Planning is always important to any surgical hair restoration. The traditional donor area depends on the quality of the hair characteristics. Even a good hair transplant candidate the donor area is a finite resource. Regardless if using the Follicular Unit Transplant and Follicular Unit Extraction technique. There is a safe maximum that can be removed. What if the traditional donor area is depleted. Hair loss may have advanced further than predicted. The donor may have been impaired due to previous surgeries. The donor area can be expanded to new areas of the body. Using areas that hols a rich source of potential donor hair. Area such as the beard, chest, legs and back.
As the FUE widens the surface area of the traditional scalp donor area. It also makes it possible to harvest from other areas of the body. Without leaving a linear scar. As a result, this gives the individual the option and or the ability to continue hair restoration. Body Hair FUE, also known as BH or BHFUE. Has been practised for a number of years with varying degrees of success. The use of body hair requires different skills even to that of extracting scalp hair with the FUE technique. Results have varied greatly. From little to no hair growth being documented. To yield like that of scalp hair in a few cases.
The FUE Technique
By using the Follicular Unit Extraction technique body hair follicles can be removed. Resulting in a punch wound being left. Superficial healing is rapid with often no need for a bandage or cover. Long-term healing leaves a small white dot scar. The size and visibility can depend on natural skin healing characteristics, area of the body, and the quality of the extraction process. Keloid formation can be a concern with body hair candidates. Knowing the scarring history of a patient is an important prerequisite to considering a body hair transplant.
The FUE tool punch size is important for a number of reasons. All reasons revolve around two important aspects. The preservation of the donor area quality. The removal of intact hair follicles, or follicular units. Larger diameter punches will remove more skin tissue. As a result, can lead to any scarring being larger and potentially more visible. Also, a larger diameter punch can encompass a larger follicular unit. Made up of more hairs or stronger hair characteristics. Most body hair units only consist of one or two hairs. Hair characteristics can differ like scalp hair. Curly or wavy, fine or coarse hair shafts. Occasionally with an acute angle as the hair exits the skin.
Skin Laxity
Certain areas of the body have greater skin laxity to the scalp donor area.
The laxity of the skin and bone structure in some areas will cause potentially high transection when trying to punch. FUE punching and extraction, as a result, can be more demanding to perform. Skin laxity will also change depending on the age of the candidate and their natural skin characteristics. This can reduce the number of follicular units that can safely be removed. Also, reduce the speed of the punching and extraction process. Resulting in smaller procedures being performed to maximise the quality of the hair grafts taken and later growing.
It is common amongst practised BHFUE practitioners to perform smaller sessions. Smaller sessions seem to be the optimum way to go. Healing is better. Trauma to the skin and surrounding hairs minimised. As well as the yield improved. Obviously, this takes longer to gain the desired result. But, as the goal is to achieve the best result possible. In the recipient and donor areas. The time frame should be secondary.
Body Hair Characteristics
Due to genetic variants, body hair will behave differently depending on the position on the body. The largest variant when compared to scalp hair. The hair characteristics and growth rate. The fact that body hair has a very short anagen phase and a very long telogen phase. The natural growth cycle of body hair is slower and shorter compared to scalp hair. The anagen, or growth phase is shorter resulting in the hair taking longer to grow in length.
The compatibility of scalp and body hair is very important. This difference in the growth rate can expose the difference between scalp and body hair when placed in the same area. This contrast can also be exposed if the hair characteristics are not similar. Hair diameter or calibre, curly or straight, and the hair colour may subtly different. Usually, the colour is rarely a limitation. But the curl can sometimes differ and there must be a satisfactory degree of compatibility for the body hair to be a viable resource.
Body hair is largely single hair units. Occasionally two hair units but rarely larger. This contrasts to scalp hair that ranges from single up to four hair units growing around the scalp. When transplanted the number of hairs per follicular unit will impact of the hair coverage and the density placed by the Doctor. With a scalp hair transplant, the average hairs per graft/unit is calculated as 2.2 hairs opposed to 1.2 with body hair transplants. As a result, this will impact on the coverage achieved when comparing the same number of hair graft used. The body hair characteristics can occasionally help to balance this. But not to the extent the results can be matched or equal.
Body hair characteristics may also lend themselves to be used in a specific area of hair restoration. Using the body hair as a “filler” to increase the look of hair density between the existing scalp hair growth. If the body hair calibre is coarser this can help to camouflage the difference between the two hair types. This is opposed to placing thick body hair grafts along a hairline. When the difference can be badly exposed. Resulting in an unnatural often “plug like” looking hairline result.
Strong Donor Area Resource
Using body hair, in certain special instances, can be a viable answer to repair or continue surgical hair restoration. With scalp hair being prone to the male hormone byproduct Dihydrotestosterone. That triggers the male pattern baldness gene. The use of DHT blockers or suppressants may hinder the use of body hair as a safe donor resource. Medications such as finasteride may cause body hair BH to thin. Possibly even shed, fall out and not regrow. If this is the case body hair cannot be advised to be used. As the potential for the hair to survive could be minimal.
Beard hair is very prominent on the face. Any visible scarring above the jaw bone would easily be noticeable. Especially if clean-shaven. A reputable doctor wants to minimise the risk of any visible scarring. Extraction can be performed under the jawline and chin areas. Often a plentiful donor hair resource anyway. Chest hair on a good candidate can be a strong donor resource. Although, care in the punching is vital. For example, if living an outdoor lifestyle can leave visible small white dot scarring. If the extraction is spread between the existing hair growth this can easily be hidden. But if all the hair is removed there is no camouflage.
To take the entire area of body hair is often simply not realistic. Respectable doctors that understand BHFUE will often perform a smaller session initially. Ensure healing is good. Then increase the size of the session. Regardless, a natural looking growth of hair must remain in some areas. Space has to be left between each punch mark. In the instance of a beard, to “design” natural looking beard growth. Not just leave patches of thick and thin hair. The same applies to other areas of the body that may normally be covered. Occasionally maybe exposed in public.
Advantage and Disadvantages
There are, maybe obviously, two schools of thought to the use of body hair as a donor resource. For some, they do not believe it is a viable technique at all. That transection rates are too high. That yield is too low. That results do not blend with the scalp hair. resulting in an unnatural appearance. Then, those who promote the use of body hair. As the answer to many hair loss sufferers whose scalp donor has been depleted. Adding to the hair restoration Doctor´s ability to restore a better, more natural hair coverage, or help to camouflage old scarring. A few, pros and cons to consider about body hair FUE:
PROS
FUE leaves no linear scarring
Ideal for smaller procedures
Able to “cherry pick” the hair follicles to suit the area of placement
Widens the available donor area
Gives an alternative to repair patients
CONS
Can leave the appearance of visible white dot scarring
Slow to perform so the graft number can be low
The potential for increased transection and lower yield
Hair characteristics may not be compatible with the scalp hair
Cost is generally higher than scalp hair transplant procedures
When researching discuss your options with a number of doctors. All who specialise in performing body hair FUE – BHFUE transplant procedures. Receive a variety of opinions as to their approach and recommendations. protocols will vary from Doctor to Doctor. Do not assume all use the same methods of FUE to extract the hair follicles. Or their donor hair planning may vary. Compare results of BHFUE patients that have similar hair characteristics to your self.
