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Dr. Arvind\'s new BHT article in Indian Journal of Dermatology


#1

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

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.

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?issn=0019-5154;year=2007;volume=52;issue=2;spage=104;epage=105;aulast=Poswal


#2

very interesting Dr. A. May we see the picture of the patient you are depicting on this case?:smiley:


#3

» very interesting Dr. A. May we see the picture of the patient you are
» depicting on this case?:smiley:

I would also love to see a picture of this patient.


#4

Dear readers,
You may view some pictures and videos of the patient at
http://hairtransplantcentre.blogspot.com/2007/07/bht-article-in-indian-journal-of.html


#5

Ahem… :wink: excuse me… :wink: Dr. Ruby. Maybe I was entirely too unclear on my previous request. Let me rephrase this question sir. I apologize for my ignorance in my initial request. Ahem…

Dear Forum Poster of Dr. Arvind Poswald…:slight_smile:

May I/we see the PICTURES and TEXT TOGETHER from the “Indian Journal of Dermatology” (recent within this thread that you initiated) that YOU so proudly posted? I am sure you are so proud to have published this article. I would be too. And the “Forum Readers” would love to be blessed to be able to “bask” in the sunlight with your accomplishments in BHT. :slight_smile:

I clicked and read the link to the abstract. And I just would love to see verification by the “Indian Journal of Dermatology’s” Peer review application pictures and text together… to see what they reviewed and how they confirmed your research.

Sometimes, in other countries… acceptance into a “journal” is relatively easy. And based on my experience with BHT and seeing all of the advancements thus far since 2003, I know deep down inside that it must have been extremely difficult for you to be able to publish in a non-European… Non-Japaneese… Non- United States Journal of Dermatology. Kudos to you sir…

So do you have what I request sir?:slight_smile: :slight_smile: :slight_smile: :slight_smile: :smiley:


#6

Dear Hairtech,
I did not know you wished to resort to cynical racism.
In case you do not understand the value of Indexed, peer reviewed journals, maybe you should educate yourself.
A visit to the local medical library will be a good start.

The librarian will help you understand the relative value of the various journals is not based as much on the country of origin as their status.

Your ignorance is superseded only by your egoistic posturing.

» Ahem… :wink: excuse me… :wink: Dr. Ruby. Maybe I was entirely too unclear on
» my previous request. Let me rephrase this question sir. I apologize for
» my ignorance in my initial request. Ahem…
»
» Dear Forum Poster of Dr. Arvind Poswald…:slight_smile:
»
» May I/we see the PICTURES and TEXT TOGETHER from the “Indian Journal of
» Dermatology” (recent within this thread that you initiated) that YOU so
» proudly posted? I am sure you are so proud to have published this
» article. I would be too. And the “Forum Readers” would love to be blessed
» to be able to “bask” in the sunlight with your accomplishments in BHT. :slight_smile:
»
»
» I clicked and read the link to the abstract. And I just would love to see
» verification by the “Indian Journal of Dermatology’s” Peer review
» application pictures and text together… to see what they reviewed and
» how they confirmed your research.
»
» Sometimes, in other countries… acceptance into a “journal” is relatively
» easy. And based on my experience with BHT and seeing all of the
» advancements thus far since 2003, I know deep down inside that it must
» have been extremely difficult for you to be able to publish in a
» non-European… Non-Japaneese… Non- United States Journal of
» Dermatology. Kudos to you sir…
»
» So do you have what I request sir?:slight_smile: :slight_smile: :slight_smile: :slight_smile: :smiley:


#7

Sorry sir.:wink: I meant no harm… just asking.:slight_smile:


#8

To insinuate that publishing in Indian medical journals is easier that in American or japanese betrays ignorance on your part hairtech.
I know you are not a doctor and cant know much about publishing papers in medical journals, but atleast think before you try to malign others.

If you really want to read the article, you can subscribe or buy it online.


#9

Ignore hairtech Dr. Ruby. Its jsut a case of sour grapes, IMO.

Congratulations on your paper getting published. That should make the bht naysayers sit up and take notice. It may also help others doctors finetune their techniques to get better results.


#10

Yes ignore my comments sir please. I apologize to the nth degree. I am as ignorant as they come.:slight_smile:

In fact… I have never in my life ever picked up a medical journal much less read one… or ever contributed to a journal publication in my life as a lowly biologist helping a doctor/s perform research for publication.

right… :smiley:

Nevertheless i said sorry… :slight_smile:


#11

In all seriousness. I totally think that something has to give… something has to come out and be definite with this BHT stuff.

I worked around it for years and saw some amazing things(twice) and some straight up crappy results. So I have to speak my peace.

I am not however pointing fingers at anyone… and certainly not saying it was anyones fault for the crappy results nor am I singling anyone I worked for out because several doctors I have worked for have performed BHT.

