|Year : 2013 | Volume
| Issue : 1 | Page : 117-120
Use of body and beard donor hair in surgical treatment of androgenic alopecia
Dr. A's Clinic Pvt. Ltd., New Delhi, India
|Date of Web Publication||20-Jun-2013|
B-104, Chittaranjan Park, New Delhi - 110 019
Source of Support: None, Conflict of Interest: None
Objectives: Follicular unit transplant is a widely used surgical treatment for androgenic alopecia. However, for patients with extensive hair loss (Norwood 5 and above), scalp donor hair are not sufficient to cover all areas of baldness. This study aims to assess suitability of beard and body donor hair when transplanted to the scalp. Materials and Methods: In 35 male patients having varying degrees of androgenic alopecia, body and beard donor hair were extracted by follicular unit extraction method (under local anesthesia). They were transplanted in different locations of the scalp. Follow-up was carried out at various intervals (6 months to 2 years). The hairs were observed for colour, curl and calibre. Results: In all the patients, there was no change in the colour, curl or calibre of the transplanted body/beard hair. They maintained the same characteristics as in their original location. Conclusion: Body and beard hair can be used as additional donor resource for treating androgenic alopecia. These hairs, however, do not change their colour, curl, and shaft diameter (calibre). Thus, proper planning is a must when using the different types of donor hair for transplanting.
Keywords: Androgenic alopecia, follicular unit extraction, body donor hair
|How to cite this article:|
Poswal A. Use of body and beard donor hair in surgical treatment of androgenic alopecia. Indian J Plast Surg 2013;46:117-20
|How to cite this URL:|
Poswal A. Use of body and beard donor hair in surgical treatment of androgenic alopecia. Indian J Plast Surg [serial online] 2013 [cited 2018 Jul 15];46:117-20. Available from: http://www.ijps.org/text.asp?2013/46/1/117/113728
| » Introduction|| |
Follicular unit transplant is a widely used surgical treatment for androgenic alopecia.  However, for patients with extensive hair loss (Norwood 5 and above), scalp donor hair are not sufficient to cover all areas of baldness. 
Follicular unit extraction makes it possible to extract the individual follicular units from the body and beard donor areas without strip excision and suturing.  This enables the use of robust body and beard hair as additional donor hair in suitable patients. The body and beard donor hair differ in characteristics, (length, calibre, colour, growth cycles etc.), from the scalp donor hair.
A total of 35 patients were observed, after transplanting body/beard hair in identifiable locations on the scalp, to study any change in characteristics of the transplanted body and beard hair, the patient acceptability of the different types of donor hair on the scalp and the best way of using the different donor hair.
A case study of 35 patients using body and beard hair as donor was carried out for the period of 3 years (2005-2008).
Aims of the study
The various aims of this study are: To observe and analyse change in body hair characteristics (calibre, length, colour, texture) after transplantation in the scalp, to assess patient acceptability of the different donor hair and to assess the best way of using the various donor hair.
| » Materials and Methods|| |
A total of 35 male patients in various stages of hair loss underwent body and/or beard hair transplant. Out of which 18 numbers of patients were caucasians. The hair was transplanted in different subsets:
- Beard hair in scar tissue on the scalp [Figure 1] and [Figure 2]
- Body hair (from legs and chest) in scar tissue on the scalp
- Beard hair transplanted alone in bald vertex and crown areas
- Body hair (chest and leg hair) transplanted in the temple points [Figure 3] and bald scalp recipient [Figure 4]
- Beard and body hair mixed and transplanted in bald vertex and crown areas [Figure 5]
- Scalp and beard hair mixed for transplanting in the frontal and vertex areas.
|Figure 1: The beard hair for this patient was thick calibre and black. They were used to fill in the scar tissue at a low density|
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|Figure 2: 11 beard hair transplanted in strip scar. They show good growth and have retained their calibre and colour|
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|Figure 4: Body hair from chest, leg, calf, pubic and armpit donor areas transplanted in the bald scalp recipient. No scalp or beard hair was used as donor source. 7000 BHT grafts were transplanted. Of the 7000 bh grafts, 700 were transplanted into the right temple and 200 + into the left temple. The rest were distributed over the entire scalp|
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Under aseptic precautions, the area was anaesthetized with 2% lignocaine. The donor hair follicles were teased out of the donor site using a 20 gauge hypodermic needle by expanding needle concept. 
