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Which BHT is better - beard or chest hair?

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Does anyone have any opinion as to which offers better success - hair from

beard or form the chest?

From aesthetic perspective it appears chest may be a better option as it's less visible to others than the beard.

How about the quality of transplanted hair (texture specifically)? Would chest hair be

equally good (or comparable from the scalp)?

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That's a good question because from everything that I have observed, there is no real consistency in results across the board. Been a lot of guys stating they were having beard hair transplanted but then, you rarely if ever hear from them again.

 

Beard hair has the highest degree of coarseness (caliber) IMHO yet can have some visual compatibility issues. Better for scars or the crown.

 

There has not been enough chest hair cases to able to formate an opinion although I have read about this from several BH surgeons who state that if BH is used, the chest is the best donor source.

 

Have you used up your scalp donor?


Gillenator

Independent Patient Advocate

 

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

 

Supporting Physicians: Dr. Jim Harris, Denver, CO - Dr. Robert True & Dr. Robert Dorin, New York, NY

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Based on my doctor's estimate, I would need about 3000 grafts - 1000 from scalp and the rest through BHT. He is suggesting 500 from beard and 1500 from chest. I am leaning towards 2000 from chest as it's less visible than beard. Moreover this would eliminate 3 donor areas (scalp, face, chest) if I go with scalp and chest.

Most of these new grafts would be for the middle and crown area.

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Hi dds,

Body hair is a boon for patients with meager supply of scalp donor hair or in patients who are coming in for a revision of a poor result. Besides rapid FUE harvest, BHT is presently my favourite field!

Though FUT is undoubtedly the Gold Standard of surgical hair restoration and shall always remain so, FUE rose in popularity due mostly to the fact that it has opened the horizons to a limitless supply of grafts by expanding the traditional donor availability. The other advantages may be debateable but this has no opposition even from die-hard FUT surgeons. Thanks to FUE the patient base has markedly increased in size. Repair cases and cases with extensive balding which were shunned earlier, can again think of getting back a “head full of hair.”

 

I have a very different approach to a client with balding which I feel shall be progressive in the long term. I goad all patients with a long term plan for their progressive balding to allow me to harvest beard grafts (besides scalp grafts ofcourse) for a better hairline definition and mid-scalp fill and keep their remaining scalp grafts as a rain cheque for future requirements especially in the crown.

For example, in a 25 year old with type 3 vertex pattern, I would plant scalp hair within the first 1.5 cm along the hairline, mix scalp grafts with beard grafts in a laid down optimal ratio till the highest point of the head. For the crown area I would encourage him to accept a low density preferably with chest grafts or chest grafts with a sprinkling of scalp grafts. I never use beard hair for the crown area. It is only to be used for the mid-scalp and just behind the hairline.

For me and my patients “only ABC is GOOD!” : I am not fond of using any hair other than beard, chest and axilla (in this order of preference) since leg, arm, belly hair, in my experience, take a long time to grow if at all.

 

(A- Axilla, B- Beard, C-Chest)

 

In darker racial group I do not venture outside the ‘shadow area’ of the beard which lies on and behind the jawline and above the Adam’s apple due to the possible risk of visible scarring).

 

Average amount of harvestable grafts (1st session) in diverse racial groups in my practice:

 

Caucasian Donor:

Axilla L&R = 114

Beard = 2554 (full beard)

Chest = 542

 

South Asian Donor:

Axilla L&R = 311

Beard = 585

Chest = 865

 

East Asian Donor

Axilla L&R = 32

Beard = 263

Chest = 212

 

Arab Donor

Axilla L&R = 286

Beard = 515

Chest = 926

 

African Donor:

Axilla L&R = 98

Beard = 102

Chest = 210

 

Given the fact that in a second session, you can harvest usually half the number of grafts again after a gap of 6 months, realisation shall dawn upon you that an average patient (except East Asian) has a large donor area just waiting to be harvested. This realization is fast becoming the game changer today in the field of surgical hair restoration.

Body hair, mostly alone, has been routinely used at my clinic for the following indications-

 

1. Extreme repair cases

2. Extensive baldness with a poor donor area of the scalp and,

3. Camouflaging wide FUT scars.

 

You can see some of my cases on this forum where almost exclusive BHT was done for want of healthy scalp grafts.

 

ddb 2000 chest grafts is not posible from the chest in one session in the vast majority. I have difficulty in harvesting more than 600-800 in one session those well endowed with hair over the chest. And I have been doing chest for over 5 years now.

 

If there be any questions you may have for me, I would be pleased to answer to the best of my ability.

Edited by David - Moderator
Formatting

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Dr. Bhatti,

 

Thanks for taking the time to share your expert insights on body hair transplantation. It's comforting to know that I can potentially tap into this supply in the future if need be.


