# Hair Transplants > Hair Transplant: Start Your Own Topic >  Body hair for transplant? Which type is best?*

## ukcali

Just been thinking about body hair. I know it has it's own problems/limitations but obviously can be used as a filler essentially. Even if just to provide better density.*

What I was wondering is what's the best hair to use? Beard hair seems popular and so does chest hair. I was just wondering what the next best thing is. I have heard of leg hair being used but only nice. Why? Is not that effective? I noticed I have quite a few "triple hairs" (like 3 seperate hair follicles grouped together) on my legs which I thought in theory would be good for density no? just thinking out loud not necessarily planning on using them.*

As always just asking loads of questions! Thanks everyone  :Smile: *

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## gillenator

As you stated, BH is still controversial to date and should always be approached with prior test sessions for any donor site being considered.  Is your scalp donor depleted?

To date, BH taken from the chest and face (beard grafts) show the most promising donor sources regarding yield.  You are correct in that leg hair cases are far and few between.  And to my knowledge, Dr. Umar has the most experience using other regions of the body including leg and arms.

The issues beyond yield are visual compatibility of the BH characteristics compared to the recipient area scalp hair.  IMHO, the best approach is when it is mixed into existing hair like the crown which is considered a lower visual impact area than the frontal zone.

Another issue is duration of the growth phase with BH and especially when it is relocated to another area.  IMHO, leg hair has been unpredictable at best in both yield and growth phase duration.

We do continue to see more repair patients and those with limited or tapped out donors to consider BH.  I for one am anxiously awaiting for more beard cases and chest hair cases to evaluate.

So best wishes to you my friend and remember to insist on doing BH test procedures to see if acceptable results manifest before investing large sums of your hard earned money into it.

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## Shan

pubic hair

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## ITNEVERRAINS

Right now unless you are doing major repair, beard grafts are the only logical non head graft to consider.

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## ukcali

Thanks everyone who replied. I have had a ht yet but I'm just trying to plan a head for the future. I will inevitably run out of sonar hair so may well need some elemnat of body hair.




> As you stated, BH is still controversial to date and should always be approached with prior test sessions for any donor site being considered.  Is your scalp donor depleted?
> 
> To date, BH taken from the chest and face (beard grafts) show the most promising donor sources regarding yield.  You are correct in that leg hair cases are far and few between.  And to my knowledge, Dr. Umar has the most experience using other regions of the body including leg and arms.
> 
> The issues beyond yield are visual compatibility of the BH characteristics compared to the recipient area scalp hair.  IMHO, the best approach is when it is mixed into existing hair like the crown which is considered a lower visual impact area than the frontal zone.
> 
> Another issue is duration of the growth phase with BH and especially when it is relocated to another area.  IMHO, leg hair has been unpredictable at best in both yield and growth phase duration.
> 
> We do continue to see more repair patients and those with limited or tapped out donors to consider BH.  I for one am anxiously awaiting for more beard cases and chest hair cases to evaluate.
> ...


 Thanks for your detailed reply. It's much appreciated. Would you mind running through all the potential issues of but for me. So far apart from the yield I have heard that body hair grows at a slower rate. Is that right? Imwas thinking if you had say 2000 grafts. Could you add in another 1000 body hair grafts to use for dense packing? Just to thicken things up? 

Thanks

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## ukcali

> Right now unless you are doing major repair, beard grafts are the only logical non head graft to consider.


 Can I ask why? Is it just the low potential yields or is it the look of it? I was thinking if it as mixed in with normal hair simply to thicken things up.

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## ITNEVERRAINS

The success rate of survival is best with beard hair, and when blended/used for repair, gives the best looking results.

Hopefully we have come to the point where the repairs we see guys like Umar make with only beard/body are no longer. IMO its an absolute last resort and does not resemble head hair follicles

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## 35YrsAfter

> Thanks everyone who replied. I have had a ht yet but I'm just trying to plan a head for the future. I will inevitably run out of sonar hair so may well need some elemnat of body hair.
> 
> 
> 
> Thanks for your detailed reply. It's much appreciated. Would you mind running through all the potential issues of but for me. So far apart from the yield I have heard that body hair grows at a slower rate. Is that right? Imwas thinking if you had say 2000 grafts. Could you add in another 1000 body hair grafts to use for dense packing? Just to thicken things up? 
> 
> Thanks


 Here are links to resources for information related to body hair studies.  Body hair should NEVER be dense packed.  The other day, Dr. Cole mentioned that half the time body hair grows and for the patients in which it grows, approximately half are satisfied with the result.  I personally participated in several body hair studies conducted by Dr. Cole.  I can tell you first hand that in my case dense packed body hair returned a yield of 0 growth.  Chest and stomach hair is the best and Dr. Cole is getting up to 90% yield with beard hair.  Chest and stomach hair should only be used when there is no other option. Body hair grew well in my scars and on my hairline.

35YrsAfter works at Dr. Cole's office

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## gillenator

ukcali,

I would never consider using BH for dense-packing into any area.  Mixing it in with scalp hair is one thing, dense-packing it is another. I have never seen any results that I would even call marginally good both in yield and appearance (characteristics).

The growth cycles of BH are varying and quite unique to the scalp.  Why?  No one seems to know and why it is still in a "try and see what happens" stage.

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## ukcali

Thanks again guys for your help it's all very much appreciated  :Smile: 

Regarding the dense packing, why is it not good to do it with body hair? 

I should point out what I meant was, You know how's its often mentioned people car have approx 90 hairs per cm2 but in transplant terms apparently approx 45 hairs per cm2 will give the illusion of full density. Well what I was suggesting was could you use say 30 scalp hairs and maybe 10-15 body hairs? whether it be beard or other areas. 

Thanks again guys. The reason I'm asking so many questions about bht is because I've gt a decent amount of body hair (I shave/wax a lot of it) and have been looking it to getting it lasered off. So I thought if I could have used some of it for my scal (even if it was a tiny bit) then it would have been useful.

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## gillenator

ukcali,

What I meant by dense packing BH was using only BH for the donor, and no scalp donor with it.

Sure, the blend of roughly 25&#37; BH with scalp donor is a better ratio and approach because even if the yield from the BH is poor, you should still see gains and coverage from the scalp donor.

One of the drawbacks is distinguishing which regrown hairs were from scalp donor and which are from the body.  Obviously with blending approximately 25% of the grafts coming from the body and 75% from the scalp, identifying the regrown BH will be very difficult.  

