For certain patients, body hair can become the source of several thousand grafts additional donor material, especially when patients have a high amount of body hair at their disposal. This extended donor area is especially indicated to increase the overall hair density or to fill in a crown area – treatment options that would not otherwise be possible for patients with limited scalp donor hair. Body Hair Transplantation is however not really indicated in case of a full hair reconstruction or to restore the patient’s hairline.
Body hairs are removed using the FUE technique, leaving no linear scar. Body hair grafts are then implanted in the same way as grafts of head hair.
Generally speaking, donor hairs are taken from the tonsure, i.e. from the back or side of the head. Patients with insufficient hair in the donor area are unsuitable for a normal transplant. The reasons for not having enough hair include normal hair loss or result from previous hair transplants making any further extraction of donor hairs from the head impossible.
The results of a hair transplant with unsuitable donor hair are generally unsatisfactory, as these can only compensate hair loss to a minor extent. Moreover any resulting scars will be visible.
Dr. True uses a special technique to determine the feasibility of a BHT - the Torso Donor Index, or TDI for short. Used for assessing the donor area for a body hair transplant, the TDI takes five criteria into account:
Where the Torso Donor Index is less than 4, the patient is deemed unsuitable for a body hair transplant. Patients with a TDI score of 5 - 7 may be suitable under certain circumstances. Patients with a score of 8 or more have more body hair than head hair suitable as donor material and are therefore suitable candidates for a body hair transplant.
The technique for transplanting body hair is derived from the FUE technique, and basically involves extending the donor area to the whole body. BHT is used primarily in cases where the donor area on the head is no longer suitable for the extraction of donor material or is not dense enough.
In such cases, and provided the physical requirements are met, follicular units can be extracted directly from different area of the body - torso, arms or legs - and transplanted to the scalp. The BHT-FUE method opens up new possibilities especially for patients whose donor areas have been badly used or even destroyed through the use of outdated methods.
Candidates for a BHT must meet certain physiological requirements, e.g. the body hair must be suitable for use as head hair. Body hairs are subject to different growth cycles. Whether these change over the course of time has not yet been scientifically proved, though our own experience points to this being the case.
FUs taken from the body are anatomically different to hairs taken from the head. Whereas FUs taken from the head generally consist of 1, 2 or 3 hairs, in most cases FUs from the body only have one hair.
The principal differences between a body hair FUE and a conventional FUE:
It is absolutely necessary for the hair surgeon doing such a transplant to have adequate knowledge and experience of both transplantation techniques - FUT and FUE - and to take certain basic principles into account, for such a transplant to be successful. These include:
There are 3 key success factors for any BHT:
1. The extraction of the hair follicles
2. The growth cycle of the body hairs
3. The compatibility of head and body hairs
This technique can be used to reduce the size of large bald patches or - in the field of reconstructive hair surgery - as a way of reducing the size of scars resulting from burns, accidents, previous transplants or infections.
To do this, an elastic band and 2 rows of small metal hooks are implanted into the bald scalp. The extender works like a rubber band, gradually pulling the scalp together and making it smaller. Through this pulling together, a fold of skin is created which needs to be removed by surgery. The result is that the previously bald patch is now covered by the parts of the scalp with hair. This operation can be repeated many times, enabling baldness to be completely eliminated.
The Frechet extender consists of an elastic band made of silicone and hooks made of titanium. After implantation it is invisible.
The expander technique is another method used to reduce hair loss and remove scarring. A balloon made of silicone, the so-called expander, is inserted under the part of the scalp covered by hair. The latter is then stretched by gradually inflating the balloon. An operation is then performed to remove the bald patches / scars, with the hair-covered scalp formed by the expander then being used to cover the former bald patches.
Both techniques - expander and extender - are carried out under local anaesthesia and enable scars to be corrected so well that they are hardly visible any longer. Both use implants inserted under the scalp for a short period, and both methods require a lot of patience, as the results are often - as with a hair transplant - only visible after a number of months.
This method is suitable for correcting problems often occurring after extender treatment. One such common problem is an unnatural hair growth direction.