David - Forum Co-Moderator and Editorial Assistant

 

I am not a medical professional. All opinions are my own and my advice should not constitute as medical advice.

 

View my Hair Loss Website

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1) Though FUT is undoubtedly the Gold Standard of surgical hair restoration and shall always remain so

 

2) I goad all patients.... to allow me to harvest beard grafts.. for a better hairline definition and mid-scalp fill

 

3) For the crown area I would encourage him to accept a low density preferably with chest grafts or chest grafts with a sprinkling of scalp grafts.

 

4) I never use beard hair for the crown area. It is only to be used for the mid-scalp and just behind the hairline.

 

5) For me and my patients “only ABC is GOOD!” :

 

.

 

 

That is five hammer blows there...at least for a brown haired, fair skinned white boy like me.

 

Forgetting about the economics entirely, for sake of argument, this is the classic way many docs prioritize empirical over aesthetic considerations.

 

I have had BHT from every place known to man, as well as beard. My maxim has been 1 beard hair = two scalp follicles for density, and 4 chest hairs = 1 follicle - but those are only for my "incredible" body.

 

More seriously, I have been told to 'leave the crown' in the final sit on more occasions than I can remember. As a result my crown is like a desert with a few shrubs.

 

I don't recommend Dr. Bhatti's approach (although I admire his collection of data and input to the discussion)

 

So let's go through the points.

 

1) Wrong..("gold standard" btw is a nonsense term.) What ever parameters you use, they are changing in the big picture. Sure, strip yields are good, but at what cost? No one wants a strip scar, especially a balding male. But it is the way a hair restoration is built around a strip scar that is another concern. It often means an empty crown and a wall of hair combed back over it- and thus, behind the crown, the flow is followed over the scar. Result, you are stuck with a combed back look with a thinning crown. Not bad, but hardly why you booked the HT in the first place.

 

2) Mid scalp 'fill' with beard hair?? Not for me. They stand out like to me. Sure, I am paranoid and over sensitive, but they look quite different to me. and they feel different too. Moreover, you get that sense that the disparity will not improve over time as the native hair weakens and these beard stalks continue. In digital photos they can be shocking ad the camera paints them like black dots against the natural diffused tones of scalp- hair They are dark and strong. Mid scalp is often light, weak and minaturized. Caveat - beard hairs often grey/gray much faster.

 

3) Accept low density for the crown? With a (gold standard) strip scar? I think no. Although I accept that in the days of social media, a wall of frontal hair can take a profile pic a long way. Guys, the crown is essential!! It is one of the tell-tale signs of balding. Remember balding itself is a nuisance and even a health risk (sun burn , facial wrinkles, etc) but what bothers us is the disqualifying nature of it's symbols. The first but weaker symbol is the receding hairline, but the killer punch is the empty crown.

 

4) I have seen some buzzed FUE heads with beard in the crown, that was very successful, especially salt 'n pepper color tones.

 

 

Anyway, that is my 2 cents.

 

I would consider these principles as an advocate of the nw3 25 yr old white male;

 

1) Don't neglect a long term strategy to cover the crown well - (and to be fair, Dr. Bhatti does state that conserving scalp hair for the crown is good)

 

2) Keep beard hair for when you are grey and only use it on the crown on scars. ..and keep you beard too if you are a hipster!

 

3) Consider what 1 BHT hair is worth to you in density and weigh up how odd it will look. Remember that top frontal scalp could be minaturized for a long time - a kind of sustained miniature state thanks to fin or other meds)

 

4) Remember what a famous FUE/BHT pioneer once said, "What you see is what you get"

Edited by scar5
point 2

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Scar you've almost rebutted everything Dr Bhatti has said, almost to the point that your opinion have a favour of being misguided arrogance.

 

Loags,

 

I couldn't refute or agree with you. That would be a matter of you and your intuition.

 

I would be interested, for the sake of argument, to ask where I am misguided. It almost suggests that I have been misled by something or someone. I am gullible if that is what you mean, and I have rationalized many HT decisions based on grasping at some idea, fact or assumption without looking at the bigger picture. Something an HT doc/rep takes as gratis in their business. However, looking back in this case, I think about how BHT works in the bigger scheme of things. As Dr. Bhatti says, it is ancillary but on the other hand, using beard in the areas he suggests might not be the best, and I definitely disagree with the 'Gold Standard' and empirical argument.

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Scar you've almost rebutted everything Dr Bhatti has said, almost to the point that your opinion have a favour of being misguided arrogance.

 

Loags,

 

I couldn't refute or agree with you. That would be a matter of you and your intuition.