Some docs use tattoo ink dots to define and mark a small specific recipient area in which only BH grafts would be placed to measure yield and monitor growth periods but do not blend any scalp grafts with it.  And the idea is not to dense pack that small area.  It is done to measure yield from the BH grafts.

And if you have that much BH, it's certainly worth trying it but try to stay with the more promising donor areas like the chest or beard.

Best wishes to you in your journey my friend.  :Wink:

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## John P. Cole, MD

Oh goodness, here we go again with body hair.  

Around the turn of this century body hair hit the chart.  Let me briefly review the history and results. 

In 2002, Ray Woods had reported on successful body hair transplants.  By 2003 I was moving hair from the chest, abdomen, back, under arms, pubic area and legs.  My first few cases were enormous successes.  Then trouble hit.  Some results were not so good.  Then i began to study variables to achieve success with BHT (body hair transplants).  Anagen hairs grow better than telogen hairs, but telogen hairs grow.  Dense packing with BHT results in less growth.  Optimal densities with BHT of less than 36 grafts per sq cm produce a better survival rate.  Dense packing a combination of BHT and scalp hair can impair the survival rate of BOTH.  Don't do it.  

With BHT about 25% of the cases result in noticeable hair growth.  The rest get cosmetically insignificant growth.  BHT can result in a rescue for those with scars and larger grafts, but it may not.  Then again, good yields can sometimes fade over time especially with leg hair so be prepared for this.  

Head hair is king. The next best is beard.  We began moving beard hair around 2007.  The first thing we noted was how fast beard hair extractions healed.  The second was how high the yield was on a consistent basis (about 60%).  Then we noted that beard hair produce a better cosmetic result than a higher number of other sources of body hair.  Beard is second best.  

What is the problem with beard hair?  It is very coarse and curly, wavy, kinky.  Some don't like it.  

Here is what i recommend.  Do a trial of bear and see how you like the healing and the growth.  if you don't like it, try something else.  Here is the other problem with other sources.  White dots or hypopigmentation.  At least 50% of chest and abdomen harvests get white dots.  White dots are very uncommon on the legs and more common on the back, though not anything near as common as chest and abdomen.   Pubic and axilla hair area hard to harvest.  

Like I said hair is king.  Use it fist.  when you run dry or if you have very bad scarring due to strips of scalp reductions, or flaps,  you may need to try BHT.  Do a small session of 500 grafts and see how you respond.  if the response is good, do more.  If not, stop.  If you like the appearance, do more.   If not, stop.  

That's the summary.  I can expound if you like as I've done in the millions of body hair grafts.   I am the prevailing expert on BHT as i'm the guy they ask to speak about BHT or write the chapter on BHT.  A summary is adequate simply because they work in some and if they work you are happy.  In some they simply don't work.  Beard is the exception as it consistently grows, but you may not like the appearance of the grafts.  

The one caveat I have not mentioned is that BHT seems to grow better with Acell and PRP.

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## topcat

I have found through my own observations and experiences that my beard and body hair procedure healed and grew much faster using superior nutrition when compared  to what I have seen with Acell and PRP. My knowledge in the area of nutrition I would be very comfortable in saying is vastly superior when compared to most doctors so I don’t necessarily fault the medical profession as in most cases they only know what they have been taught and rarely question it so it sometimes makes them very limited.

So far I am very pleased with my own result and it has made all the difference.

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## 35YrsAfter

In my opinion, more and more people are waking up to the reality of the importance of good nutrition.  Several years ago, I had high blood pressure, actinic keratosis, venous reflux, and severe neck pain. These health issues disappeared after I changed my diet.  I credit my wife for modifying my family's eating habits.  We now eat only organic fruits and vegetables, grass-fed beef from a reputable farm, drink non-fluoridated water and avoid GMO like the plague just to name a few changes we've made.  That said, I have personally witnessed benefits from PRP and ACell while working at Dr. Cole's. 

-35YrsAfter works at Dr. Cole's office

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## topcat

Yes 35 years Im sure you have seen but I have not.  I have only heard about it for several years now. Presenting substantial proof to back up claims is very simple to do. Of course double blind placebo would be nice to avoid research bias but whatever you got please feel free to post it.

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## gillenator

Definitely some good points and information outlined by Dr. Cole.  It seems that beard grafts have become the buzz these days but I whole heartedly agree with many of the points that Dr. Cole mentioned.

On another thread I had mentioned the differences in characteristics of various BH sources, especially beard donor.

1) Beard hair can in fact bear acute visual differences in their characteristics as compared to the patient's scalp hair.  For most, beard hair grows more kinky/wavy however in my own observations, it does grow to length unlike leg, back, abdomen, etc.

2) It appears that beard hair has more consistent growth periods or longer duration once within the growth phase although there are few to no clinical studies outlining or identifying differences in growth cycles of various BH sources.

3) BH from the beard typically has a much greater degree of coarseness as compared to the patient's own scalp hair.  And this becomes even more visually noticeable if there is diffusing native hair within the recipient area.

4) These fatter beard grafts can stick out visually speaking on patients that have a wide hair to scalp color contrast, especially dark hair on a fair complexion.  And if the beard grafts are used on the hairline, they can appear unnatural because of the visual differences in hair shaft diameter.  So even if there is no kink or acute wave to the regrown beard hair, the differences in caliber can still be a big issue.  This becomes even more noticeable as the diffused weak hair is lost over time but the beard hair will stay.

5) BH from the legs, back, chest, etc does not appear to be as coarse as beard grafts for most people, but may not grow to length, and the yield and survivability is very unpredictable as was mentioned.

So yes, I have always been an advocate of doing tests sessions before committing to any larger sessions.  And as I have stated before, these BH grafts can be located in a lower visual impact area like the midscalp to monitor yield and compatibility.  Some docs use a special ink to mark, chart, and identify a well defined surface area with very small dots where the BH grafts are placed with no other scalp grafts.  The area does not have to be large, usually a squared centimeter of space to start with.

Good thread!

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## wylie

I wouldn't argue too much with what Dr. Cole said, other than one comment, where he said "I am the expert on BHT", which is not true, and has never been true. Dr. Umar is the current expert on BHT, and I'm not sure who "they" is that he is referring to asking him to speak on the matter, but Dr. Umar's research is published in peer reviewed medical journals, and his results speaks for itself. 

Sorry Dr. Cole, but you aint the expert on BHT. That title would be shared between Dr. Woods and Dr. Umar, with you finishing a distant third.

