Transplanting hair from the body to the balding scalp, typically referred to as Body Hair Transplantation or BHT for short, has become a subject of intense interest to many patients (especially those who are endowed with the body hair of hairy back gorilla).

Some hair transplant physicians have been experimenting with and studying the viability of such body to scalp hair transplants, including Coalition member Dr. Bob True in New York City.

Dr. True made an excellent presentation on this subject at the recent annual ISHRS (International Society of Hair Restoration Surgery) meeting in San Diego this October. He was kind enough to provide me with his presentation so that I could share highlights of his findings on this forum.

According to Dr. True, there are up to 5 million hair follicles on the body. The follicles vary widely in hair character and behavior with the hairs on the torso generally most similar to scalp hair. Some races have very little torso hair. It is rare for a woman of any race to have much torso hair.

He finds that there is a wide variance among men who do have torso hair and that for men torso hair increases to the sixth decade of life.

Another fascinating phenomenon is that frequently the transplanted torso hair does not shed. Dr. True has observed this in several cases and believes that the determining factor is that the grafts have been placed in small batches immediately upon harvesting. However, he finds that the hairs do shed if the grafts are placed at the end of a several hour harvesting session.

He also finds it fascinating that torso hair transplanted to the scalp typically changes character. It tends to lose its wave, grows longer and becomes more similar to the native scalp hair.

However, unresolved questions remain and include:

what is the best and most reliable technique?
the survival rates of torso grafts?
the effect of the scalp host on torso follicle cycle?

For selected patients the torso represents a resource of many thousands of grafts. This expanded resource can be used to achieve higher density than their scalp donor allows, cover more of the bald scalp, and or accomplish repairs not otherwise possible.

However, patient selection based on their body hair donor characteristics is critical since only a minority of hair loss sufferers are ideal or viable candidates for a body hair transplant (BHT).

Dr. True uses a methodology for determining and scoring a patient's viability using a "Torso Donor Index" (TDI) which evaluates five key patient characteristics:

(1) Density which may be more than 40FU/cm2
(2) Similarity between scalp and torso hair
(3) Proportion of 2- 3 hair FUs (Follicular Units)
(4) Size of the hair bearing area
(5) Length of the torso hair

Patients with Torso Donor Index (TDI) scores of 4 or less are not candidates. Patients with TDI scores of 5, 6, and 7 have limited supplementary resource that may allow for focused touch up work. Patients with TDI scores of 8 and above may have a donor resource that exceeds their scalp donor resource.

This methodology for evaluating patients is shown in the accompanying photos as well as a patient with a high score of 9 who garnered 3,000 grafts from his chest and stomach areas.

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This is really really good.

This is the FIRST comprehensive SCIENTIFIC study I've seen on body hair transplants. Dr. True is to be commended for taking the time and energy to do it.

There is no quantitative information on "yields", but Dr True's observation that hairs immediately planted after extraction seems to be a very useful bit of information. For the first time since coming to my own conclusion that bht has very little value, Dr. True's observations may offer a way toward cosmetically significant success.

In my own experiments with bht, the grafts were out of the body between 1/2 hour and 2 hours. Perhaps these bh grafts can't tolerate being out of the body that long compared to scalp hair as Dr. True suggested.

I will experiment with bht again, but this time I will arrange to implant them immedietly after excision. Should be interesting to see if the yields improve.

Thank you Dr. True,
Dr. Feller

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Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments

Dr. Feller,

Apparently it takes a great FUE physician to notice one. Your humble response is in refreshing contrast to much of the FUE chest pounding discussions online.

I suspect you and Dr. True will both end up being very popular with all hairy backed gorrillas and then go blind. Be careful with what procedures you choose to offer!

Pat

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Never Forget - It's what radiates from within, not from your skin, that really matters!

My Hair Loss Blog

View some of the Leading Hair Transplant Clinics that I have visited.