 

I would be interested, for the sake of argument, to ask where I am misguided. It almost suggests that I have been misled by something or someone. I am gullible if that is what you mean, and I have rationalized many HT decisions based on grasping at some idea, fact or assumption without looking at the bigger picture. Something an HT doc/rep takes as gratis in their business. However, looking back in this case, I think about how BHT works in the bigger scheme of things. As Dr. Bhatti says, it is ancillary but on the other hand, using beard in the areas he suggests might not be the best, and I definitely disagree with the 'Gold Standard' and empirical argument.

 

Scar5, I don't understand your comments on the empty crown, which you have mentioned a few times. If you have an empty crown, couldn't you get a second FUT or an FUE for it?

 

Yep, sure you can. Sorry for not being clear.

Will you have enough hair for it? I think that crowns require a lot of hair and that is why you need to match the density to other areas of the scalp, or else it will look thin. I think beard might help, especially for older gents with white/grey mixed in and a short cut.

 

Buzzing down areas to match the density of a thinning but well transplanted crown requires you to be able to cut the back short. If you have a strip scar that may be complicated, however, once again, beard hair and old age may help.

 

also don't forget that although facial hair comes and goes with fashion - the 90s goatie isn't that fashionable for younger people now, there is still something to be said for keeping some of them whiskers if you are a baldie.

 

But yes, you can cover the crown. A lot of strip docs concentrate on building the front up at the expense of the crown. It is a pragmatic approach, but leaves many with a balding crown. Meds complicate it (favourably) but still, I think it is a shame to have a balding crown after years of HT surgery. Others don't give a damn, just throw some product in there, comb back, and drive their porche off into the sunset.

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Nicely put scar and I agree totally.

Its only in extreme cases that I believe bht should be looked at a a resource but still then a great deal of thought should go into the graft placement.

Major repair cases were bht is the only viable option is when I believe that bht really put to its best use as its bht or nothing.

Umar whilst aleivating the terrible appearance of scars by utilising bht the patients still end up looking like someone with a head of non of us would wish for on ourselves.

If I felt bht was good I have that much I could have 200fu cm2 over my entire bonce.

Have a good day

 

That is five hammer blows there...at least for a brown haired, fair skinned white boy like me.

 

Forgetting about the economics entirely, for sake of argument, this is the classic way many docs prioritize empirical over aesthetic considerations.

 

I have had BHT from every place known to man, as well as beard. My maxim has been 1 beard hair = two scalp follicles for density, and 4 chest hairs = 1 follicle - but those are only for my "incredible" body.

 

More seriously, I have been told to 'leave the crown' in the final sit on more occasions than I can remember. As a result my crown is like a desert with a few shrubs.

 

I don't recommend Dr. Bhatti's approach (although I admire his collection of data and input to the discussion)

 

So let's go through the points.

 

1) Wrong..("gold standard" btw is a nonsense term.) What ever parameters you use, they are changing in the big picture. Sure, strip yields are good, but at what cost? No one wants a strip scar, especially a balding male. But it is the way a hair restoration is built around a strip scar that is another concern. It often means an empty crown and a wall of hair combed back over it- and thus, behind the crown, the flow is followed over the scar. Result, you are stuck with a combed back look with a thinning crown. Not bad, but hardly why you booked the HT in the first place.

 

2) Mid scalp 'fill' with beard hair?? Not for me. They stand out like to me. Sure, I am paranoid and over sensitive, but they look quite different to me. and they feel different too. Moreover, you get that sense that the disparity will not improve over time as the native hair weakens and these beard stalks continue. In digital photos they can be shocking ad the camera paints them like black dots against the natural diffused tones of scalp- hair They are dark and strong. Mid scalp is often light, weak and minaturized. Caveat - beard hairs often grey/gray much faster.

 

3) Accept low density for the crown? With a (gold standard) strip scar? I think no. Although I accept that in the days of social media, a wall of frontal hair can take a profile pic a long way. Guys, the crown is essential!! It is one of the tell-tale signs of balding. Remember balding itself is a nuisance and even a health risk (sun burn , facial wrinkles, etc) but what bothers us is the disqualifying nature of it's symbols. The first but weaker symbol is the receding hairline, but the killer punch is the empty crown.

 

4) I have seen some buzzed FUE heads with beard in the crown, that was very successful, especially salt 'n pepper color tones.

 

 

Anyway, that is my 2 cents.

 

I would consider these principles as an advocate of the nw3 25 yr old white male;

 

1) Don't neglect a long term strategy to cover the crown well - (and to be fair, Dr. Bhatti does state that conserving scalp hair for the crown is good)

 

2) Keep beard hair for when you are grey and only use it on the crown on scars. ..and keep you beard too if you are a hipster!

