Hair Restoration Blog

We have discussed different methods to repair hair transplant donor scar in the past. There was an interesting article in Dermatologic Surgery Magazine last months on repairing the wide donor scar using body hair by Dr. Robert Jones from Oakville, Ontario, Canada.

Dr. Jones has reports revising a wide donor scar after previous hair transplant surgery by body hair transplant. He uses chest hair removed by follicular unit extraction method using a 1mm punch device. He has transplanted the grafts directly into the scar area so follicular unit grafts did not have to wait more than a few seconds.

Three months post-op follow up pictures were shown with some hair growth on transplanted donor scar with some reasonable coverage. The growth of the transplanted hair is not completed before 6-8 months after hair transplant and it is expected to see better coverage by the end of that period.

I have had a presentation on revising neurosurgical scars using hair transplant with follicular unit transplantation in the annual meeting of International Society of Hair Restoration Surgery in 2007. In that meeting, I presented four patients who underwent hair transplant surgeries to revise the widened scar of their neurosurgical scars. The results of the hair transplant on those patients were great and the appearances of the scars were completely vanished in all four of them.

Again the current article by Dr. Jones proves that hair restoration could be used effectively for improving the appearance of scalp scars. My personal preference and the method that I use in our Los Angeles hair transplant clinics is to use scalp scar rather than body hair unless patient’s donor area is completely depleted and there is not enough harvestable hair on the donor area. In those cases body hair transplant could be an alternative if patient have good quality body hair for a body hair transplant through FUE (Follicular Unit Extraction).

Different types of body hair and the indication for the procedure is a question that I have been asked many times in last week. So that is why I thought I should write a post to answer it for everyone. Body hair transplant has been discussed in Hair Restoration Blog in the past in several posts. Patients ask which one is a better source for body hair transplant to the scalp: chest hair, abdominal hair, pubic hair or armpit hair.

Hairs of the body have different characteristics, than hair from the scalp Pubic hair is generally thicker and curlier than other areas of the body. Chest hair may be thick in some patients, but may be finer than scalp hair. Armpit (Axillary) hair is also generally curlier than scalp hair, but may not be as thick as the other types of body hair.

Before deciding to use body hair, a hair transplant surgeon has to examine the scalp donor hair carefully and then only consider body hair if the scalp hair is severely depleted. Depending on the area that you want to use body hair, you may choose different types of body hair. If you want to choose body hair only to fill in the crown area in patients who already have good coverage on top and front, pubic hair could be a good option.

Research has shown that body hair characteristics may change and become longer when transplanted to the scalp. It also shows the anagen phase of body hair may become longer after transplanting it to the scalp. Which is why this is one more advantage for body hair transplant, but still body hair transplantation needs to be done selectively.

Q:

I am 65 with 2 hair transplant surgery in the past. I ran out of donor hair and I was told I don’t have much more hair for my crown area. Is it possible to use armpit hair and pubic hair for hair transplant on to my crown? Is it going to be a high rate of transection for hair from those areas because of the curly hair there?

A:

The best option is always transplanting hair from scalp to scalp. Scalp hair is the most economical in terms of the number of hair that can stay and grow at any given time. Because of efficiency of hair on the back of the scalp (donor hair), we hardly ever use body hair transplant including armpit (axillary) or pubic hair, but hair from those areas could be used in some conditions such as violated donor areas from old technique surgeries leaving not much donor hair to work with, in presence of large balding area. Body hair transplant, as we discussed before is not a good substitute for scalp hair transplant, because of of the difference in hair growth cycle in those areas as long sleep phase (telogen) and short growth phase (anagen). There are some new studies indicating that body hair may change its trait in favor of recipient area (grow for a longer period of time thus become longer), but it cannot completely become scalp hair.

Body hair transplant with pubic and armpit hair in particular has its own problems. Body hairs have different characteristics from scalp hair. They are limited in numbers and should be reserved for the cases that no other alternatives are available. As we mentioned before, in cases of severely diminished donor hair, body hair could be an alternative to scalp hair. Body hair could be conveniently obtained with FUE techniques. Patient needs to be tested before the procedures with FOX test. If patient is FOX positive, it means that the hair could be harvested for the actual procedure with no trouble.