of scar tissue sometimes can start to make the scar bed softer and less scarred. This can occur possibly due to the stem cells that naturally exist within a hair follicle. For example, if someone who has had Accutane in the recent past, the oil glands within the hair follicle become reduced which is the source of skin renewal. This is why people that have had recent Accutane treatment cannot have a skin peel or laser to the skin. Perhaps the new oil glands in the transplanted hairs help rejuvenate the skin, and this is the explained mechanism by which the donor hair influences the recipient area. All of these ideas are fascinating to me as a hair transplant surgeon.