Body hair for transplant? Which type is best?*

[gillenator]

Definitely some good points and information outlined by Dr. Cole. It seems that beard grafts have become the buzz these days but I whole heartedly agree with many of the points that Dr. Cole mentioned.

On another thread I had mentioned the differences in characteristics of various BH sources, especially beard donor.

1) Beard hair can in fact bear acute visual differences in their characteristics as compared to the patient's scalp hair. For most, beard hair grows more kinky/wavy however in my own observations, it does grow to length unlike leg, back, abdomen, etc.

2) It appears that beard hair has more consistent growth periods or longer duration once within the growth phase although there are few to no clinical studies outlining or identifying differences in growth cycles of various BH sources.

3) BH from the beard typically has a much greater degree of coarseness as compared to the patient's own scalp hair. And this becomes even more visually noticeable if there is diffusing native hair within the recipient area.

4) These fatter beard grafts can stick out visually speaking on patients that have a wide hair to scalp color contrast, especially dark hair on a fair complexion. And if the beard grafts are used on the hairline, they can appear unnatural because of the visual differences in hair shaft diameter. So even if there is no kink or acute wave to the regrown beard hair, the differences in caliber can still be a big issue. This becomes even more noticeable as the diffused weak hair is lost over time but the beard hair will stay.

5) BH from the legs, back, chest, etc does not appear to be as coarse as beard grafts for most people, but may not grow to length, and the yield and survivability is very unpredictable as was mentioned.

So yes, I have always been an advocate of doing tests sessions before committing to any larger sessions. And as I have stated before, these BH grafts can be located in a lower visual impact area like the midscalp to monitor yield and compatibility. Some docs use a special ink to mark, chart, and identify a well defined surface area with very small dots where the BH grafts are placed with no other scalp grafts. The area does not have to be large, usually a squared centimeter of space to start with.

Good thread!

[wylie]

I wouldn't argue too much with what Dr. Cole said, other than one comment, where he said "I am the expert on BHT", which is not true, and has never been true. Dr. Umar is the current expert on BHT, and I'm not sure who "they" is that he is referring to asking him to speak on the matter, but Dr. Umar's research is published in peer reviewed medical journals, and his results speaks for itself.

Sorry Dr. Cole, but you aint the expert on BHT. That title would be shared between Dr. Woods and Dr. Umar, with you finishing a distant third.

And speaking from my own experience, having over 5000 beard grafts extracted, beard hair can be trained on the scalp over time, repeated combing can help with the natural tendency for this hair to be curly to the point of being kinky, and if you cut your scalp hair short, say around an inch to an inch and a half, it is virtually indistinguishable from scalp hair. When it grows over 2 inches in length I personally have to use some kind of styling gel (I currently use Samy styling gel, works great) but when it is under 2", I don't have to use anything.

It does get tricky in the strip scars, I don't like to shave the back too short, due to numerous strip scars, and the beard tends to curl up in back, which makes it noticeable, and my barber knows to clip this hair separately during each haircut.

As far as I'm concerned, this is a far better option than having to wear my hair much longer in back due to long lines of bald scalp in the back that was still visible with long-ish hair in back. These scars are no longer noticeable after around 1000 grafts into my scars. I even had it shaved close once by my barber, and it looked passable, but I was not comfortable enough to wear the look full time. However, shaving it close was not an option before I had beard into my scars. I'm thinking SMP added to the beard in the strip scars could be the coup de grace, but that industry worries me and seems to be crawling with con artists and charlatans, much like the HT industry of the 90's.

My research is ongoing.

[ukcali]

Thanks again everyone for your answer. The more information the better I think!


A very big thank you to Dr Cole for your long and detailed answer it's very much appreciated

Oh goodness, here we go again with body hair.

Around the turn of this century body hair hit the chart. Let me briefly review the history and results.

In 2002, Ray Woods had reported on successful body hair transplants. By 2003 I was moving hair from the chest, abdomen, back, under arms, pubic area and legs. My first few cases were enormous successes. Then trouble hit. Some results were not so good. Then i began to study variables to achieve success with BHT (body hair transplants). Anagen hairs grow better than telogen hairs, but telogen hairs grow. Dense packing with BHT results in less growth. Optimal densities with BHT of less than 36 grafts per sq cm produce a better survival rate. Dense packing a combination of BHT and scalp hair can impair the survival rate of BOTH. Don't do it.

With BHT about 25% of the cases result in noticeable hair growth. The rest get cosmetically insignificant growth. BHT can result in a rescue for those with scars and larger grafts, but it may not. Then again, good yields can sometimes fade over time especially with leg hair so be prepared for this.

Head hair is king. The next best is beard. We began moving beard hair around 2007. The first thing we noted was how fast beard hair extractions healed. The second was how high the yield was on a consistent basis (about 60%). Then we noted that beard hair produce a better cosmetic result than a higher number of other sources of body hair. Beard is second best.