And speaking from my own experience, having over 5000 beard grafts extracted, beard hair can be trained on the scalp over time, repeated combing can help with the natural tendency for this hair to be curly to the point of being kinky, and if you cut your scalp hair short, say around an inch to an inch and a half, it is virtually indistinguishable from scalp hair. When it grows over 2 inches in length I personally have to use some kind of styling gel (I currently use Samy styling gel, works great) but when it is under 2", I don't have to use anything.

It does get tricky in the strip scars, I don't like to shave the back too short, due to numerous strip scars, and the beard tends to curl up in back, which makes it noticeable, and my barber knows to clip this hair separately during each haircut. 

As far as I'm concerned, this is a far better option than having to wear my hair much longer in back due to long lines of bald scalp in the back that was still visible with long-ish hair in back. These scars are no longer noticeable after around 1000 grafts into my scars. I even had it shaved close once by my barber, and it looked passable, but I was not comfortable enough to wear the look full time. However, shaving it close was not an option before I had beard into my scars. I'm thinking SMP added to the beard in the strip scars could be the coup de grace, but that industry worries me and seems to be crawling with con artists and charlatans, much like the HT industry of the 90's.

My research is ongoing.

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## ukcali

Thanks again everyone for your answer. The more information the better I think! 


A very big thank you to Dr Cole for your long and detailed answer it's very much appreciated  :Smile: 




> Oh goodness, here we go again with body hair.  
> 
> Around the turn of this century body hair hit the chart.  Let me briefly review the history and results. 
> 
> In 2002, Ray Woods had reported on successful body hair transplants.  By 2003 I was moving hair from the chest, abdomen, back, under arms, pubic area and legs.  My first few cases were enormous successes.  Then trouble hit.  Some results were not so good.  Then i began to study variables to achieve success with BHT (body hair transplants).  Anagen hairs grow better than telogen hairs, but telogen hairs grow.  Dense packing with BHT results in less growth.  Optimal densities with BHT of less than 36 grafts per sq cm produce a better survival rate.  Dense packing a combination of BHT and scalp hair can impair the survival rate of BOTH.  Don't do it.  
> 
> With BHT about 25% of the cases result in noticeable hair growth.  The rest get cosmetically insignificant growth.  BHT can result in a rescue for those with scars and larger grafts, but it may not.  Then again, good yields can sometimes fade over time especially with leg hair so be prepared for this.  
> 
> Head hair is king. The next best is beard.  We began moving beard hair around 2007.  The first thing we noted was how fast beard hair extractions healed.  The second was how high the yield was on a consistent basis (about 60%).  Then we noted that beard hair produce a better cosmetic result than a higher number of other sources of body hair.  Beard is second best.  
> ...

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## gillenator

wylie,

You may have already mentioned this but how long ago did you have the 5,000 beard grafts, where did you have the procedure done, and how would you rate the overall yield in terms of percentages?

Glad to see that you are happy and your comments on training the beard hair as it achieves length is great to know.  Beard hair obviously has a much greater degree of coarseness.  What is the maximum length that it has grown in inches?

Thanks again for sharing your details.  :Wink:

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## ukcali

Quick thought just crossed my mind. Could chemically straightening your train sort out any wavy etc body/beard transplanted hair? 

Lots of girls have it done and it makes your hair much smoother. Google it to see what I mean. It was just a thought that it could work  :Smile:

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## 35YrsAfter

Identical twin hair loss studies indicate that hair dyes and hair straighteners can be detrimental to healthy hair growth. I use hair dye every month or so and haven't noticed any negative effects.
As I have stated before, identical twin studies indicate the big three things to avoid are smoking, stress and overexposure to the sun's rays on the scalp.

-35YrsAfter works at Dr. Cole's office

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## wylie

> wylie,
> 
> You may have already mentioned this but how long ago did you have the 5,000 beard grafts, where did you have the procedure done, and how would you rate the overall yield in terms of percentages?
> 
> Glad to see that you are happy and your comments on training the beard hair as it achieves length is great to know.  Beard hair obviously has a much greater degree of coarseness.  What is the maximum length that it has grown in inches?
> 
> Thanks again for sharing your details.


 Well, I have had 4 surgeries of 1500 grafts each, with around 1000 or so scalp grafts rebuilding my hairline. If you have only had strip, and are stripped out, FUE can still harvest some scalp grafts that are not available by strip harvesting, usually 1000 at a minimum can be found, but 1500 to 2000 are possible as well. The rest have been all beard grafts. I believe my first repair was done in either 2009 or 2010, and then, in 2011, a combination of impatience and down time allowed me to get two surgeries done in a time span of three months. Even though not the recommended approach, I was on medical leave from work and had one done in September, a month before my return. When I got back, I found out I had 2 weeks vacation, even though I had been off from work all year. So in December, I had another done, and my most recent surgery was 9 months ago, and the fourth surgery was mainly in the strip scars, with around 500 grafts added on top. 

So that is four surgeries in total. My hair looks like something I never before thought possible, to go from hopeless to a normal appearance is hugely satisfying. 

As far as length goes, I have had my hair around 3 to 3.5" in length on top, but I'll add that I need to use a gel to keep everything in place. At its present length of around  1.5", no gel is necessary. 

And let me state there is no way in hell anyone could tell that beard hair is scalp hair at short length. When it grows longer, it sometimes does not lay straight and it can stand out a bit from scalp hair, but would anyone even notice? I highly doubt it. I barely can and I know what to look for. In my opinion, there is no noticeable difference between scalp and beard hair, at least in my case. I read constantly about people saying "it only should be used for repair"  or for those "desperate cases" or whatever other reason one can come up, but I honestly cannot see any difference on the scalp. If there is a noticeable difference, it is strip scar repair. The hair has a tendency to curl up, which is far more noticeable than on ones scalp, which isn't really noticeable at all. 

My only advice is it is best worn short on top, and if you grow it longer, it is best to use a small amount of gel or hairspray on top. Right now my hair requires no maintenance on top at all when short, and that was NEVER the case before I got butchered all those years ago, and had virgin scalp on top. My thin, wiry hair required a daily dose of gel. Not anymore.

Now on to the yield. This is the tricky part. For my particular case, to achieve this level of repair from 6500 to 7000 grafts, I would have to surmise the yield is at least 80&#37;. I've seen alot of videos with graft counts to think that, considering my dreadful state at the start of my repairs, the yield had to see at least 5000 grafts grow, but possibly more, I honestly cannot say. If the yield was less than 5000 grafts than beard hair produces even better results than I thought possible, but it is also possible the yield is higher than 80%. My results would back that up.

