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Body Hair Transplantation

Two different BaldingBlog readers had two similar questions…

Dr. Rassman,
recently some hair transplant surgeons reported very good results from body hair transplants. Other doctors remain more cautious and say it may yield good results in some, but not all patients. What’s your view on this?

Dr. Rassman,
Would you ever consider using bodyhair for some of the grafts in the scalp? I was wondering because it would seem a good way to increase density results. I am a bit paranoid about using only scalp hair to graft because I would not want to run out before getting decent density. I would think that you could mix in some sideburn or beard hair with regular scalp hair in the crown. What is your take on this. Thanks for your time.

Body hair has generally low densities (contrary to what it looks like on some men) so they do not make for a good donor supply in terms of quantity. A focus upon head hair should be primary. Then if you run out, moving to other body parts may be reasonable, especially as some studies are now appearing that indicate that this type of transplant works (leg and body to head or neck). What is still missing is the yield rates from the leg or body and the growth success from these areas.

As far as using sideburn or beard hair, this is an option in certain circumstances. They should only be considered as a last resort, when all usuable scalp donor hair is used. The other time that sideburn or temple hair can be used is when a patient is going to have a face lift and the sideburn/brow area is going to be excised as the brow is raised up.

Until the research information about body hair transplants is in our hands, it must be looked at as if it were human experimentation. A number of our patients have volunteered for this, so I am clearly interested in following the experience of others who I trust and then possibly get involved myself. I just do not want to sell hype and disappoint anyone.

I have performed one body hair transplant. The transplant was done from the abdomen to the eyebrows and it failed to yield hair in 10 months. I lost contact with the patient so I do not know if the transplant showed delayed growth or reflected some mechanism that caused it to fail. What I believe is that we need better scientific evidence on the following questions:

  1. Does it works reliably 100% of the time?
  2. If #1 is true, is that for all donor sites?
  3. What is the yield of viable grafts?
  4. What are the risks of body scarring / complications?
  5. Is it cost effective?

I would want to see many successful patients before I recommend it routinely for my patients.

While I can perform body hair transplants, I choose not to until they have been proven as a reliable procedure. If I make representations to my patients, I must be able to support what I say. If I embark on body hair transplants now (even on a limited basis), my patients must know the many uncertainties associated with the procedure. Until my comfort level is higher, I will not be doing body hair transplants.

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Botched female hairline

This woman had a botched hairline from a hair transplant. Clearly the doctor did not understand that the female hairline shape is concave, so I put some marks on her forehead to show what might be a reasonable correction. Of course, the final design should be with the patient, one on one with the doctor. This is not even a good hairline for a man as it looks like Eddie Munster. Doctors who do this type of work, unfortunately, can’t be stopped other than by the patients who can take them to court for a lot of money and find a doctor like me willing to be an expert witness in any court action taken.


2020-08-08 09:49:25Botched female hairline

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My barber found a bald spot, what is it caused by? (photo)

This looks like Alpecia areata, an autoimmune disease which impacts the hair. You should see a dermatologist and upon examination with a hand microscope he/she will see ‘exclamation mark’ hairs which makes the diagnosis. The a biopsy and a special treatment routine is needed.


2020-07-09 13:55:22My barber found a bald spot, what is it caused by? (photo)

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Breast lump from finasteride, I think

I took finasteride for a year and developed gyno from it. When i noticed the lump in my left chest i stopped taking it. However, what happened was weird. After stopping finasteride for like more than a month, the hard lump in my left chest disappeared but at the same time a hard lump appeared in my right chest. My left nipple is still swollen and big though. But on pressing it i dont feel a lump.

I want to know whether this gyno will go back on its own or if surgery is must. I never had gyno before and i’m 100% sure its from finasteride.

If the lump remains, you should see a doctor. Breast cancer is very rare in men, but it does happen.


2020-11-03 09:20:24Breast lump from finasteride, I think

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My Daughter Had a Bad Chemical Burn on Her Scalp When She Was Hours Old

I have a 11 year old daughter who has a bald spot in her head. She received this chemical burn when she was about a few hours old when she stopped breathing and they had to put an IV in her head. She has really dealt with this situation for the past few years but now she complains because she can only wear her hair one way. I have taken her to a dermatologist and they said that her follicules were dead and that she would have to have a hair transplant. I have been researching about microscopic follicular hair transplants and I think I want to have it done for her this summer. I really want to know if you think she is to young for this surgery.

Depending upon the size of the area, the treatment should be customized for that size and location. Some children develop very large areas of balding from such events and these may require more than a hair transplant. I would have to see photos of her to tell you what could be done (you can send them here and please reference this post in your email). Photos will remain confidential unless permission is granted to use them.


2008-05-19 08:39:56My Daughter Had a Bad Chemical Burn on Her Scalp When She Was Hours Old

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Bumpy skin in recipient area

I had a hair transplant 8 months ago and I am bothered by bumps which are on the skin everywhere there is a graft. What can this be and will it go away?

