Chest Hair FUE as donor for the Scalp

[Dr. David Josephitis]

FUE has come a long way over the years. It has enabled many patients who would otherwise not have had a hair transplant procedure the ability to get one. It allows patient who wish to shave their hair shorter the freedom to do that. FUE is not without limitations though. FUE in general may not yield as many total grafts in a patient’s lifetime. The average patient can yield somewhere between 4000 and 8000 usable grafts over a number of procedures.

Beard and body hair FUE has been available for a number of years. There is much debate as to how effective and useful this type of hair is. At Shapiro Medical Group, we have been doing FUE for a number of years and getting great success with our patients. Over the years, some have asked to try beard and body hair to add extra grafts. There is currently much debate amongst surgeons as to the usefulness of beard and body hair. Unfortunately, there are not any good studies comparing scalp and body hair FUE.We have been doing beard FUE on a regular basis for over a year with good results. We typically add beard for patients with a limited donor supply that still need to add extra density.

Beard has been commonly accepted as a useful addition to the scalp hair with FUE. The yield is relatively good. Chest and back hair are other area of body hair that have been tried in the past. These areas of donor are less useful for a couple of reasons. First of all, most people don’t usually have a strong, robust amount of this type of hair. Also, because of the fine nature of the hair, the yield (how much hair actually survives) is usually very low. Some physicians think chest and back hair has a yield of less than 50%.Arm and leg hair is also used, but is usually finer still and also has a poor yield in general.

With beard and body hair the area that the grafts are placed is also important. Because the characteristics of body hair is typically different than scalp hair, the body hair grafts have to be in less obvious area of the recipient scalp. We typically mix the body hair with the scalp hair so that the hair is helpful with density, but not very noticeable.

The patient presented here was limited on scalp donor hair and desired for us to use chest hair. Thankfully, he had excellent, coarse chest hair.Also, the chest hair also contained a number of 2-haired grafts which is unusual in body hair.

A close up of the area show a number of 2 –haired grafts. Also from the picture of the individual grafts you can see the grafts are coarse and strong.

Because of the fine and fragile nature of the chest hair grafts we used implanters to place the grafts. This way, we could minimize the handling of the grafts.

As I mentioned before, it is important to put the body hair in a useful but inconspicuous area of the scalp. The chest hairs were mixed with scalp and placed in the posterior of the recipient area.

Just like in the scalp, the tiny incisions of FUE heal very rapidly. Here is a photo of 3 days post op.

As we did with this patient, with extra care in handling of the fragile body hair in FUE, there may be extra donor reserve for other patients.

We will update you on this patient.

[mikeyhwk]

Will look very forward to seeing how this progresses but that chest donor looks immaculate for 3 days post. Thank you for sharing this Dr Josephitis!

[HairLostYears]

Nice write-up, DrJosephitis.

 

I've read at least a couple times before of non-scalp grafts eventually 'behaving' the same when implanted into the scalp; becoming more or less indistinguishable from scalp grafts over time. That's always been sort of fascinating to me, would be interested to hear your take on this.

[TakingThePlunge]

Thank you for sharing this case! We often get questions from members about using body hair on the scalp. I hope we'll get a chance to see this case mature.

[Dr. David Josephitis]

Nice write-up, DrJosephitis.

 

I've read at least a couple times before of non-scalp grafts eventually 'behaving' the same when implanted into the scalp; becoming more or less indistinguishable from scalp grafts over time. That's always been sort of fascinating to me, would be interested to hear your take on this.

 

 

 

Yes. This is an interesting phenomenon. There has been some research in this area in the past.

 

 

Clinically I have seen that the hair does seem to look and behave like the surrounding hairs. This works well for beard hair that is transplanted into the scalp. Beard hair is usually coarser and doesn't grow as long as native scalp hair. Over time, I have seen that the growth cycles of the transplanted beard hair may lengthen slightly, and that they may become less coarse over time. This is not perfect though. The beard hair and body hair for that matter, always remain different than scalp hair. It is just that over time, they are "less different."

 

 

It would be an interesting study to determine why this happens exactly.

[Melvin- Admin]

Yes. This is an interesting phenomenon. There has been some research in this area in the past.

 

 

Clinically I have seen that the hair does seem to look and behave like the surrounding hairs. This works well for beard hair that is transplanted into the scalp. Beard hair is usually coarser and doesn't grow as long as native scalp hair. Over time, I have seen that the growth cycles of the transplanted beard hair may lengthen slightly, and that they may become less coarse over time. This is not perfect though. The beard hair and body hair for that matter, always remain different than scalp hair. It is just that over time, they are "less different."

 

 

It would be an interesting study to determine why this happens exactly.

