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The disadvantages of BHT


#1

Dear forum readers,

I have written the guidelines for use of body donor hair at
http://www.hairsite.com/hair-loss/board_entry-id-17106.html

They give an idea of how to correctly use body donor hair.

However, I feel its equally important that we discuss the inadequacies of BHT too.
Just like scalp hair HT has its inadequacies, so has BHT. Its helpful to understand them and thus make an informed choice/plan.

I hope this will help prospective patients get a balnced view and plan their hair restorations better.


The more obvious of the inadequacies of body hair are -

  1. Shorter hair length,
  2. Lesser hair calibre/diameter,
  3. Less number of hair per graft,
  4. Shorter duration of anagen/growth phase,
  5. Lesser %age of hair in anagen/growth phase,
  6. Shorter overall duration of the hair growth cycles.

Others being difference in color, curl and predisposition to greying.


#2

It is essential to understand that coverage following a transplant will depend on the length, calibre and number of hair per graft.

Even when using scalp only as donor hair, its known that better calibre (and curly) hair will give more coverage.

In BHT, the coverage for the same number of grafts is less for this reason.


However, even if for a patient, the body donor hair calibre is comparable to scalp donor hair, and the number of hair per graft is adjusted, and the patient keeps hair 1 inch long, the coverage is not going to be equal.

The scalp donor hair will still provide better coverage.

Reason -

An understanding of the body hair growth cycles will provide the answer.


#3

The shorter duration of growth cycles ensures that by the time the scalp hair completes one growth cycles, (and enters the resting phase), the body hair has already completed 5 to 8 growth cycles.

That means it has passed through the resting/telogen phase 5 to 8 times while the scalp hair was in anagen all the time.

Therefore, the cyclical variation seen in hair growth in BHTs.
(We shall discuss how to attempt to minimise this variation at a separate thread).


#4

Irrespective of the fact that the body donor hair have been extracted in anagen/growth phase, over a number of growth cycles, the %age of hair in anagen will settle down to what it was in its original location.

Till that happens, there will be a cyclical variation in the hair coverage, as shown in the graft below.

Please do not consider the evening out of the growth cycles to mean a lesser yield.

The actual yield is seen in the first time growth. Something I will expect in the first 6 to 12 months, post transplant.


#5

So, in short, body donor hair is no match for the scalp donor hair.

Yes.

That brings us to next question.
Should body donor hair be used ever?! If so, what would be the ideal and what less than ideal way to approach it?

The veterans know that these issues have been discussed before. However, I feel that the new readers need to know all the details.

Regards,
Dr. A


#6

Dear forum readers,
While there are all the limitations of body donor hair, it still has an important role to play.

For most patients with extensive hairloss, (Norwood 5 or more), scalp donor reserves are never going to be enough for a good density hair restoration in all the bald/balding areas.

Thus, the importance of additional donor hair from other sources.

The best way to use this hair is to use it in a pre planned ratio, from the begining.

There have been patients who have gone for scalp hair only HT first followed by BHT (scientist, Optimist etc.), as well as BHT only first followed by scalp hair use (Topshiny, for example).

Both of the above strategies can be used. However, the best way is to use a combination of scalp donor hair, suitable body donor hair and facial hair in a judicious mix (e.g. finallyfree, schmoe).

Regards,
Dr. A


#7

Some examples of the different ways in which patients used and benefitted from BHT are available at
http://www.hairsite.com/hair-loss/forum_entry-id-4812.html