Transplanting hair from the body to the balding scalp, typically referred to as Body Hair Transplantation or BHT for short, has become a subject of intense interest to many hair transplant patients (especially those who are endowed with the body hair of hairy back gorilla).
Some hair transplant physicians have been experimenting with and studying the viability of such body to scalp hair transplants, including Coalition member Dr. Bob True in New York City.
Dr. True made an excellent presentation on this subject at the recent annual ISHRS (International Society of Hair Restoration Surgery) meeting in San Diego this October. He was kind enough to provide me with his presentation so that I could share highlights of his findings on our community.
According to Dr. True, there are up to 5 million hair follicles on the body. The follicles vary widely in hair character and behavior with the hairs on the torso generally most similar to scalp hair. Some races have very little torso hair. It is rare for a woman of any race to have much torso hair.
He finds that there is a wide variance among men who do have torso hair and that for men torso hair increases to the sixth decade of life.
Another fascinating phenomenon is that frequently the transplanted torso hair does not shed. Dr. True has observed this in several cases and believes that the determining factor is that the grafts have been placed in small batches immediately upon harvesting. However, he finds that the hairs do shed if the grafts are placed at the end of a several hour harvesting session.
He also finds it fascinating that torso hair transplanted to the scalp typically changes character. It tends to lose its wave, grows longer and becomes more similar to the native scalp hair.
However, unresolved questions remain and include:
- what is the best and most reliable technique?
- the survival rates of torso grafts?
- the effect of the scalp host on torso follicle cycle?
For selected patients the torso represents a resource of many thousands of grafts. This expanded resource can be used to achieve higher density than their scalp donor allows, cover more of the bald scalp, and or accomplish repairs not otherwise possible.
However, patient selection based on their body hair donor characteristics is critical since only a minority of hair loss sufferers are ideal or viable candidates for a body hair transplant (BHT).
Dr. True uses a methodology for determining and scoring a patient’s viability using a “Torso Donor Index” (TDI) which evaluates five key patient characteristics:
(1) Density which may be more than 40FU/cm2
(2) Similarity between scalp and torso hair
(3) Proportion of 2- 3 hair FUs (Follicular Units)
(4) Size of the hair bearing area
(5) Length of the torso hair
Patients with Torso Donor Index (TDI) scores of 4 or less are not candidates. Patients with TDI scores of 5, 6, and 7 have limited supplementary resource that may allow for focused touch up work. Patients with TDI scores of 8 and above may have a donor resource that exceeds their scalp donor resource.
This methodology for evaluating patients is shown in the accompanying photos as well as a patient with a high score of 9 who garnered 3,000 grafts from his chest and stomach areas.
Best wishes for great new growth, Pat
Publisher of the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog. To share ideas with other hair loss sufferers visit our Hair Restoration Discussion Forum.