Follicular Unit Extraction: Is Nape Hair Safe For Hair Transplant?

Follicular unit extraction (FUE) is a hair transplant technique that proffers many advantages over its major competitor, strip surgery. One of the greatest benefits of FUE is its ability to select and harvest donor hair beyond the confinements of the traditional linear strip. But this ability has also begun to raise questions amid the hair transplant patient community. In particular, a rise in the use of nape hair has become a cause for inquiry.

Dr. Umar, a world-leading follicular unit extraction practitioner, has become known throughout one such online patient community—the Hair Transplant Network—for his impressive FUE using nape hair. But with nape hair being outside the safe donor area (SDA), or the “safe zone,” people are asking:

  • Is nape hair okay to use for long-term graft survival?
  • Will nape hair fall out quicker than hair from the mid-rear scalp?
  • Will a transplant procedure using hair from the nape cause obvious scarring?


Anyone would hate to undergo a procedure transplanting nape hair, only to have that transplanted hair fall out a few years later. Patients want results that will not only look great, but will last. Dr. Umar addresses the above concerns, debunking the notion that nape hair is necessarily DHT susceptible. He states that, in most cases, nape hair is more resistant to the testosterone metabolite than hair in the areas of baldness. True, nape hair is not in the SDA; however many patients have been treated with enduring success using hair outside the SDA. This includes hair from the nape of the neck and behind the ears. The use of such donor follicles is especially idea for an individual with a more depleted donor source, for whom strip surgery is not an option anymore. Nape hair is also ideal for those seeking a softer, more natural-looking hairline due to its fine caliber. And in regard to scarring, any scars as a result of FUE are typically negligible no matter where the hair is extracted.

Ultimately, the choice to trust the use of non-SDA hair long-term comes down to the patient. Finer caliber hairs, such as those from the nape and legs (in body hair transplant, another subset of FUE), are growing in popularity as a resource for better hairline design and for eyebrow transplantation. Thus far, the long-term results have been promising.