What is the problem with beard hair? It is very coarse and curly, wavy, kinky. Some don't like it.

Here is what i recommend. Do a trial of bear and see how you like the healing and the growth. if you don't like it, try something else. Here is the other problem with other sources. White dots or hypopigmentation. At least 50% of chest and abdomen harvests get white dots. White dots are very uncommon on the legs and more common on the back, though not anything near as common as chest and abdomen. Pubic and axilla hair area hard to harvest.

Like I said hair is king. Use it fist. when you run dry or if you have very bad scarring due to strips of scalp reductions, or flaps, you may need to try BHT. Do a small session of 500 grafts and see how you respond. if the response is good, do more. If not, stop. If you like the appearance, do more. If not, stop.

That's the summary. I can expound if you like as I've done in the millions of body hair grafts. I am the prevailing expert on BHT as i'm the guy they ask to speak about BHT or write the chapter on BHT. A summary is adequate simply because they work in some and if they work you are happy. In some they simply don't work. Beard is the exception as it consistently grows, but you may not like the appearance of the grafts.

The one caveat I have not mentioned is that BHT seems to grow better with Acell and PRP.

[gillenator]

wylie,

You may have already mentioned this but how long ago did you have the 5,000 beard grafts, where did you have the procedure done, and how would you rate the overall yield in terms of percentages?

Glad to see that you are happy and your comments on training the beard hair as it achieves length is great to know. Beard hair obviously has a much greater degree of coarseness. What is the maximum length that it has grown in inches?

Thanks again for sharing your details.

[ukcali]

Quick thought just crossed my mind. Could chemically straightening your train sort out any wavy etc body/beard transplanted hair?

Lots of girls have it done and it makes your hair much smoother. Google it to see what I mean. It was just a thought that it could work

[35YrsAfter]

Identical twin hair loss studies indicate that hair dyes and hair straighteners can be detrimental to healthy hair growth. I use hair dye every month or so and haven't noticed any negative effects.
As I have stated before, identical twin studies indicate the big three things to avoid are smoking, stress and overexposure to the sun's rays on the scalp.

-35YrsAfter works at Dr. Cole's office

[wylie]

wylie,

You may have already mentioned this but how long ago did you have the 5,000 beard grafts, where did you have the procedure done, and how would you rate the overall yield in terms of percentages?

Glad to see that you are happy and your comments on training the beard hair as it achieves length is great to know. Beard hair obviously has a much greater degree of coarseness. What is the maximum length that it has grown in inches?

Thanks again for sharing your details.

Well, I have had 4 surgeries of 1500 grafts each, with around 1000 or so scalp grafts rebuilding my hairline. If you have only had strip, and are stripped out, FUE can still harvest some scalp grafts that are not available by strip harvesting, usually 1000 at a minimum can be found, but 1500 to 2000 are possible as well. The rest have been all beard grafts. I believe my first repair was done in either 2009 or 2010, and then, in 2011, a combination of impatience and down time allowed me to get two surgeries done in a time span of three months. Even though not the recommended approach, I was on medical leave from work and had one done in September, a month before my return. When I got back, I found out I had 2 weeks vacation, even though I had been off from work all year. So in December, I had another done, and my most recent surgery was 9 months ago, and the fourth surgery was mainly in the strip scars, with around 500 grafts added on top.

So that is four surgeries in total. My hair looks like something I never before thought possible, to go from hopeless to a normal appearance is hugely satisfying.

As far as length goes, I have had my hair around 3 to 3.5" in length on top, but I'll add that I need to use a gel to keep everything in place. At its present length of around 1.5", no gel is necessary.

And let me state there is no way in hell anyone could tell that beard hair is scalp hair at short length. When it grows longer, it sometimes does not lay straight and it can stand out a bit from scalp hair, but would anyone even notice? I highly doubt it. I barely can and I know what to look for. In my opinion, there is no noticeable difference between scalp and beard hair, at least in my case. I read constantly about people saying "it only should be used for repair" or for those "desperate cases" or whatever other reason one can come up, but I honestly cannot see any difference on the scalp. If there is a noticeable difference, it is strip scar repair. The hair has a tendency to curl up, which is far more noticeable than on ones scalp, which isn't really noticeable at all.

My only advice is it is best worn short on top, and if you grow it longer, it is best to use a small amount of gel or hairspray on top. Right now my hair requires no maintenance on top at all when short, and that was NEVER the case before I got butchered all those years ago, and had virgin scalp on top. My thin, wiry hair required a daily dose of gel. Not anymore.

Now on to the yield. This is the tricky part. For my particular case, to achieve this level of repair from 6500 to 7000 grafts, I would have to surmise the yield is at least 80%. I've seen alot of videos with graft counts to think that, considering my dreadful state at the start of my repairs, the yield had to see at least 5000 grafts grow, but possibly more, I honestly cannot say. If the yield was less than 5000 grafts than beard hair produces even better results than I thought possible, but it is also possible the yield is higher than 80%. My results would back that up.