The excess dermal tissue was trimmed from the extracted follicular units. These follicular units were transplanted into recipient slits created in the designated areas of the scalp. Pictorial record of the immediate post op and follow-up visits were kept to monitor the growth and characteristics of these hairs.
Follow-up was carried out at various intervals (6 months to 2 years). The hairs were observed for colour, curl, and calibre. Since, many of the patients continued to get their regular haircuts; it was not possible to monitor the change in length of the transplanted body/beard hair.
| » Observations|| |
The growth and characteristics of the transplanted body and beard hair was monitored. In all the patients, there was no change in the colour, curl or calibre of the transplanted body/beard hair. They maintained the same characteristics as in their original location [Figure 6] and [Figure 7]. The beard hair, due to its thicker calibre provided cosmetically better coverage in the scar tissue, compared to the thin calibre body hair.
|Figure 6: The transplanted beard and scalp hair were cut and placed side by side for comparison|
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|Figure 7: Beard hair transplanted to the scalp retains its sheen and calibre|
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The curl of the hair is a significant factor in patient acceptability of beard/body hair, if the beard/body donor hair is used alone in a slick bald area of the scalp, if the patient's own scalp hair is straight.
The patient acceptability of different donor sources was highest when the beard and/or body donor hair were mixed with scalp donor hair. This held true even in cases where the patient's scalp hair was fine calibre and straight while the beard donor hair was thick calibre and wavy. The use of the needle tip as a cutting instrument reduced the difficulty posed by larger extraction sites and at the same time, lowered the transection rates of the body donor hair. 
| » Discussion|| |
In suitable patients, with ample beard and body hair growth, these can be used to augment the scalp donor resources to provide a fuller hair restoration. However, when using body and beard areas as the additional donor source, it is important to observe the differences in the characteristics of this hair compared to the scalp hair. It must also be impressed on the patient that the body and beard donor hair are not going to change their characteristic curl, colour, calibre after transplant to the scalp. Due care needs to be devoted to use a mix of the various donor hair in any bald area of the scalp
[Figure 7]. This will avoid the situation where different areas of the recipient scalp may have differing hair types. The thicker calibre beard hair should not be transplanted in the hairline and the temples as these areas typically have finer calibre hair. The ideal hair combination in these areas would be a mix of the scalp and finer calibre body hair [Figure 8]. Use of beard donor hair for previous strip scars - this is another area where the beard donor hair can be used very effectively. However, in cases where the scalp and beard donor hair differ widely in terms of calibre and colour, it is not advisable to transplant the thicker calibre, different coloured beard hair at a high density all along the strip scar. This will lead to the strip scar being replaced with a linear zone of thick calibre, different colour hair. In such patients, it's advisable to transplant the beard hair at a low density (<20 grafts per sq cm), and to mix them with donor hair follicles derived from the scalp and other parts of the body.
|Figure 8: The temple points have fine/thin calibre hair growth. Therefore, thin calibre body hair was transplanted to recreate the temple points. 225 BHT (thigh donor area) were transplanted into the temple areas|
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| » Conclusion|| |
Body and beard hair can be used as additional donor resource for treating androgenic alopecia. These hairs, however, do not change their colour, curl, and shaft diameter (calibre). Thus, proper planning is a must when using the different types of donor hair for transplanting.
Further studies need to be carried out to study whether transplanting body and facial hair to scalp affects their anagen-telogen ratios, duration of anagen, and speed of growth and length of the transplanted hair.
| » References|| |
|1.||Rassman WR, Bernstein RM, McClellan R, Jones R, Worton E, Uyttendaele H. Follicular unit extraction: Minimally invasive surgery for hair transplantation. Dermatol Surg 2002;28:720-8. |
|2.||Norwood OT. Male pattern baldness: Classification and incidence. South Med J 1975;68:1359-65. |
|3.||Poswal A. Body hair transplant: An additional source of donor hair in hair restoration surgery. Indian J Dermatol 2007;52:104-5. |
|4.||Poswal A. Expanding needle concept for better extraction of body hair grafts. Indian J Dermatol 2013;58:240. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8]