Really, accurately stating ones yield is tricky, with the doctor being the best judge in this regard. We all know that doctors are more than likely to give you best case estimates, so I base mine on my results versus the graft count, which I believe makes it safe to say that my yield would be 80%. I cannot imagine less than 5000 grafts could give me this result.

I plan on getting some good pics. of my hair in its present state and will post them here when I do. I don't have too many "before" pics, but Dermhair clinic does. I personally don't want to remember what I looked like in 2009, it was pretty scary ( :EEK!: ), and I was not seen without a hat. That is a habit I am just now learning to break.  It's really fun going out and about without one.  :Smile:

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## ukcali

[QUOTE=35YrsAfter;128675]Identical twin hair loss studies indicate that hair dyes and hair straighteners can be detrimental to healthy hair growth. I use hair dye every month or so and haven't noticed any negative effects.
As I have stated before, identical twin studies indicate the big three things to avoid are smoking, stress and overexposure to the sun's rays on the scalp.

Interesting point. Whist I don't disagree for a second that dyes and straightening must be bad for your hair, many women (and men) spend their lives dying/blow drying etc their hair and have no issues whatsoever. Is it just that transplants hairs are weaker? So maybe more susceptible to damage? Or is the study showed that these things are "bad" for your hair but didn't necessarily say that it'll damage your transplant?

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## 35YrsAfter

The identical twin study did not include hair transplant patients.  The study's purpose was to determine how "set in stone" the effects of a person's genes are on hair loss.  The study demonstrated that the effect of a person's genes can be "swayed" a bit in both directions.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant - Atlanta
Toll Free 1-800-368-4247
Phone 678-566-1011

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## gillenator

Wylie,

Let me first state that I am very happy for you regarding your matured results.  That was a lot of grafts that you had!  It sounds like the beard hair was a good option for you as long as you keep it short as you stated.

True, it is very difficult to determine the overall yield with a session that large and then trying to determine which grafts were beard and which ones were scalp.  Either way, the bottom line is that you are happy with the end result and have been able to achieve the level of coverage that you wanted.  And from where you came as a repair patient, I would say that was a huge success.

Look forward to your pics and wish you the best in your new appearance. :Wink:

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## didi

This is why you need to be careful with BHT, look at this case 

2000 chest only on true nw6

http://www.woodstechnique.com.au/lar...-2000-fue.html


bad hairline, yield and hair growth/direction is sub par

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## 35YrsAfter

It's often difficult to evaluate a result from photos.  2,000 grafts on a Norwood 6 or 7 is a pretty insignificant number.  Severe cases of hair loss require several passes. Of course finer hair should always be used on hairlines, so the shortcomings of the first pass should be anticipated and planned for so they can be addressed later.  

35YrsAfter also posts as CITNews and works at Dr. Cole's office

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## gillenator

Although it may be true that 2,000 grafts spread throughout such a wide recipient area is not going to show much visual gain, still, having the procedure done in 2011 where is the length of the chest hair grafts?  No mention made if he was cutting the hair shafts, but it certainly does not appear so nor that he has done anything else to the hair.

The other missing element is a good quality photo of his chest area before and after the extractions.  What was the length and quality of the original donor hair?  We do not know and so the integrity of the regrowth is also questionable.

To clarify, I am not saying or implying that this case was a failure.  There is no audio statement made by the patient post-op so we really do not know if he is satisfied with the first BH pass or not.   I mean did he send Dr. Woods the photos because he is not happy "or" for the purposes of planning the second procedure.  The clinic did not hear from him for two years?

Obviously his expectations before surgery were discussed with him.  And we have to be careful because it is his appearance, not ours.  His goals and expectations may be totally different for what we might expect from 2,000 chest hair grafts.  And I would not call that a hairline but more of a frame.

After reviewing the case, I wonder why no scalp FUE was used especially in the frontal zone.  Very possible that Dr. Woods may have initially advised against surgery with the patient.  Possibly after consideration of the surgical limitations, the patient still wanted some level of coverage to build confidence in his appearance.  

Some individuals living with advanced classes of hairloss can have much lower expectations than those who still have a fair amount of hair volume and density.

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## didi

Considerin this surgery would have cost him $30K its safe to say the outcome is disappointing.

Sounds like patient isn't happy with this result, you can tell by dr woods comments.

I don't think this patient have more confidence now than he had before HT, trying to imagine this guy under normal sunlight.

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## gillenator

> Considerin this surgery would have cost him $30K its safe to say the outcome is disappointing.
> 
> Sounds like patient isn't happy with this result, you can tell by dr woods comments.
> 
> I don't think this patient have more confidence now than he had before HT, trying to imagine this guy under normal sunlight.


 You are right about the cost and yes I did get the impression that he is not happy, especially since there was no commentary from the patient.  Again I wonder why no scalp FUE.  It's also cheaper in cost as compared to BHT.  :Roll Eyes (Sarcastic):

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## didi

yes dr woods comes across as very defensive, its a bad sign..
I mean ffs if in 2013 we have to spend 30k and get such crappy result then im speechless..

If I was this patient I would be pushing for refund, shave it off and maybe get smp till something better coms along.


Why he  used body hair only? No FUE?
My understanding is its last resort and patient seems to have virgin donor.


imho its unethical to perform such surgery on patient who clearly isn't good candidate


body hair is *overhyped* by some doctors in industry

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## John P. Cole, MD

There are a few salient points anytime one contemplates body hair.
1.  It looks like body hair when it grows.
2.  The typical good yield is 40 to 60%.
3.  The hair will grow about 1/10 th of a millimeter per day faster on the scalp than on the body, but still 1/10th of a millimeter per day slower than scalp hair.
4.  As a result, after a month body hair will be shorter than scalp hair that are both grafted in the same place.
5.  If you graft body hair at densities greater than 36 grafts per sq cm, the yield may drop from let's say 60% to 4 or 5%.
6.  Body hair may not last more than one or two or three cycles before it goes away.
7.  Beard hair acts more like scalp hair.  It grows fast.  It covers well.  Still a 60% yield is about average.
8.  Beard hair grows like beard hair meaning it may be coarser and wavy like beard hair.  This can be a stark difference between scalp and beard hair when scalp hair is fine.
9.  Body hair may turn white long before scalp hair.
10.  Some people have alot of body hair done and they are disappointed with the results.  
11.  Body hair can in some instances rescue a bad hair transplant.
12.  For this reason, do a small test of BHT to determine yield, quality, and acceptance.  If you do a large session and it does not grow, you will be out a ton of money and time.  You will be very depressed.
13.  Body hair may not grow at all especially in scars.  
14.  Anagen hairs will grow better with a higher yield than telogen hairs so wet shave body hair 3 days before a procedure to identify anagen hair and wet shave beard hair 1 day before because beard grows faster than the rest of the body hair.

