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| Body hair transplant (BHT) |
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 There are about one hundred thousand hairs on the normal human head and about 1 million hairs of the body. Person having major loss of class 7 (almost 75000 hair out of 100000 are lost) may not have enough donor hairs at the back and side of the head (only 12500 hairs out of permanent 25000 may be transplanted). Often donor hair may be even less. This situation made some surgeons to look for other Body hairs. Body Hair Transplant (BHT) as a major plus point may become donor hair because they are not genetically DHT susceptible hairs as some of the scalp hairs in MPB (Male Pattern Baldness). But there are many issues with the effective use of BHT as routine. The conventionally used donor hairs from the back and sides of the scalp are very much similar to the hairs to be replaced in MPB but the characters of the BH has many variations such as thickness, length, colour, texture, the growth period etc. As a result for many years BHT was given the back seat. But some studies have shown that BHT hairs may change some of the character if not fully but partially when transplanted to the scalp (recipient "co-dominance" - or partial donor dominance) and this generated more interest and BHT is now being seen more seriously. . BHT is not widely practiced because, it requires special instruments, is very time consuming and the results can be somewhat unpredictable. Results are typically not at par with scalp hair yields many patients consider body hair unnecessary and try to remove it. A body hair transplant serves a dual purpose by moving unwanted body hairs to the scalp, where they are more productive. For common baldness primarily the hair roots from the back side of the head is preferred because of their better quality and predictability but in some situations hairs roots from other part of the body are used which is called BHT
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Procedure:
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Essentially it is FUE (Follicular Unit Extraction) but often; acute exit angle; bulky soft tissue underneath without strong bony support of Body hairs makes it more difficult than that from the scalp. Usual sites are Beard, Pubic, Chest and Back. |
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Advantages of Body Hairs:
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- Esp. Valuable when scalp donor is exhausted or limited Minimal evidence of scaring due to FUE technique used
- Large Donor area of Body hair pool
- May be a better choice for eyebrow reconstruction where one can have better matching hairs then the fast growing thick scalp hair
- DHT resistant hairs
- BHT can be used to feather out the hairline by cherry picked fine Body Hairs in patients with coarse donor hairs in the occipital area.
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Disadvantages:
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- Slow procedure and very taxing for surgeon not only due to awkward positioning but also this is due to acute angulations of more superficially placed follicles. The follicles are often in the more bulky soft tissue with less bony support. Some of the Body Hairs are not strong shafted to facilitate easy extraction.
- Not all Body Hairs are of good quality some may take long time to grow, and may not even grow long & thick enough (We believe Beard, armpit and Pubic hairs are of better quality hair for head hair replacement) This May leave pigmented or Hypo pigmented marks in donor site esp. in dark skin
- Most FU have one and very few have 2 hairs. Whereas 3 and 4 hair FU in BHT are practically non-existent. So we are transferring less number of hairs and therefore BHT turn out more expensive to patients.
- There is cyclical variation in the amount of coverage that the body hairs provide. Body hairs often grow longer than in their original location, but do not grow as long as scalp donor hair.
- Persons with Fitzpatrick type 3-6 skins are prone to healing with initial hyper pigmentation (much like the dark marks that you get temporarily subsequent to an acne attack) Sometimes, instead of dark pigments, you could get lighter pigmentation (hypo pigmentation) in the initial phase as well. The improvement of hyper pigmentation (dark spots) can be hastened by the use of fading creams. Wounds that heal initially by hyper pigmentation can end up finally with a much shrunken spot that is either normal in color relative to the surrounding skin or may assume a relatively faintly hyper or hypo pigmented hue.
- Follicluitis esp. in case of buried or transected follicles with ingrown hairs may sometimes need antibiotics or steroid to resolve.
- Keloid esp. is possible in the chest and shoulder area- one may do a small test grafting
- Redness for few weeks may be possible avoid sun exposure and use steroid application
- Unpredictable growth at times
- Synchronous cycling is a possibility where a lot of transplanted hair cyclically falls during the same period.
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Precaution:
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For avoiding the telogen hair from extracting you need to shave the area about 4-5 days in advance of the procedure because the telogen hair are likely to be damaged during extraction due to flimsy the nature of its secondary germ structure.
Body hair varies in caliber, texture and color. It is recommended to mix body hairs with scalp hair to achieve a uniform look and feel.
Body hairs from various areas have been used:
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Dry zone: Beard, chest, back, limbs, abdomen |
Wet zone or Apocrine zone: Armpits and pubic hairs. In the case of sweat produced by the apocrine glands, which are located near hair follicles on the scalp, underarms, and groin area, the sweat contains fatty compounds. Bacteria feed on this sweat when it is secreted to the skin’s surface, and the resulting waste products, fatty acids, ammonia, and chemical reactions form a an odor which is unique for every individual. |
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Precaution:
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- 1. Obviously the most common use of BHT is as a viable option for those whose traditional donor hair supply is depleted.
- 2. To feather out hair line by cherry picked thin and soft body hairs esp. in the people with strong and coarse scalp hairs where taking the thin hairs from the nape of the neck or pre auricular area may not be a good option because they do not belong to what is conventionally called safe donor zone of scalp.
- 3. To camouflage the widened strip scars of already depleted donor area where taking further the hairs from the scalp either by strip or FUE is not a sensible option. Coarse Beard hairs and other BHT from Apocrine area, which grow thick and long is a good option.
- 4. Body hair is an excellent filler to increase the density for use in between the thin density of scalp hair.
- 5. Transplanted scalp hair for the eyebrow restoration may not be the best match and grow very fast and need to be trimmed often. Some body hair with better match (lighter colour, thinner diameter and slow growth compared to that of that of scalp hairs).
- 6. Body hairs may be used for restoration of the hairless scar etc that become more obvious in the exposed part of the body.
- 7. Donor recharging or Donor sealing of the scalp donor area by BHT esp. when the scalp donor area is very thin.
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