Occipital Donor Area Grading and Profile in Indian Population

BACKGROUND: Safe donor area (SDA) in hair transplant surgery had been categorized by various studies. We designed a study to profile the occipital donor area in our population and devise a grading scale the donor area. AIM: To profile and grade the pattern of receding hair over the occipital donor area among men in the age group of 50–55 years with androgenetic alopecia (AGA). MATERIALS AND METHODS: A total of 681 men with AGA (grade 3 and above Norwood scale, diffuse unpatterned AGA, and retrograde AGA) in the age group between 50 and 55 were included in the study group. Their occipital donor area was analyzed and photographed with the head in the sagittal plane. A team of two dermatologists graded the hair loss and the pattern of the receding hair over the occipital donor area and devised a grading scale and profiled the donor area. RESULTS: Grades 1, 2, and 3 occipital donor area constituting 76.05% of the subjects analyzed, fulfilled the standard SDA criteria and 22.31% of the subjects did not fit well into the standard SDA widely followed. Diffuse thinning and reverse thinning of the occipital donor area was observed among the subjects. CONCLUSION: There is no clear cut defined SDA. There are lot of individual variations in SDA. SDA selection should be always conservative and over harvesting of the occipital donor region should be avoided.