I don't like this result at all.  Recognize that 90% of patients with nearly good results like this are happy.  Ray is certainly happy or he would not have posted the video/photos.  Ray is correct, the patient would look better with the hair cropped shorter, however.  One needs a good aesthetic sense to get great results.  I'm not salivating over this particular result.  

Some patients prefer body hair.  If you plan to shave your head, it does not hurt to try a test session of BHT to see how it grows, what the yield is, and what it looks like.  Only then should you jump off the cliff for a 2000 graft session.  Scalp hair is far more consistent and better looking so i'd start with this.  If the patient plans to shave his head, i think a small trial of BHT and scalp is a good option.  If they don't like either, stop right then and there.  2000 grafts is far above a trial.  Sometimes 2000 or 5000 or 10,000 BHT do not grow at all or only 4 to 5%.  Don't take such a risk.  Set the bar low and do a small trial first.  

Gillenator, what the heck do you know about BHT?  Probably what you read and that's a thimble full at best.

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## topcat

I think what is most important here is Dr. Woods just shows it and it is what it is and with that patients can make an informed choice. He does not hide or try and bury it. Nor does he e-mail patients or posters to say this or that so that he can polish his image as a good guy. In fact he goes out of his way to be politically incorrect and truthful about this industry so he is often in my opinion unfairly portrayed as a bad guy.

 Others should take note that honesty is always the best policy. I am speaking most recently on the exposed e-mail from one rep of which there are plenty more and the buried necrosis case for which one forum had to gall to ban me as it was bad for his business when I brought it up.

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## didi

I agree with dr Cole, he is realistic about bht, you always say like it is..no fluff

I mean, if you see this particular patient in the street you would think something is not queite right? Nobody goes to have HT expecting such poor result.


Didn't dr woods claim that body hair takes on characteristics of head hair? sorry but Not in this case


bht was a big hit 10 years ago but it never really took off..woods hyped it up and everyone thought that donor issue is solved

hope dr cole gets in touch with dr nigam and start doubling donor

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## John P. Cole, MD

didi, anyone over hyping BHT today is a fool.  The one absolute distasteful thing I can say about Dr. Woods is that he never told us that sometimes BHT does not grow well.  He made it sound like a panacea.  Then in 2003 patients began ringing my hook off about BHT.  It was a result of his limited disclosure about only the great results with BHT.  When I told them that BHT was not proven and I could not guarantee healing or growth, they still wanted to pursue it.  My first case of about 200 thigh hair into a 2.5 cm strip scar done by CZ grew like crazy.  How one makes a 2.5 cm wide scar in the first place is beyond me, but the story i got was that on his scar revision, CZ tried to get as many grafts a possible and turned a thinner scar into a disaster.  You just don't do that unless your only goal is to make more money.  So, we grafted the scar and it did well.  Then we did another case that was larger and it did well.  then we had a mix of success and failure.  Now, I would tell anyone thinking about BHT that they need a trial first.  Had Ray been more forthright from the beginning we'd have told everyone that they needed a trial first.  Then later on even patients with good leg hair growth at first began to loose hair later on in life. At least Ray never advocated leg hair.  

Frankly, I don't see many good aesthetic results coming out of this clinic even when it grows well.  Yes, he cares about the patient, yes he seems honest and caring, but he needs someone to teach him how to build a hairline that looks good.  It is so easy, but some just never seem to get a grasp on how to do it.  

This is a patchy body hair result that is common with BHT.  Perhaps he was a lucky one that got the 40 to 60&#37; yield, but that's about all he got and it does not look natural at all.  

Hey, the ISHRS is putting on a workshop in October called beautiful brows.  The only problem is the result they are showing as "the model" looks like a transplant.  Oh yeah!  I want to walk around looking like i had a transplant on my face for the rest of my life.  Last year a guy presented one case after another of his eyebrow results in the Bahamans.  They all looked like a transplant.  No aesthetic sense at all.  Guess what.  He's giving the same talk this year.  Sometimes I just think hair transplant docs only see hair and they don't see what it looks like.  Why else would anyone put plugs on a guys head for over 20 years?

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## gillenator

What's the matter Dr. Cole?  Is what I say "bad for business?"  And yet you send me a PM last week wanting to be friends again and because I did not reply, you time and time again show your true colors.  Zebras never lose their stripes.  :Roll Eyes (Sarcastic): 

And those of us who have character do not make grandiose statements that they are the best at this and that, nor do they take pot shots at their colleagues as you do repeatedly.  You were rightfully called out on that too by another forum member remember?

You see a true professional does not have to disrespect others in order to make a point.  The very best are humble individuals.  They do not have to repeatedly come on a public forum insulting their colleagues and others in order to gain market share.

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## John P. Cole, MD

Dr. Nigam invited me to his clinic.  I'm going to go.  I don't like walking into that drug resistant tuberculosis infested place, but i'm going.  If he has something, I'm going to catch on to it and hopefully not catch "it".  If not, he better wish he'd not invited me.  We asked Dr. Gho too, but he never responded.  All I care about is a better result for my patients.  If they have something, I want it.  I don't care what it costs.

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## didi

Dr Cole

great stuff.. 

I know how it went with dr gho, sad state of affairs, he kinda chicken out when he heard you coming...

This dr nigam seems like a real deal but of course I want you to 'grill' him and see if he can double hair or not.

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## John P. Cole, MD

Gillenator, I stand by my comment on BHT toward you.  If you don't know a subject especially one that produces terrible results at times, you should refrain from comment.  

That does not change the way I feel about you.  I always liked you and frankly no matter what you say to me, I will always like you.  You got under my skin in a good way long ago.  I will never forget the chili you made me at your house with your wife years back.  That creeps up in my mind every time I read something you post.  

Now, about body hair, I'm very caustic because I'm the guy with the most bad experience doing BHT.  I made guys very unhappy about their BHT result.  They spent tons of money on it and i worked many 12 hours days with my head bent over like a contortionist trying to get the hair out.  I even had a guy pass wind in my face getting pubic hair out.  You try that sometime.  

You know who fixed up your ragged hairline, but you never give that guy credit.  Time to bury the hatchet.  We both have the same agenda and that is to help out guys with hair loss.  You are a great guy.  I love you to death.  You don't sugar coat the poison berry and neither do I.  I really do miss you.  

