Body Hair Transplantation
In body hair transplantation, body hair is used as donor hair for transplantation primarily to the head. This type of hair transplant should be performed using the FUE method exclusively as the risk of iatrogenic injury caused by the conventional methods far outweighs the benefit
The various types of body hair provide the physician and patient with new sources of donor hair that can be used for transplantation. Depending on the individual patient, donor hair can be harvested from chest hair, back hair, axillary hair, abdominal hair, pubic hair, and leg hair.
Left: Scarring and iatrogenic effluvium (shock loss) secondary to two hair transplants using the strip method. Right: Iatrogenic effluvium (shock loss) in the region of the hair fringe after extraction of 3300 FUs in a single session using the FUE method
Status post hair transplant with the strip method. A strip of skin was harvested from the chest, yielding 80 chest hair follicles for transplantation to the head and creating a scar 10 cm long and 1.5 cm wide. The damage caused by the strip method far outweighs the benefit
The Patient Group Transplantation of body hair is particularly suitable for patients who show iatrogenic thinning in the donor area of the hair fringe as a result of having undergone one or more previous hair transplants.
Moreover, transplantation of body hair may be a good idea in young patients with a poor prognosis insofar as their hair loss represents a great emotional burden and they have sufficient donor hair on their bodies.
Beard Hair as Donor Hair
Single-hair units constitute about 90% of beard hair and 2-hair FUs another 10%. Three-hair FUs are extremely rare. As beard hair primarily consists of 1-hair FUs, it will not create the same density as will a comparable number of FUs from the region of the hair fringe.
Example: If one extracts 1000 FUs from the beard region, this will represent about 1150–1200 hairs. Yet if one harvests 1000 FUs from the scalp hair, this will correspond to about 1600–2800 hairs, a larger number of hairs and thus greater hair density and a better visual effect.
The hair shaft diameter of beard hair averages 0.12 mm, which compared with the hair shaft diameter of scalp hair, 0.07 mm, is lightly larger. This also applies to the dermal papilla of the beard hair.Because of its thickness, beard hair is particularly suitable for treating scar tissue (resulting from traumatic injury or a hair transplant using the strip method).
After transplantation of beard hair to the scalp, miniaturization of the dermal papilla occurs, in turn leading to a decrease in hair shaft diameter of up to 50%. This adaptation process allows beard hair to be used for transplants to restore the scalp hair. Beard hair is also well suited for transplantation into male eyebrows.
I personally prefer and recommend harvesting beard hair from the chin and neck region as it is usually possible to extract about 600 beard hair follicles from this region for use as grafts. Beard hair should be extracted from the chin and neck region using a cannulated needle with an inside diameter of 0.95 mm and an outside diameter of 1.05 mm to avoid scarring.
Even better are the so-called Pro FUE needles, which have an inside diameter of 0.9 mm. These very thin-walled extraction needles are available from Mediquip Surgical in the USA .
In contrast, harvesting beard hair from the cheek is more difficult. Yet in patients with dense beard growth, this region can yield about 1000–1500 beard hair follicles.
Given the exposed position of the beard in the face, patients should be comprehensively informed about the possibility of micro-scarring.The longitudinal growth of transplanted beard hair is similar to that of scalp hair, although its survival rate in scar tissue is higher than that of transplanted scalp hair follicles
Chest and Back Hair as Donor Hair
About 90% of chest and back hair consists of 1-hair follicular units, and about 10% consists of 2-hair FUs, very rarely 3-hair FUs as well. The hair shaft diameter of this hair varies greatly between individual patients.
As longitudinal growth is not genetically determined but is influenced by the surrounding scalp tissue, the longitudinal growth of transplanted chest and back hair adapts to that of the scalp hair. That makes this hair particularly suitable for transplantation to the scalp.
However, chest hair is more difficult to extract than scalp hair even with the optimal extraction needle (inside diameter 0.95 mm and outside diameter 1.05 mm) due to the structure of the skin in the chest region. For this reason we often use the nex larger cannulated needle (inside diameter 1 mm and outside diameter 1.1 mm) or larger, although this is associated with greater micro-scarring. Usually, the microscars are well covered by the remaining chest hair and other hairs that were in the telogen phase at the time of the transplant (about 70%) and later grow back .
Back hair is usually not as plentiful as chest hair but is very similar in terms of its structure and growth behavior. This hair also consists primarily of 1-hair FUs and, like chest hair, adapts its longitudinal growth to that of the recipient area after transplantation. The skin tissue of the donor area on the back is not as susceptible to scarring from extraction as is the chest skin
Axillary Hair as Donor Hair
The skin tissue in the axillary region is very soft, which makes extraction of the hair follicles difficult. There is also very little axillary hair, and as a result it is rarely used for hair transplants to the scalp.
Hair of the Extremities as Donor Hair
As the follicles of arm and leg hair are usually very short and narrow, they are only suitable for hair transplants to a limited extent. Because of the acute exit angle of these hairs, extracting them creates large elliptical wounds that remain reddened and inflamed for a long time and are associated with severe scarring .
Abdominal and Public Hair as Donor Hair
The skin in the abdominal and pubic region is highly mobile because of its plentiful subcutaneous fat. Placing the tip of the cannulated needle on the skin with even the slightest force will displace the hair follicle relative to the skin. This means that
View 3 weeks postoperatively. Removal of leg hair follicles using micromotors with large extraction needles in a 27-year-old patient
follicles are easily damaged during extraction, which is reflected in a higher transection rate. The extraction quota of abdominal and pubic hair that can be achieved with currently available extraction needles is generally rather low, which is why this hair is not usually considered as donor hair for hair transplants to the scalp.
