MY EXPERIENCE WITH HAIR TRANSPLANT
Hair transplant is a rapidly evolving field where hair restoration surgeons are trying to find newer methods to improve the graft yield and improve the overall final aesthetic result of hair restoration procedure. Traditionally, hair transplantation utilizes harvesting of follicles from safe donor area of the scalp and transplantation of these follicles into the balding areas on the scalp.
There is a limited supply of follicles to be harvested from the safe donor area zone; approximately up to a maximum of 6000 hair follicular units in best of donor area density. This is inadequate to provide appropriate coverage. In such cases, hair follicles from other parts of body inclusive of beard, chest, arms, and legs in hirsute individuals can be utilized as source of additional donor supply.
Normally scalp hair are used for transplant in any hair transplant procedure. But nowadays in many cases, the patients do not have a good and enough donor area to serve the purpose. Hair from the body is used in such cases of extensive baldness, e.g. transplant beard to head. To treat extensive cases of baldness with poor donor scalp is also treated by a suggestive option by transplantation of body hair into the scalp. Hair treatment in Jaipur is suggested for this.
Body hair transplantation is a relatively new surgical technique used for hair restoration. The scientific basis for the procedure is provided by the concept of recipient influence, which suggests that dermis in the recipient area may exert influence on the growth pattern of transplanted hair and hence when body hair is transplanted on to scalp, it would grow longer, thicker.
Since the procedure is performed by extraction method which produces very small scars, and body is a cosmetically less significant area, body hairs can help to provide an alternative source of donor’s hair in selected patients. Hair treatment is trending and highly recognized in Jaipur. This is particularly so in Indian patients, who do not expose body in public as sunbathing so common in the west, is not popular in Indians. Our report represents additional proof that body hair indeed can be a valuable alternative source in patients who lack scalp hair.
LIMITATIONS OF BHT
the technique has limitations and the concerns that are yet to be addressed fully:
a The procedure is possible only in patients who possess good body hair, as in our patient. His chest hair density was particularly good, with density of 22 units per sq cm (roughly half the occipital area density).
b Routine methods of anesthesia such as infiltration and blocks are not useful and hence the procedure can be painful. This was indeed so in our patient and hence tumescent anesthesia had to be followed, which provided pain-free surgery.
c Only the FUE method is suitable for harvesting body hair. This makes the procedure slow and painstaking.
d The procedure is slow and needs high degree of motivation for the patient
e Body hairs are usually found as 1 and 2 hair units, and hence the density and thereby results achieved may not be as impressive as with scalp hair.
f Body hairs are shorter in length, are thinner and hence their extraction needs special technique and expertise. On an average the roots were located at a depth of only 3–4 mm. Transaction rates therefore are higher. The transaction rates vary in patients from 13% to 32%. Chest hair showed the least transaction rate, while back, arms, and abdomen showed much higher transaction rate. However, since the patient was not bothered about the loss of body hair, the cosmetic impact of transaction was not relevant to the patient.
Lastly, strong evidence for the procedure is lacking. Hence the procedure should be performed only in selected patients, in those who are well motivated, and after proper counseling and consent.
In summary, body hair can be an alternative source in highly selected patients, with poor donor scalp and good body hair. Chest hair is possibly the best among the different body sources, but even this chest hair growth and yield is moderate. Proper counseling is essential before performing the surgery. The method needs to be established properly with more data to define its role and hence the author strongly feels that the current trend of publicizing it on internet websites is unjustified and should be discouraged.
Body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair. The techniques of harvesting body hairs are more time consuming, requiring higher degree of skill than regular scalp FUE. Transplantation procedure can be successfully used in combination with scalp hair or either alone in the cases of advanced grades of baldness, in scarring alopecia and also for improving the cosmetic appearance of hairlines when there is paucity of donor scalp hair. Body hair harvesting opens up a new viable donor source for hair restoration surgeons.