Now on body hair, be careful.  It can work miracles and it can really mess a guy up financially and mentally.  Remember, when you spend 10s of thousands of dollars and don't get any growth, you can become very depressed.  

Ok, let's go fishing together sometime and put this all behind us.  I gave you the name Gillenator for a reason and that's because you are awesome.

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## gillenator

Well at least you're coming clean on some points.  Yet trust me, I am not the only one who finds your grandiose spirited comments distasteful and unprofessional.  There are ways to effectively communicate without attempting to make yourself look good at the expense of insulting your colleagues or me.  If you have a beef about or with one of your colleagues then give specific names and examples.  Ranting without specific cases and actual facts only shows a hidden agenda.  I have often told you in the past that you tend to be your own biggest opponent.  

And you do not have to attempt to discredit me regarding my commentaries.  If you think I don't know what I am talking about, simply quit reading my posts.  It's really that simple.  The real truth is just maybe that my comments are not good for your FUE business. Your comment towards me was a potshot and uncalled for.  My posts speak for themselves and do not need your approval or disapproval.  Yes I do participate to help others who suffer from hairloss but as an independent advocate and not under the control/direction of any employer who might want to dictate what I say to patients in order to gain market share.  :Roll Eyes (Sarcastic): 

My opinions are based on countless observations over the past 34 years now, and yes also from what I read including some of the good things you have said from a clinical/research standpoint.  And if you want to think otherwise, that's your entitled opinion.  Just have a little class when you express yourself.  Don't worry, I am not angry or anything.  I just don't allow anyone to take pot shots at me.  And I do not have any problem admitting if I am wrong about something either.  I am human just like you.

I do see you as one of the more passionate doctors and want to personally thank you for that as you have made some awesome contributions to HT surgery.  I remember when you went to see Dr. Woods a decade ago and wanted to start doing FUE in North America.  Many criticized you at the time but you felt at the time it was a better option than strip.

I do not necessarily agree with that opinion along with many other of your colleagues who also offer both methods. But I suppose you might again think I do not know what I am talking about.  Results are what count and patient satisfaction whether strip or FUE.  You yourself have stated that FUE is not for everyone.  You can think whatever you like.  :Wink: 

Anyway I wish you well.  Hope that your children are doing well and read that one of your daughters is becoming quite the violinist.  She must take after her daddy although you never could sing a note on key! Just kidding.

Peace....

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## garethbale

> Dr. Nigam invited me to his clinic.  I'm going to go.  I don't like walking into that drug resistant tuberculosis infested place, but i'm going.  If he has something, I'm going to catch on to it and hopefully not catch "it".  If not, he better wish he'd not invited me.  We asked Dr. Gho too, but he never responded.  All I care about is a better result for my patients.  If they have something, I want it.  I don't care what it costs.


 I appreciate this Dr Cole, and I understand your skepticism.  However, I would not expect an IAHRS surgeon to comment so disrespectfully, particularly as Dr Nigam might read the comment.  You are obviously highly regarded in your field so a degree of professionalism is important.

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## StinkySmurf

> Dr. Nigam invited me to his clinic.  I'm going to go.  I don't like walking into that drug resistant tuberculosis infested place, but i'm going.  If he has something, I'm going to catch on to it and hopefully not catch "it".  If not, he better wish he'd not invited me.  We asked Dr. Gho too, but he never responded.  All I care about is a better result for my patients.  If they have something, I want it.  I don't care what it costs.


 Wow!  I can't wait to hear what you think Dr. Cole!

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## gillenator

Doc,

Forgot to clarify one thing that you stated.  When you stated that I had my "ragged hairline" fixed, I presume that you meant fixed by "you" when you did my third HT procedure in 2004.  I want you to know that you did a very nice procedure on me although Drs. Patrick Mwamba and Chris Bisanga did the majority of the work.  My point is that I liked and still appreciate the work that was done on me. So thank you for that.

That procedure however was for the purposes of adding density and coverage and only about 400 of the 2400 grafts went towards any part of my frontal hairline. About 17% of the total grafts.  To clarify, and speaking for myself as a patient, the ragged hairline that you referred to was done by Dr. Ron Shapiro.  It was not ragged.  It was very good.  You even applauded the work at the time.  And I was perfectly happy with his work which you also knew.  :Smile: 

In fact, Dr. Shapiro did my fourth and last procedure in 2006 and was happy with that one too!  :Wink: 

Just wanted you to know my because we have not seen each other since 2004 is it? Almost 10 years now...take care.

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## PayDay

I think Dr. Cole should be very skeptical of Dr. Nigam's claims. Personally, I think it's sad to see so many young guys potentially being taken advantage of by someone with zero credibility in the field of medicine or science.

I also agree with gillenator and find it extremely unprofessional and in poor taste for Dr. Cole to make many of the remarks that I have seen him make on this forum. If you really are the best at what you do, you don't have to shoot other people down to prove it.  It's really kind of pathetic.

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## John P. Cole, MD

Allright, that's the Gillenator I know and love so much.  Thanks for expressing your opinions boldly.  

To be quite frank with you, I don't worry about my colleague's opinions about my commentary.  I am really sick about the false and misleading rhetoric in this industry.  I've had just about enough of it.  With FUE on the cusp of breaking through as the gold standard, the last thing I want to see is to have it ruined by a docs who want to profit by it at the expense of patients.  You are not gold standard when you let your assistant watch a robot harvest your patients' grafts in my very experienced FUE opinion.  

Dr. Nigam seems to be a very nice guy, as are all the doctors from India, but he is stating that he is getting complete donor regrowth.  If he is accurate, then we all need to know.  If he is not, then we all need to know.  I think that is as clear as I can state it.  If I go there and the results are equivocal, I will say we need to give the technology more time, but it looks promising or it may not be so promising.  If the results are amazing, I will make this clear and highly recommend him.  If the results are poor, I will make that clear, as well.  If they work, I will do my best to help him spread his technology.  Yes, the tuberculosis stuff was a bit off the cuff poor taste, but the facts are the facts.  I know of one girl who contracted TB there and it is drug resistant.  She will die with the disease, and she was in India as a volunteer to the poor.  It is very sad, actually. I still have two children at home so I worry about such a journey.   So does my wife.  Then again, I have never considered myself an IAHRS physician or anyone looking to be simply professional.  I just tell it like I see it.  Sometimes I'm wrong and then I apologize profusely.  I know, the professional guy is what we like, but where has that gotten us?   We have over 20 years of plugs, flaps, and scalp reductions.  We have snake oils that grow hair. We have guaranteed pencil line thin strip scars.  We have non-surgical FUE procedures.  Now, we have follicle regeneration.  Even with my own work on Acell I have some degree of skepticism.  I think professionalism is done in the hair restoration industry.  We need a very high degree of truth.  We don't need to continue to turn our backs on what is being done.  We need to look closely and make a very real assessment.  Turning a blind eye is hardly the path I will ever pursue.  