Really, accurately stating ones yield is tricky, with the doctor being the best judge in this regard. We all know that doctors are more than likely to give you best case estimates, so I base mine on my results versus the graft count, which I believe makes it safe to say that my yield would be 80%. I cannot imagine less than 5000 grafts could give me this result.

I plan on getting some good pics. of my hair in its present state and will post them here when I do. I don't have too many "before" pics, but Dermhair clinic does. I personally don't want to remember what I looked like in 2009, it was pretty scary (), and I was not seen without a hat. That is a habit I am just now learning to break. It's really fun going out and about without one.

[ukcali]

[QUOTE=35YrsAfter;128675]Identical twin hair loss studies indicate that hair dyes and hair straighteners can be detrimental to healthy hair growth. I use hair dye every month or so and haven't noticed any negative effects.
As I have stated before, identical twin studies indicate the big three things to avoid are smoking, stress and overexposure to the sun's rays on the scalp.

Interesting point. Whist I don't disagree for a second that dyes and straightening must be bad for your hair, many women (and men) spend their lives dying/blow drying etc their hair and have no issues whatsoever. Is it just that transplants hairs are weaker? So maybe more susceptible to damage? Or is the study showed that these things are "bad" for your hair but didn't necessarily say that it'll damage your transplant?

[35YrsAfter]

The identical twin study did not include hair transplant patients. The study's purpose was to determine how "set in stone" the effects of a person's genes are on hair loss. The study demonstrated that the effect of a person's genes can be "swayed" a bit in both directions.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant - Atlanta
Toll Free 1-800-368-4247
Phone 678-566-1011

[gillenator]

Wylie,

Let me first state that I am very happy for you regarding your matured results. That was a lot of grafts that you had! It sounds like the beard hair was a good option for you as long as you keep it short as you stated.

True, it is very difficult to determine the overall yield with a session that large and then trying to determine which grafts were beard and which ones were scalp. Either way, the bottom line is that you are happy with the end result and have been able to achieve the level of coverage that you wanted. And from where you came as a repair patient, I would say that was a huge success.

Look forward to your pics and wish you the best in your new appearance.

[didi]

This is why you need to be careful with BHT, look at this case

2000 chest only on true nw6

http://www.woodstechnique.com.au/large-norwood-7-2000-fue.html

bad hairline, yield and hair growth/direction is sub par

[35YrsAfter]

It's often difficult to evaluate a result from photos. 2,000 grafts on a Norwood 6 or 7 is a pretty insignificant number. Severe cases of hair loss require several passes. Of course finer hair should always be used on hairlines, so the shortcomings of the first pass should be anticipated and planned for so they can be addressed later.

35YrsAfter also posts as CITNews and works at Dr. Cole's office

[gillenator]

Although it may be true that 2,000 grafts spread throughout such a wide recipient area is not going to show much visual gain, still, having the procedure done in 2011 where is the length of the chest hair grafts? No mention made if he was cutting the hair shafts, but it certainly does not appear so nor that he has done anything else to the hair.

The other missing element is a good quality photo of his chest area before and after the extractions. What was the length and quality of the original donor hair? We do not know and so the integrity of the regrowth is also questionable.

To clarify, I am not saying or implying that this case was a failure. There is no audio statement made by the patient post-op so we really do not know if he is satisfied with the first BH pass or not. I mean did he send Dr. Woods the photos because he is not happy "or" for the purposes of planning the second procedure. The clinic did not hear from him for two years?

Obviously his expectations before surgery were discussed with him. And we have to be careful because it is his appearance, not ours. His goals and expectations may be totally different for what we might expect from 2,000 chest hair grafts. And I would not call that a hairline but more of a frame.

After reviewing the case, I wonder why no scalp FUE was used especially in the frontal zone. Very possible that Dr. Woods may have initially advised against surgery with the patient. Possibly after consideration of the surgical limitations, the patient still wanted some level of coverage to build confidence in his appearance.

Some individuals living with advanced classes of hairloss can have much lower expectations than those who still have a fair amount of hair volume and density.

[didi]

Considerin this surgery would have cost him $30K its safe to say the outcome is disappointing.

Sounds like patient isn't happy with this result, you can tell by dr woods comments.

I don't think this patient have more confidence now than he had before HT, trying to imagine this guy under normal sunlight.

[gillenator]

Considerin this surgery would have cost him $30K its safe to say the outcome is disappointing.

Sounds like patient isn't happy with this result, you can tell by dr woods comments.

I don't think this patient have more confidence now than he had before HT, trying to imagine this guy under normal sunlight.

You are right about the cost and yes I did get the impression that he is not happy, especially since there was no commentary from the patient. Again I wonder why no scalp FUE. It's also cheaper in cost as compared to BHT.