Sanusi Umar, M.D., a clinical instructor of medicine in the Division of Dermatology at University of California at Los Angeles, describes a series of 122 patients in which he used body hair transplants to treat baldness. Results from the series, published November 2016 in the Aesthetic Surgery Journal, suggest that using follicular unit extraction (FUE) to harvest body hair to treat baldness is a viable option if one chooses the right patients.
Dr. Umar, who has a U.S. patent for the UGraft and UPunch technologies (Pro-Dex) used in the study, documents the experiences of patients at his practice from 2005 to 2011. He preselected these patients for having adequate body hair from the beard, trunk and extremities to transplant to the scalp. He also reports on what the patients who responded to an emailed survey had to say about their outcomes.
Body hair transplant candidates often are those who lack head donor hair to treat scalp baldness and must have a lot of good quality hair in the beard or on other body areas. Dr. Umar writes that shorter and finer leg hair can be used to treat hair loss at the hairline and temples. Beard hair, which is coarser, is better for creating density and repairing surgical scars.
Something to keep in mind: Body hair tends to retain its characteristics after being transplanted. As a result, it’s important to adequately match follicle diameter, hair color, curliness, texture, growth rate and shaft angle to the recipient site, according to Dr. Umar.
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Hair Transplant How-To
Dr. Umar used the previously described follicular unit extraction, which generally involves transplanting about 1,500 to 1,800 grafts in an eight- to nine-hour operation, divided into graft extraction and placement.
He performs graft extraction with a hypodermic needle with a modified tip, called the UPunch Rotor. Dr. Umar describes it in the paper as having a circumference that is flared outward to form a punch-like instrument mounted on a rotary tool — a modification that minimizes graft damage and lessens follicle injury.
When it comes to extracting gray hairs, Dr. Umar uses only 18-gauge needles because using smaller punches could increase the risk of disrupting follicle integrity and viability. He hydrates grafts with a piece of wet gauze, using a two- to three-minute interval between scoring and follicle removal. Dr. Umar automated this process with his UGraft Revolution.
Because some grafts separate from all tissue attachments following UPunch Rotor scoring, Dr. Umar uses a the “FUE swipe maneuver” to quickly identify and remove the follicles, as well as store them in physiologic media, separately ahead of attached grafts. This involves rubbing wet gauze over donor areas soon after scoring 50 to 100 follicles.
Dr. Umar leaves postoperative non-head hair donor sites open and coats them with bacitracin or Neosporin ointment (Johnson & Johnson Consumer) for seven days post-op, twice daily. He also uses triamcinolone lotion 0.1% once daily, the first three days post-op.
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Patient & Peer Input
There were 79 patients who responded to the survey, an average 2.9 years after their last surgeries. On a scale of 0 to 10, with 10 being the highest, patients reported an average 7.8 for healing status, hair growth in recipient areas and overall satisfaction with surgery.
Hair transplant surgeon Alan J. Bauman, M.D., medical director of the Bauman Medical Group, in Boca Raton, Fla., says he uses body hair transplants in appropriate candidates.
“In my practice, body hair is used when scalp donor follicles are limited by previous surgery or other factors. Patients who want more density but have limited scalp donor are typically excited with the prospect and the results of using body hair to accomplish their hair restoration goals,” Dr. Bauman tells Cosmetic Surgery Times. “I’ve successfully used FUE to extract body hair follicles for implantation into the scalp for density and for scar coverage. Mainly, we use beard hair because it is the most robust and has long anagen (growth) cycles. However, FUE harvesting of follicles from the chest, abdomen, extremities… even pubic and axillary harvesting is also possible.”
According to Dr. Bauman, transplanting mixed scalp and body hair into the crown area is effective. He says patients who have old-style linear scars from strip harvesting are the most thrilled with the use of body hair to camouflage those telltale scars.
“My experience with FUE since 2001 has led us down this path, and I have also found that patients, when selected properly, are quite happy with the results as Dr. Umar has described,” Dr. Bauman says. “My caution to hair transplant novices is to be careful to explain to patients the differences in hair quality of scalp versus body hair follicles and to avoid areas where these differences in the transplanted hair quality might be more noticeable, like the hairline for example.”