Body hair transplantation offers hope for patients with depleted scalp donor areas. This case study documents one patient’s 14-month journey with 5,000+ body hair grafts.
What is Body Hair Transplantation?
Body hair transplant (BHT) harvests follicles from the chest, back, beard, or other body areas and transplants them to the scalp. It’s typically reserved for patients who have exhausted their scalp donor supply.
BHT requires specialized skills and equipment. The procedure takes longer than standard FUE because body hair grows at different angles and depths than scalp hair.
Case Overview: A Complex BHT Candidate
Body Hair Transplant results (BHT) are beginning to trickle in.
This body hair case was done just shy of 14 months ago.
It shows that body hair transplant procedure is a viable entity and a valuable source for hair transplant surgery in cases of a limited scalp donor area.
It is not easy to perform given today’s tools. One must be somewhat of a contortionist to successfully perform the procedure.
Expanding Hair Supply For Hair Loss Patients
This patient had exhausted traditional options. Here’s what we were working with.
Procedure Details
This case was 8 consecutive days of surgery.
During this time, we softened the hairline with about 1000 grafts taken via CIT from the scalp donor region and about 5000 BHT grafts into approximately 80 square cm of a bald crown.
Patient Background
You can see that he had many procedures in the past to treat his hair loss.
He had a limited donor supply, a low follicular density, multiple strip scars, and a tight scalp.
Prior to seeing me, he had given up on hair transplant surgery and began to wear a hair wig.
He is now hairpiece free.
Early Results at 14 Months
He has dyed his hair from white to brown.
This effort makes it more difficult to achieve the illusion of coverage.
Many of the body hairs are still short and fine. Many have not begun to grow. Many have only begun to grow.
It will be very interesting to follow him for the next 12 months.
We are cautiously optimistic about the potential for body hair as an additional source of hair for the bald or thinning scalp.
4 Years of Progress: Long-Term Follow-Up
In some instances, results seem to improve two or more years after the body hair transplant procedure.
It is important to note that body hair transplantation results may vary. this is a good example of great improvement 4 years post-op B.H.T
Key Findings From This Case
This case reveals many points for consideration.
First, BHT densities above 60 grafts/sq cm can be viable.
Second, 8 consecutive days of surgery into adjacent regions of the scalp can be well tolerated.
Third, in the second year, a higher percentage of body hairs begin to grow. There are many grafts that are just beginning to grow. I suspect that even more is going to grow.
Fourth, BHT can be done with minimal evidence of scarring.
Fifth and most importantly, BHT can be considered a valuable source of hair for the patient with hair loss and he can achieve a cosmetically significant result from its use alone.
Hair Length Observations
There does appear to be some increase in hair length with some of the BHT, but I cannot be absolutely certain at this time.
As previously stated, there were some grafts from the scalp in the crown area at the time of initial presentation to my office.
Like many of my FUE patients, he chooses to wear his hair quite short.
He shaves most of his body hair so it is not possible to document a non-shaven hair length.
How Different Donor Sites Perform
Not all body hair is created equal. Each donor site has unique characteristics that affect results.
Other interesting points include the difference in coverage for some regions.
Each day, we treated a zone. Each day, we harvested from a different region of the body.
Some days from the back. Some days from the mid-sternum. Some days from over the pectoralis muscles. Some days from the upper, lateral chest.
Hair Characteristics by Region
The hairs and the telogen percentages from each area can be quite different.
Anagen ratios are higher in the mid-sternum.
Hairs on the central chest are more coarse.
Hairs on the upper chest are finer.
Hairs on the back and upper shoulders are often much finer.
Interestingly, sometimes the anagen ratio of hairs over the latissimus dorsi muscles is much higher.
Evidence of Increased Hair Length
We are still waiting for even better evidence that the length of hairs can increase following BHT to the scalp.
We have seen an example of leg hair that grew significantly longer in the supraauricular area.
I am fairly certain that some of these body hairs have grown longer than 4.5 cm, which is about the maximal length for most chest hair.
The Science Behind Body Hair Growth
Understanding why body hair behaves differently helps set realistic expectations.
We have never considered the use of BHT experimental.
I have heard through the grapevine that some have considered it as such.
Hair is hair. If you transplant it, it should grow.
When we began transplanting body hair, the questions that remained to be answered were the issues of scarring, the rate of growth, yield, and length of growth.
Understanding Graft Yield
Recall that if you move 10 head hairs to the leg, only 6 will grow.
If you move these 6 back to the scalp, 5 will grow.
These yields correspond to the higher anagen percentage on the scalp and the higher telogen percentage on the leg.
Head hairs grow short on the leg or eyebrow.
It follows that body hairs should grow longer on the head.
Who is a Candidate for Body Hair Transplant?
BHT is not for everyone. It’s a specialized procedure for specific situations.
Limitations and Risks of BHT
We believe in honest communication about what BHT can and cannot achieve.
How long does it take to see body hair transplant results?
Initial growth appears around 4 to 6 months, but body hair has longer growth cycles than scalp hair. Significant improvement often continues through year two. This case showed continued progress at the 4-year mark.
What is the survival rate for body hair grafts?
Survival varies by donor site. Beard hair typically yields 75% to 90%. Chest hair ranges from 50% to 75%. Back and shoulder hair may yield 25% to 60%. We recommend test sessions of 50 to 500 grafts before committing to larger procedures.
Will body hair grow longer once transplanted to the scalp?
Evidence suggests body hair may grow longer on the scalp than it did on the body. We’ve observed chest hairs exceeding their typical 4.5 cm maximum length after transplantation. Research continues on this phenomenon.
Does body hair transplant leave visible scars?
Scarring depends on the donor site. Beard extraction typically heals with minimal visible scarring. Chest and back extraction may leave noticeable marks, especially in patients prone to scarring. We assess healing potential during consultation.
Can body hair be used for the hairline?
Body hair is generally not ideal for hairlines due to texture differences. In this case, we used 1,000 scalp grafts for the hairline and reserved body hair for crown density. Blending scalp and body hair creates more natural results.
References
1. Umar S. Body hair transplant by follicular unit extraction: my experience with 122 patients. Aesthet Surg J. 2016;36(10):1101-1110.
2. Saxena K, Savant SS. Body to scalp: Evolving trends in body hair transplantation. Indian Dermatol Online J. 2017;8(3):167-175.
3. Cole JP. An analysis of follicular punches, mechanics, and dynamics in follicular unit extraction. Facial Plast Surg Clin North Am. 2013;21(3):437-447.