Bumpy skin in the recipient area (called cobble stoning) reflects the types of recipient sites and the way the grafts were placed at the time of your original surgery. If the grafts were small, the wounds were very small and the grafts were left flat to the surrounding skin, then there should be no bumps present. See your surgeon and ask your surgeon about the problem that is clearly bothering you.


2020-08-07 10:22:46Bumpy skin in recipient area

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My Diet Has Become More Healthy Over the Past 2 Years, But My Hair Improves So Slow

I’m a 27 year old male. About 3 year ago, at the age of 24, I went to work abroad for a year. At the time of leaving home I had a full head of hair.

When I was abroad my diet deteriorated. During this time my hair became very unhealthy. It became brittle and it stared to fall out. I returned home 2 years ago and my diet has returned to normal. My hair’s condition has improved and it has stopped falling out.

Though it has improved, progress is very slow and it has not returned to its former condition.

Could you help me, please?

A normal diet should not have any significant impact on hair loss. If you were malnourished during your travels abroad, it may have had some impact. However, once you start the hair loss process, I have found that it is difficult to stop the hair loss process. Some have explained this phenomenon by analogizing to a light switch that is turned on, but can’t be turned off. You should have your scalp hair mapped for miniaturization to see it there is a pattern to this hair loss. You have a component of genetic hair loss which may not be related to the diet issue.


2007-05-22 11:33:07My Diet Has Become More Healthy Over the Past 2 Years, But My Hair Improves So Slow

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Can a hair line mature unevenly?

Can a hairline mature unevenly? My hairline hasn’t been totally straight since I was about 14. Every man in my family is sort of Norwood 1.5 or 2, my dad is 60 with Norwood 2 but he is thinning a bit. Nobody except my maternal grandfather has ever gone bald. I’ve really freaked out about my hairline since I noticed it at the beginning of this year. It’s changed very slightly since I was about 14, however it has remained unchanged for about a year. It’s about a norwood 1.5. My forelock is still where it’s always been, which makes my temples look far more receded than they are. One temple seems to be a bit higher than the other, just slightly. Is it possible that the front of my hairline will mature too, making it look less dramatic? Or will this stay the same? I don’t really think it’s MPB, but I’ve had a lot of grief over it. I’d love not to worry about it anymore. I’m 18 by the way!

Yes, hairline maturation can be asymmetrical but eventually it evens out if you give it time.


2020-11-04 08:36:14Can a hair line mature unevenly?

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My Doctor Said I Wasn’t Programmed to Have Crown Loss, So Propecia Wasn’t Necessary

First, I can’t thank you enough for maintaining this resource–it’s alleviated a lot of my anxiety about hair loss simply by giving my a place to find answers to my questions.

I recently had a consultation with a surgeon about reshaping my temples. I’m 29, and probably a NW2-3. (I’ve had relatively high temples since high school, though the spaces have expanded slowly since though then.) He ultimately recommended 1100 grafts to fill in my temples and create a relatively straight hairline.

I have two questions:

1. He told me that diet has a significant impact on hair loss, second to genetics. He advised a vitamin regimen of L-Lysine, Vitamin E, Saw Palmetto, MSM, Glucosamine, Chondroitin Sulfate, and Ester-C. In addition, he recommended that I stop consuming creatine, and eat a sulphite/nitrite-free diet that’s rich in antioxidants and low in refined sugar and bleached flour. I realize that much of this might be good health advice generally, but does it have any non-negligible connection to hair loss? I appreciate interest in my general welfare, but this had me a tad skeptical.

2. After examining the entirety of my hair, he told me that I’m “programmed” for hair loss not beyond a NW3. He did not conduct a miniaturization study; this was a “naked eyeball” examination. Because he didn’t think I’m “programmed” for any crown-area loss, he said Propecia wouldn’t be necessary. Should I take this pronouncement with a grain of salt, or could he accurately reach that conclusion via the type of examination he made?

Many thanks, and all the best. If it’s at all relevant, he did not recommend any type of hairline lowering, but simply filling in the temples and leaving the forelock as is.

While it is possible that you won’t advance beyond a Norwood class 3 hairline, I don’t trust doctors who give eyeball opinions for predicting hair loss. There are some good tests (miniaturization mapping and better yet, bulk analysis) that will tell you with some certainty if you are balding.

The decision to take drugs like finasteride should be based upon clinical evidence of balding. You might want to consider getting a second opinion, hopefully from a doctor that can give you a more thorough analysis of your hair. If you aren’t balding, Propecia isn’t necessary (though you should consider it to prevent shock loss from any hair transplant you may have). If you do have early balding, now would be the best time to start the medication.

As for the recommended vitamins, I am not a nutritionist, so your doctor’s suggestions may be good ones for your overall health. I wouldn’t expect to see lush hair growth upon taking them, though. None of those have satisfactory evidence linking them to treating genetic hair loss.