I guess here we go again with the thought that assistants control a top quality procedure, Gillenator.  Dr. Mwamba and Dr. Bisanga were not physicians in the USA and they were not called doctor.  They were very good assistants or surgery techs.  Grafts can only go into recipient sites in the direction they are made. Only the physician can decide where to place the grafts of any given size by making sites that will accommodate them.  In other words, a proper site for a one hair graft should not tolerate a 2 hair graft, etc.  However, sometimes it does.  This is why the physician has to make sure that the proper grafts are placed in the correct location.  In a strip procedure, the technicians (assistants) generally cut and place the grafts.  In FUE, the physician should be the one extracting grafts though in some clinics, assistants do this.   If the physician has experience cutting and placing grafts, the physician will know what should be done at all levels and pass this expertise on to the assistants.  In many clinics if not most, the physician has placed few grafts and cut even fewer.  These physicians do not know what a graft should look like and they don't really know placing either.  Gillenator, to suggest that my team did most of the work is a complete fabrication on many levels.  First, they were taught exactly how I wanted the grafts cut and exactly where to place them long before they ever worked on your scalp or hairline.  Furthermore, I personally placed a fair amount of those grafts myself.  It was a long procedure and a difficult procedure, but as a team we got the job done.  A hair transplant is always a team effort, but those teams have also produced some very bad results with other physician control.  To suggest that your hairline was ragged is accurate, but Dr. S and his team were not the only people to work on you so who know's who were the culprits.   What I do know is what I see.  As stated, most patients with near good hairlines can't see the bad.  The reason is simple.  When you look in the mirror, the focal length is twice the distance to the mirror.  Most can't see that well to zoom in on suboptimal work so 90&#37; think near good is good when it is not.  It is up to the physician to make sure the result is good by evaluating the results as they proceed.  If you don't know what to look for, you have no idea if the job is good or bad.  I know what to look for, which is why Drs. Bisanga and Mwamaba are good physicians today. They were taught the optimal basics.  In an average to poor practice, yes the assistants control a procedure.  In a high quality practice, the physician controls the procedure from start to finish.

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## John P. Cole, MD

Payday, there are many fine FUE surgeons across the globe.  Some have different philosophies, which you will not find in this particular forum unfortunately.  While I’ve done over 8000 strip procedures I’d hardly classify myself as a great one any more simply because I don’t do many.  I have done over 5000 FUE procedures, which probably ranks me tops in experience in the world.  Experience does not make someone the best, but it sure is helpful.  As Malcolm Gladwell noted in his book, Outliers, one does not become really, really good at anything until they have at least 10,000 hours of experience.  So, based on experience and my results, I’d consider myself very good at what I do.  That in no way implies that I’m the best.  There are varying philosophies in FUE.  Some have more practice at one, but less at another.  This is where FUE becomes very technical and well beyond the scope of this predominate strip forum.  Now, in regard to FUE I am an expert.  I know what I’m talking about.  While some would like to be led down the primrose path, others are grateful for the enlightenment so that they can avoid such mistakes.  I take it that you were never disfigured by the unwise solutions offered in the past.  I also suspect that you have no experience trying to hide your obvious hair transplant results.  If you did, you would have a much clearer perspective of where I am coming from.  If you were living under the veil of conspicuousness, you would have a completely different opinion of my perspective in my posts.  Remember, I deal with the horrific results that you might consider professional every single day of my life.  You may turn a blind eye to these gruesome stories and ruined lives, but I do not.  You may consider it acceptable to turn your back on the atrocious work that still exists, but I do not.  Exposing such terrible work does not make me the best.  It simply puts me on an island by myself championing for better work across the board.  I don’t want more work.  I have plenty.  What I want is for physicians to hold themselves to a higher standard of care.  What I would like to see is far less repair work.  I often cringe when I see the ghastly results I’m met with.  I simply can’t imagine how someone could do that sort of work on another human being.  Have you ever repaired a bad result?  I doubt it.  It's incredibly hard.  Few can do it.  It nearly breaks my neck to do it for a day.  I'm sick of seeing it.  I want it to end.  While it is hard on me, all I can think of is how difficult it is for my patient to live through it, so i persevere.  

Now, the optimal way for me to get this message across is not in a forum.  It is to train more physicians to do the job right from the beginning.  I can’t do it all.  I don’t want to do it all.  One can never make all patients happy with coverage.  What we must avoid at all cost is making them look like they’ve had a hair transplant.  That is much worse than thin or bald or inadequate coverage.  

One may not recognize the limitations of the donor area.  One may not recognize the greater difficulties with FUE procedures as a whole.  One may consider it pathetic to bring to light those methods and physicians who perform suboptimal FUE.  Well, good on you.  You never had to live through a wasted donor area.  You never had to live through a suboptimal result.  You never had to live through a disfiguring result.  Others have and I’ve had the heartbreak of living that experience with them.  

I’m all about the patient and honesty.  I don’t work for physicians who own a robot.  I don't have to figure a way to promote physicians who don't have a clue how to do FUE so they buy a robot.  I do make my own equipment, but my equipment will not make a bad doctor good.  I don’t have to pretend that a robot is good just because I get paid to promote them.  I don’t have to pretend that bad doctors are good and I don’t have to pretend that mediocre doctors are great.  I guess that qualifies me as unprofessional. However, if that means that I don’t have to stand by the status quo in the hair restoration industry as a whole that has ruined lives for many years, I’ll take the unprofessional label with a degree of pride and encourage others to do so, as well. 

Payday, I don't know your story, but I'd say you have a leg up on naive.  Perhaps you are simply blissfully ignorant.  i work for my patients.  I don't work for complements from people who have no idea where the hair restoration industry started, where it went, where it redirected, or where it is headed.  I work for the welfare of patients.  Color me unprofessional if you like.  I'll wear that badge with honor.

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## topcat

Patients learn more from open honest exchange and can make better decisions when those in the industry worry less about being politically correct.  Being politically correct is what has been doing most of the harm to patients when it comes to these forums.  One would need to ask why is anyone here if is not to help the actual patient make an informed decision with open honest information.

