Indian Journal of Dermatology
Body hair transplant: An additional source of donor hair in hair restoration surgery

Author: Poswal Arvind
Dr. A's Clinic, A-9, 1st Floor, Chitranjan Park, New Delhi-110019, India

Correspondence Address:
Poswal Arvind
Dr. A's Clinic, A-9, 1st Floor, Chitranjan Park, New Delhi-110019
India
poswalarvind@yahoo.co.in

Abstract
Androgenic alopecia (pattern baldness) is a condition in which there is androgen mediated progressive miniaturization and loss of hair follicles in a genetically susceptible individual. A 47-year-old male patient with advanced degree of hair loss (Norwood 6 category) wanted to go for full hair restoration surgery. Due to the limited availability of donor hair in the scalp, a small session with 700-chest hair was performed. On follow-up at eight months it was observed that chest hair grew and formed a cosmetically acceptable forelock.

Keywords: Androgenic alopecia, body hair, follicular unit


Introduction

Androgenic alopecia is classified into seven stages by Norwood classification system. [1] Norwood 5 and above is what can be referred as extensive hair loss. An individual in this stage has lost more than 20,000 follicular units from the frontal region and crown area of scalp (assuming the total scalp to contain 45,000 follicular units). [2],[3]

Surgical treatment in the form of follicular unit hair transplant (FUHT) is an accepted form of treatment for Androgenic Alopecia. [4]

FUHT involves transplanting hair follicular units from the back and sides of scalp to the bald/ balding area.

However, this area does not have sufficient follicular units to be able to provide cosmetically significant hair coverage to patients having extensive hair loss. For this reason, additional hair follicles need to be made available. One of the possible solutions is to use body hair follicles in individuals that have robust body hair. We transplanted 700 chest hair follicular units to form a forelock for a Norwood 6 patient.


Case Report
The patient, a 47 year old normotensive, nondiabetic approached our clinic. He is a Norwood 6 with robust body hair on chest, abdomen, legs, thigh and arms. The patient wanted to complete his hair restoration using body hair as the donor. In the first stage, to assess the growth and cosmetic appearance of the transplanted body hair, 700 follicular units were transplanted from the chest to the forelock area of the scalp.

Investigations

All routine investigations , including coagulation profile, were within normal limits.


Surgery

Under proper aseptic precaution and after local anesthesia administration, follicular units (one to two hair each) were extracted from the chest area of the patients. The follicular units were extracted individually by teasing/ dissecting them from the surrounding skin by a 20-gauge needle.

These chest follicular units were kept in chilled ringer's lactate (4°C). Recipient sites were made in the premarked anesthetized recipient area on the scalp, followed by placement of the chest hair grafts in those sites.

At the end of the procedure antiseptic dressing was applied over the recipient as well as the donor areas.

The dressing was removed from the recipient area after 18 hours and from the donor area at seven days. The patient was put on antibiotics for five days postoperatively.

Follow-up

The recipient and donor areas were observed at one-month, two-month and eight-month interval. At eight-month, the recipient area showed cosmetically acceptable hair growth as shown in the accompanying pictures. They had grown to same length as they had grown on the chest.

People with extensive hair loss due to androgenic alopecia (Norwood 5 and above) [1] may use robust body hair as an adjunct to scalp donor hair.

This will help provide fuller hair restoration.

Pictures & Videos - patient Topshiny on HairSite

Video of recipient site http://www.hairsite.com/images/ht/41436/CCLP-02.wmv
Video of donor site http://www.hairsite.com/images/ht/41436/CCLP-01.wmv

References

1. Norwood OT. Male pattern baldness: Classification and incidence. South Med J 1975;68:1359-65. [PUBMED]
2. Price VH. Hormonal control of baldness. Int J Dermatol 1976;15:742-4. [PUBMED]
3. Bergfeld WF, Redmond GP. Androgenic alopecia. Dermatol Clin 1987;5:491-500. [PUBMED]
4. Nordstorm RE. "Micrografts" for improvement of the frontal hairline after hair transplant. Aesthetic Plast Surg 1981;5:97.

Source: http://www.e-ijd.org/article.asp?is...page=104;epage=105;aulast=Poswal