Body Hair Transplantation (BHT) | Factors to Consider

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Trapianto di peli del Corpo

Body hair transplantation is one of the topics that generates most interest in baldness forums but also at international conferences.

Image from the DHI clinic on body hair transplantation and their growth direction.

This is because body hair can often be a resource for those patients with a poor or depleted donor area as a result of previous surgeries.

One of the most interesting studies in this regard is the one by Dr.Robert True presented in San Diego during the 2006 ISHRS conference.

According to Dr.True there can be up to 5 million hair follicles in the body. The follicles look different depending on the area of the body considered but qthose on the torso are generally thought to be more similar to scalp hair. In some breeds there is a tendency to have little chest hair.

Dr.True states that there are large differences between men who have chest hair and that there is an increase of it in people over 60 years of age.

 

Body hair transplantation – Breast hair is the best.

Another interesting aspect highlighted by Dr.True is that chest hair, once transplanted is not subject to initial shedding (a shedding phenomenon typical of transplanted hair).

Dr. True has observed this phenomenon in several cases and believes that the determining factor is that the follicular units were grafted immediately into the recipient site after extraction, using the stick and place technique.

If, on the other hand, follicular units taken from the breast are grafted only after all incisions have been made then there is a risk of temporary shedding.

 

Body hair transplantation – Do they become hair-like?

An interesting finding is also related to the fact that chest hairs transplanted into the scalp would appear to change their characteristics. In particular, chest hair once grafted into the scalp would tend to become smoother, grow more in length and become similar to the hair of the scalp. The image below describes this situation well:

Without a doubt Chest hair can be a resource that can provide thousands of follicular units for some patients.

Careful patient candidate selection for body hair transplantation (bht) is necessary, however, as only a fraction of hair loss sufferers are ideal candidates for BHT.

Dr.True uses an interesting methodology to determine and qualify a patient’s eligibility for hair transplantation.

 

Body Hair Transplantation – Am I a Good Candidate?.

5 patient characteristics that are assigned a score between 0 and 2 :

    • PECT HAIR DENSITY:If the density is less than 20 follicular units per cm2 a score of 0 is assigned, if the density is between 20 and 40 f.u. per cm2 a score of 1 is assigned and if it is greater than 40 f.u. per cm2 a score of 2 is assigned.

If the density is less than 20 follicular units per cm2 a score of 0 is assigned, if the density is between 20 and 40 f.u. per cm2 a score of 1 is assigned and if it is greater than 40 f.u. per cm2 a score of 2 is assigned.

  • SIMILARITY BETWEEN HAIR AND BREAST HAIR:If the chest hair is totally different from the hair a score of 0 is assigned, if there is a fair similarity a score of 1 is assigned, if the similarity is high a score of 2 is assigned.
  • PERCENTURAL OF DOUBLE AND TRIPLE FOLLICULAR UNITS:If less than 20% of the breast follicular units are double and triple, a score of 0 is assigned, if the percentage is between 20 and 30% of the total a score of 1 is assigned, if more than 30% of the breast follicular units are double and triple a score of 2 is assigned.
  • The SUPERFICIAL FOLICULULAR UNITS:If the percentage is between 20 and 30% of the total a score of 1 is assigned, if more than 30% of the breast follicular units are double and triple a score of 2 is assigned.
  • SURFACE WITH EXTRACTABLE HAIR:If the area with hair is less than 50 cm2 a score of 0 is given, if it is between 50 and 200 cm2 a score of 1 is given and if it is greater than 200 cm a score of 2 is given.
  • BODY HAIR LENGTH:If the length of the chest hair is less than 2 cm you assign a score of 0, if it is between 2 and 5 cm you assign a score of 1 and if it is greater than 5 cm you assign a score of 2.

 

The Scores Obtained in Body Hair Transplantation and Conclusions.

The sum of the scores obtained for the 5 characteristics gives us the TORSO DONOR INDEX (TDI).

Patients with a TORSO DONOR INDEX of 4 or lower are not candidates. The figure below shows this type of patient

Patients with a Torso Donor Index of 5-6 or 7 may use I bht from the chest as a limited resource for minor touch-ups.

Patients with a TDI greater than 8 are excellent candidates for chest hair transplantation..

The image below shows the case of a patient with a Torso Index score of 9, for whom 3000 follicular units could be extracted from the chest and abdominal area.

 

Protocol to be adopted in case a patient is interested in BHT.

  • In general, the protocol to be adopted in case a patient is intending to use body hair should follow these guidelines:
  • Verify that there is no longer the possibility of safely extracting follicular units from the scalp,
  • Check that the TORSO DONOR INDEX is greater than 8
  • Make an initial test of 200-300 grafts to verify the rate of regrowth.
  • Only follicular units that can be easily extracted (without excessive pulling or twisting) should be used
  • The follicular units should be checked under the microscope and only intact ones should be used.
  • This should be done in stages
  • The patient should be informed that regrowth rates may be variable.

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