Sharing is what keeps this community vital. Please join in. To learn how I restored my hair and started this community, click here.

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Dr. True's treatment protocol is also the most sane I've seen and I agree with each line of it. Especially the part where he only accepts easily removed grafts that don't have to undergo significant traction forces and then double checking them under the scope to make sure they are really intact. This has rekindled my interest in this area of HT. Even better knowing someone nearby is also working in this arena.

Pat, losing a bit of vision might be worth it IF the yields improve into the 85% or better range. Actaully, it is easier on the eyes to remove bht because they are spaced so far appart when compared to scalp FUE.

This is what I love about these forums. I didn't go to the last ISHRS meeting and would never have known about that presentation. Thanks for posting it here Pat.

Dr. Feller

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Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments

Great post!

Props to Dr True. I had a consultation with him just over a year ago and he was showing me some BHT cases then.

One question though, why is chest hair the main BHT site? I know Dr A has used Leg and arm hair but most others seems to use chest hair by default. My chest hair is of the same texture and length as that of my arm and leg hair. The only difference being that I have more hair in my legs and arms . I personally would rather lose my leg/arm hair than my chest hair.

I hope BHT yields improve and I look forward to hearing more results from various surgeons. I would especialy like to see more BH into scar tissue cases.

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Dr. Feller - since you said you would do further experimentation regarding this method of bht, have you done so yet? if so what are the results like?

Excellent thread!

Gentlemen, I'd like to add there are plenty of doctors who have had successful BHT sessions for the past few years. (Some of them are persona non grata on this forum) I dont even want to mention their names but I do want to add they have an impressive array of photographs that I've viewed of patients who look pretty good. I've seen some pictures of almost entire BHT on their noggin's (say an NW7) to adequate coverage over their entire head. Many had great body hair to work with. Thats one advantage they had in such a successful result. There is one photo of a gentleman with strcitly chest donor who's hair is about 6 inches in length throughout (held beside tape measure) and he had no remaining scalp donor before his session.

It provides a genuine alternative for those who thought they had run out of alternatives.

I've heard beard hair donor is one of the best donors available. I dont know if its because it grows better or because it is such a thicker caliber. It usually works best when blended with scalp hair. Some scalp hair or even leg hair is necessary for hairlines/temples. But I've also seen all beard donor BHT's that looked promising.

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My hair is a man made disaster.

I agree that beard hair is very promising, IMO.

I however disagree that BHT is even a consideration--- In fact, I do not believe that Docs should be charging for it, unless they are taking a small deposit and then charging the patient for ACTUAL GROWTH.

We are yet to see any real success and unfortunately almost every BHT patient has scalp hair mixed in which dilutes results.

Additionally, many of the BHT results we have "seen" that are being touted as a success are of Indian/Middle Eastern descent who have 3-5K of scalp donor mixed with BHT and promoted as a success.

They are not a success.

Back to beard hair--- this is the one body hair source that has me very excited--- the growing/resting phases are more consistent and each hair is more robust, so if mixed in with scalp hair may provide excellent density. Even if a patient got 1000-1500 1 hair beard grafts, say in the crown or mid-scalp region it would provide a huge boost if they grow.

I am not taking a shot at you wylie, just disagreeing with you that BHT is a genuine alternative.

There are several docs who have been touting BHT for several years-- in fact..one of my good friends has had bht--sat in the chair for 2 weeks and got nothing.
The results just are not there.

Of course, I hope that is does work out-- don't think it will, but I am really hoping that beard hair works out.

Jason

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6721 transplanted grafts
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Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

This is a typical "glass half empty" reply.

There is a reason the results are "diluted", it's called "design".

Thats exactly the intended result, a blend of both scalp and body hair for the "diluted" look.



P.S. I'm not taking a shot at you either, but the results you will see featured by almost every doctor doing this are usually a blend of both scalp and body hair. Exclusive BHT are probably a low success rate.

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My hair is a man made disaster.