 

I would love to see SMG start this study, or perhaps start a study showing the survival of chest and beard hair to the scalp. I have an abundance of both chest and beard hair, if these are viable donor resources it would be a big change in terms of lifetime grafts. Also does the beard and chest hair last a lifetime?

[Windjammer]

In this case described above, how many chest hair grafts were intermixed with the scalp hair grafts?

[spyk777]

What is your FUE rate for body hair transplant doctor?

Kindly keep updating. Will be following the thread.

Thank you.

[Dr. David Josephitis]

I would love to see SMG start this study, or perhaps start a study showing the survival of chest and beard hair to the scalp. I have an abundance of both chest and beard hair, if these are viable donor resources it would be a big change in terms of lifetime grafts. Also does the beard and chest hair last a lifetime?

 

 

 

I am not sure we know if beard and chest hair lasts a lifetime or not. My suspician is that body hair acts alot like the "safe" donor area on the scalp. It may very well last a lifetime, but it does undergo natural aging. The hair may lose its color and it may also get thinner over time. These changes would follow the tranplanted hair wherever they were moved.

 

 

We transplanted about 500 chest hairs in this patient. These hairs we intermixed with scalp hair. The majority were placed towards the posterior part of the scalp in the recipient.

[pkipling]

Extremely fascinating and informative. Very much looking forward to seeing how this progresses. Thanks for sharing.

[Sean]

Honesty, for the number of days post op, the chest area looks pretty good. Hopefully, in a year the chest completely heals without any noticeable scars. Cant wait to see updates.

[Rashid36]

Wonder if they are dht resistant ?

 

My chest hairs are much thinner than my scalp hair

[Dr. David Josephitis]

Rashid36

 

 

The good news is that body hair is for the most part DHT resistant. Over time and as you age, the hair does thin somewhat and also loses its color. It does not fall out though, like the scalp hair does because of androgenetic alopecia. The results that you may have had initially with body hair can be slightly lessened over time because of this.

 

 

The bad new for people with considerably thinner body hair is that they are not good candidates for this procedure. In order for body hair to be effective, the donor hair must be somewhat coarse in order to make a considerable difference. It would still be technically possible to tranplant body hairs in someone with finer body hair, it would just not be very helpful in the overall results.

[Sean]

Aren't body hairs impacted by finasteride though? Finasteride causes that particular type of hair + beard hairs to shed and fall? Some docs advise to no longer take finasteride if bht and beard hair ar transplanted. Is this true Dr. Josephitus?

[Dutchie]

Thanks for posting this dr. J.

 

It looks like I might be a customer soon

[Sultsay]

Thanks dr, very useful.

 

With regards to body hair and DHT, I thought body hair not only was resistant to DHT but in fact they are dependent on DHT. This is clearly demonstrated by the fact that body hair and other secondary sexual characteristics develop when we reach adulthood, these are promoted by DHT.

In addition, the reality that body hair growth is adversely affected after initiation of finasteride and this process reverses on discontinuation of mentioned drug proves it.

 

We have had feedback from different members here about the effects of Finasteride on BHT, this again does not seem to be universal for everyone using it.

 

Would be keen to know your thoughts

[home1212]

great read, thank you!

[harin]

Yes. This is an interesting phenomenon. There has been some research in this area in the past.

 

 

Clinically I have seen that the hair does seem to look and behave like the surrounding hairs. This works well for beard hair that is transplanted into the scalp. Beard hair is usually coarser and doesn't grow as long as native scalp hair. Over time, I have seen that the growth cycles of the transplanted beard hair may lengthen slightly, and that they may become less coarse over time. This is not perfect though. The beard hair and body hair for that matter, always remain different than scalp hair. It is just that over time, they are "less different."

 

 

It would be an interesting study to determine why this happens exactly.

 

I could attest to the fact that in my particular case, at this time there is very little visually discriminating features between scalp and beard hairs, if I grow it out more than couple of inches then it becomes a bit kinky, but nearly not as kinky as it would even 6 months ago!, interesting but i will take it any day.

[Slush]

Very interesting, as the entire body "donor supply" would be over an order of magnitude larger than the head alone. (5M vs 150k follicles)

 

 

I presume this would be more successful for patients with great similarity between head and body hair. As a Caucasian male for example, I have a huge amount of chest and beard hair but it is black and relatively coarse while my head hair is a fine blonde/light brown. An awkward match for sure. Arm and leg hair, at least in my case, are a better match for color and texture but are even more fine in nature. Perhaps persistent use of minoxidil could help, but it seems BHTs are best as a bulking agent.

 

The question about those using DHT blockers is also extremely valid, as it is stated that a reduction in body hair is a side effect.