Hair Replacement for Areas other than the Scalp

I know hair can be transplanted to the scalp, but where else can hair be transplanted?

Hair transplants can be used to replace eyebrows lost to trauma or years of plucking, eyelashes, the beard area, and chest hair. It is important to note that transplanted hair will continue to grow as if it were in its native location. This is important because the growth cycle of hair is different depending on its location. Scalp hair has a longer growth cycle than hair on the arms or legs. Transplanted hair may need to be trimmed more than would be expected for native hair.

What are some donor sites for hair transplant surgery?

For patients undergoing hair restoration for androgenic alopecia, typical male pattern baldness, the hair must come from an area which does not have receptors for dihydrotestosterone. Typically the donor site is the side of the scalp or back of the scalp. This provides the best match for color, texture, and growth. This is also the area used most often for transplant to other areas of the body. Should there not be enough hair on the scalp or the patient desires another donor site, hair may be taken from any other part of the body. The problem with donor sites other than the scalp, especially for a scalp recipient site is the difference in hair cycle. Hair on parts of the body other than the scalp generally have a shorter growth cycle than hair on the scalp and spend more time in the resting phase of the hair cycle. This leads to hair which is not as long as scalp hair and can produce an unnatural appearance after grafting.

How are eyebrow transplants different from scalp hair restoration?

Though the majority operation is the same for either scalp restoration or eyebrow restoration, several important differences must be noted. First, the distribution of the eyebrow hair is very random and does not follow as orderly of a pattern as scalp hair. Great care must be taken to ensure that the random nature of native eyebrow hair is maintained if any transplant is undertaken. Second, most surgeons will only use single or double follicular unit grafts when recreating eyebrows as this produces the most natural eyebrow recreation.

What is follicular unit extraction?

In an effort to provide differentiation, some surgeons have begun harvesting the donor sites through a process termed follicular unit extraction. In a manner similar to previous hair plug removal, very small punches are used to remove single or double follicular unit grafts. The grafts are then transplanted similar to a traditional donor strip follicular unit grafting procedure.

The biggest advantage to this procedure is the lack of a linear scar compared to strip harvesting techniques. For patients who may one day decide to shave their heads, this can be advantageous. Because individual hairs are harvested by one person, operating times for this method are longer than strip harvesting and often more costly. Studies have shown a slightly higher follicular transection rate than with traditional strip donor site harvesting. Unfortunately no clinical studies have been done to compare the results of FUE to traditional donor site harvesting methods. Overall, a clear advantage of FUE to donor strip harvesting has not been shown to make it the preferred method for harvesting donor hair during follicular unit grafting procedures.

Follicular unit extraction can be a good method for harvesting donor hair for areas requiring smaller recipient numbers, including eyebrow transplants and eyelash transplants.