 

3) Consider what 1 BHT hair is worth to you in density and weigh up how odd it will look. Remember that top frontal scalp could be minaturized for a long time - a kind of sustained miniature state thanks to fin or other meds)

 

4) Remember what a famous FUE/BHT pioneer once said, "What you see is what you get"

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Yep, sure you can. Sorry for not being clear.

Will you have enough hair for it? I think that crowns require a lot of hair and that is why you need to match the density to other areas of the scalp, or else it will look thin. I think beard might help, especially for older gents with white/grey mixed in and a short cut.

 

Buzzing down areas to match the density of a thinning but well transplanted crown requires you to be able to cut the back short. If you have a strip scar that may be complicated, however, once again, beard hair and old age may help.

 

also don't forget that although facial hair comes and goes with fashion - the 90s goatie isn't that fashionable for younger people now, there is still something to be said for keeping some of them whiskers if you are a baldie.

 

But yes, you can cover the crown. A lot of strip docs concentrate on building the front up at the expense of the crown. It is a pragmatic approach, but leaves many with a balding crown. Meds complicate it (favourably) but still, I think it is a shame to have a balding crown after years of HT surgery. Others don't give a damn, just throw some product in there, comb back, and drive their porche off into the sunset.

 

Of course, but as we know, beggars can't be choosers, so I think most of us higher norwoods aren't looking for the "nonbalding" look...but looking better while still balding so we don't aim for perfection....you may have seen some of the results on here where surgeons try to do hairline to crown, with...eh results. That said, it seems to me that most people have enough donor for 2 FUTs usually. In addition, the crown is the area where concealers work best...so if you have good frontal hair, you can quietly add coverage in the back with something like Hairmax fibers.

 

In case you are speaking from experience from your own case, if you have donor left, perhaps you can look into Lorenzo. He has a big emphasis on crown work it seems like.

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For the crown area I would encourage him to accept a low density preferably with chest grafts or chest grafts with a sprinkling of scalp grafts. I never use beard hair for the crown area. It is only to be used for the mid-scalp and just behind the hairline.

 

Interesting. My hair transplant with Dr. Umar went different.

 

I had 500 chest hairs and 4100 FUE scalp and beard grafts done five months ago, over four days. The first two days used donor from my beard and scalp to fill my crown. The last two days had hair from my scalp and chest used to rebuild my temples and lower my hairline. In both cases, the scalp hair was mixed with beard and with chest donors.

 

The results have been coming in and I have no complaint with beard hairs being used in my crown. Since I keep my hair buzzed to 1/8", it is not noticeable to a typical person that there are beard hairs back there. I can, however, feel the contrast in coarseness when I put my hand over the crown; yes the beard hairs feel more prickly.

 

In my case, I am fortunate to have a strong donor area of beard hair. After the healing was done and the scabs came off, I did not perceive a thinning of the areas from my jowl and chin where the grafts were taken from. I will be using a lot more beard hairs in the future to add density.

 

Interestingly, I initially sought an online consultation with Dr. Bhatti as his reviews have been very positive. Since I am of partial south Asian descent, he would not agree to any more than 1000 grafts from the beard, due to concern of a side effect where the donor area loses pigmentation and becomes noticeably discolored. All being said, I have no complaints with how my hair transplant went, and the additional cost that associated with it. Dr. Umar has given me a great result five months in and I am looking forward to how it will look after 12 months.

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..beggars can't be choosers,

 

...most of us higher norwoods aren't looking for the "nonbalding" look

 

...the crown is the area where concealers work best...

 

....you can quietly add coverage in the back with something like Hairmax fibers.

 

...In case you are speaking from experience from your own case, if you have donor left, perhaps you can look into Lorenzo. .

 

I hear you there KO.

 

For me, I wanted to hide going bald, then I wanted to hide having a hair transplant, then I wanted to hide that I even cared. Too late for that.

 

You are far more realistic than I have ever been. Good for you.

 

That said, I don't think all HT punters wanna get the 'balding look' in preference to 'the bald look'

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..beggars can't be choosers,

 

...most of us higher norwoods aren't looking for the "nonbalding" look

 

...the crown is the area where concealers work best...

 

....you can quietly add coverage in the back with something like Hairmax fibers.

 

 

I hear you there KO.

 

For me, I wanted to hide going bald, then I wanted to hide having a hair transplant, then I wanted to hide that I even cared. Too late for that. No donor left.

 

You are far more realistic than I have ever been. Good for you.

 

That said, I don't think all HT punters wanna get the 'balding look' in preference to 'the bald look'

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Thanks AB I had actually seen them photos.

I will follow your progress.

Thanks and have a good day

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