What I am saying… is the fact that there are clinics that are pushing BHT recklessly… I’m not saying Dr. Arvind Poswal is… just asking questions about stuff that bothers me ok?


#12

» In all seriousness. I totally think that something has to give…
» something has to come out and be definite with this BHT stuff.
»
» I worked around it for years and saw some amazing things(twice) and some
» straight up crappy results. So I have to speak my peace.
»
» I am not however pointing fingers at anyone… and certainly not saying it
» was anyones fault for the crappy results nor am I singling anyone I worked
» for out because several doctors I have worked for have performed BHT.
»
»
»
» What I am saying… is the fact that there are clinics that are pushing
» BHT recklessly… I’m not saying Dr. Arvind Poswal is… just asking
» questions about stuff that bothers me ok?

Go ahead and ask tough questions. I certainly wish I had done more of that before having a hair transplant which forever ruined my appearance. No insult to any of the doctors in this thread but this industry is saturated with charlatans who are out to make a quick buck. My life suffered immensely as a result. I applaude any ethical doctors who are really trying to advance this field out of the swamp it has been in for decades.


#13

What happened to you butt? Will you start a different thread that details your story? I really want to know. It saddened me when I just read your post. Or post your story here. Please?:slight_smile:


#14

» What happened to you butt? Will you start a different thread that details
» your story? I really want to know. It saddened me when I just read your
» post. Or post your story here. Please?:slight_smile:

Hey Hairtech, I appreciate your very informative posts. I will be happy to share my story, but I am heading to work right now and won’t be home until tomorrow morning (third shift). I will type it out tomorrow when I get home.


#15

» Hey Hairtech, I appreciate your very informative posts. I will be happy
» to share my story, but I am heading to work right now and won’t be home
» until tomorrow morning (third shift). I will type it out tomorrow when I
» get home.

Ok cool!


#16

» » Hey Hairtech, I appreciate your very informative posts. I will be happy
» » to share my story, but I am heading to work right now and won’t be home
» » until tomorrow morning (third shift). I will type it out tomorrow when
» I
» » get home.
»
» Ok cool!

Hairtech, you do a great job adding info to this board. Just wanted to say thanks again. Anyway, my story is pretty typical of many I suppose. I started balding very young, by the time I was 21 (I am 39 now) it was falling out in clumps. Until that point I could wear so it wasn’t so obvious and it didn’t look too bad. All of a sudden one week it started coming out extremely rapidly and I really panicked. Shaving my head didn’t seem like an option because I have always had very bad psoriasis all over my scalp. So I went to Bosley as fast as I could (this was 1990) and they knew I was very concerned (hairloss is hard at 21) so they showed me some excellent before and after pictures of class 5 and 6 bald guys who looked great now. They convinced me to have a scalp reduction for the crown and plugs up front. They did the scalp reduction the very next day (I was so naive). They said I would need 2 more and plugs. I fell for it, and had a series of operations and forked out thousands of dollars and I looked like hell. Along the way I realized this was a joke, there is no way their “plan” for me was going to work. The doctor who worked on me had to know it from the start but decided to take my money without regard.

I somehow found Dr. Rassman and made an appointment to see him. I know he catches a great deal of debate with his comments about HM but he was a very straight shooter with me. He examined my donor area and told me that I had very poor density and would never be able to finish the “Bosley plan”. He didn’t even think much more could be done in terms of repairing the mess I was left with because so much of my donor hair had been depleted. I was devastated. My life changed dramatically after my first operation with Bosley. If I had it to do over again, I would not have had surgery. I was a very poor candidate to begin with, I was too young and destined to be a class 6 and it was the worst mistake I ever made. Some men are great candidates and have great results. I was one of the failures and still living with my mistake. I am hoping one day either BHT or HM will provide me some aid.


#17

Dear Butt…

I applaud you for coming forward with your story. This is very hard as you very well Know. It is a thorn in your hand as it bothers you everyday that you awaken since you stepped out of Bosley’s office in the 90’s. Even if your head was solved today this very moment, would you still think of what you have gone through the last 15 years or so of your adult life. You are traumatized.

Having said this, I have great respect for Dr. Rassman. He is the Godfather of what is known as FUT today, however… his time has passed in terms of innovations(no dis-respect to him by no means but the fact of the matter is… technology has advances passed what he knows and does) So what I am asking you is not to give up quite yet. I also ask that you think about taking pictures of your scalp… not face of course, and post them here so you can get a conglomerate of really seasoned posters that will truly give you a non-biased approach to your dilemma. I have only seen in the past few months one case (Zayden) that made me think… F*&K man what are we going to do…? Not to down play your issues at hand. Hairloss, past procedures, and butchers, are relative ONLY to the folks that have had it done to them. In other words, what is less harsh to others might be totally devastating to you… So give this some thought ok.

One last thing. Start a new thread because this thread does not deserve to have the information you may provide in education thus forward.