I love to see brutal honesty because it is good for the patient, its a breath a fresh air in a very polluted industry. I also agree it cannot be done alone and those that can should at least try.

The same goes for patients when you don't come back to help others most especially when things have gone wrong then you help perpetuate what has happened to you.

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## FearTheLoss

> Payday, there are many fine FUE surgeons across the globe.  Some have different philosophies, which you will not find in this particular forum unfortunately.  While I’ve done over 8000 strip procedures I’d hardly classify myself as a great one any more simply because I don’t do many.  I have done over 5000 FUE procedures, which probably ranks me tops in experience in the world.  Experience does not make someone the best, but it sure is helpful.  As Malcolm Gladwell noted in his book, Outliers, one does not become really, really good at anything until they have at least 10,000 hours of experience.  So, based on experience and my results, I’d consider myself very good at what I do.  That in no way implies that I’m the best.  There are varying philosophies in FUE.  Some have more practice at one, but less at another.  This is where FUE becomes very technical and well beyond the scope of this predominate strip forum.  Now, in regard to FUE I am an expert.  I know what I’m talking about.  While some would like to be led down the primrose path, others are grateful for the enlightenment so that they can avoid such mistakes.  I take it that you were never disfigured by the unwise solutions offered in the past.  I also suspect that you have no experience trying to hide your obvious hair transplant results.  If you did, you would have a much clearer perspective of where I am coming from.  If you were living under the veil of conspicuousness, you would have a completely different opinion of my perspective in my posts.  Remember, I deal with the horrific results that you might consider professional every single day of my life.  You may turn a blind eye to these gruesome stories and ruined lives, but I do not.  You may consider it acceptable to turn your back on the atrocious work that still exists, but I do not.  Exposing such terrible work does not make me the best.  It simply puts me on an island by myself championing for better work across the board.  I don’t want more work.  I have plenty.  What I want is for physicians to hold themselves to a higher standard of care.  What I would like to see is far less repair work.  I often cringe when I see the ghastly results I’m met with.  I simply can’t imagine how someone could do that sort of work on another human being.  Have you ever repaired a bad result?  I doubt it.  It's incredibly hard.  Few can do it.  It nearly breaks my neck to do it for a day.  I'm sick of seeing it.  I want it to end.  While it is hard on me, all I can think of is how difficult it is for my patient to live through it, so i persevere.  
> 
> Now, the optimal way for me to get this message across is not in a forum.  It is to train more physicians to do the job right from the beginning.  I can’t do it all.  I don’t want to do it all.  One can never make all patients happy with coverage.  What we must avoid at all cost is making them look like they’ve had a hair transplant.  That is much worse than thin or bald or inadequate coverage.  
> 
> One may not recognize the limitations of the donor area.  One may not recognize the greater difficulties with FUE procedures as a whole.  One may consider it pathetic to bring to light those methods and physicians who perform suboptimal FUE.  Well, good on you.  You never had to live through a wasted donor area.  You never had to live through a suboptimal result.  You never had to live through a disfiguring result.  Others have and I’ve had the heartbreak of living that experience with them.  
> 
> I’m all about the patient and honesty.  I don’t work for physicians who own a robot.  I don't have to figure a way to promote physicians who don't have a clue how to do FUE so they buy a robot.  I do make my own equipment, but my equipment will not make a bad doctor good.  I don’t have to pretend that a robot is good just because I get paid to promote them.  I don’t have to pretend that bad doctors are good and I don’t have to pretend that mediocre doctors are great.  I guess that qualifies me as unprofessional. However, if that means that I don’t have to stand by the status quo in the hair restoration industry as a whole that has ruined lives for many years, I’ll take the unprofessional label with a degree of pride and encourage others to do so, as well. 
> 
> Payday, I don't know your story, but I'd say you have a leg up on naive.  Perhaps you are simply blissfully ignorant.  i work for my patients.  I don't work for complements from people who have no idea where the hair restoration industry started, where it went, where it redirected, or where it is headed.  I work for the welfare of patients.  Color me unprofessional if you like.  I'll wear that badge with honor.


 I just want to say thank you for this, we need more doctors/people like you in this world. 

..and I'm very excited to hear about your meeting with Dr. Nigam.

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## gillenator

Ohhhh Dr. Cole.  Please forgive me.  Let me be more specific.  I was not discrediting the work that you did on me.  In fact, I failed to point out that you did all of the recipient sites and also harvested my donor strip.  And although it's true that both Drs Mwamba and Bisanga were in fact surgery techs and not yet licensed physicians in the US, still they were both licensed physicians in their native country Belgium where they both practice today.  I always showed them that respect by addressing them as doctors.  I think most would agree with me even though they were not licensed in the US.

What I meant was that they cut my grafts and placed them for the most part.  Francine also assisted in the microscopic dissection of my strip.  I also remember you coming in at the end and you re-positioned some of my grafts.  But in all honesty, you had several other procedures going on concurrently with mine which was MHRs protocol. 

Doc, I remember the time when we first started working together and I had stubbed my big toenail sooo bad the prior evening that you got down on your hands and knees to examine my toe.  You prescribed me an antibiotic, gave me instruction and advice how to care for it.  Throughout the next week you kept asking me to remove my shoe and sock so you could have another look for any possible infections, etc.  You did not have to do that but you cared about my pain and recovery as I limped around for a week.  I know that I thanked you then but I also wanted to thank you publicly.

I am also skeptical of the claims made by Dr. Nigam however at least you are going to see for yourself and trust you will give us the clinical findings and whether there are any clinical substantiations to support them.

BTW, I still say that Dr. Shapiro gave me awesome hairline work "twice".  You can still feel otherwise as you are entitled to your opinion.  Also, any other HT doctors that looked at Dr. Shapiro's work on me said it was outstanding.  So did Drs Mwamba and Bisanga.  The other doctor that worked on me was a very small procedure from Dr. Brad Kurgis in California who also was a MHR doctor at the time.  That was horrible work that I believe you are referring to yet Dr. Shapiro and you both were the majority of my surgical restoration.

Thanks again John and have a safe trip there and back.  :Wink:

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## 35YrsAfter

> I just want to say thank you for this, we need more doctors/people like you in this world. 
> 
> ..and I'm very excited to hear about your meeting with Dr. Nigam.


 I posted photos in another forum illustrating the healing benefits of ACell.  The progress photo was taken 3 months after surgery.  We generally check for follicle regeneration at 10-12 months post op.  My photo alignment was a little off, but my purpose of showing these three month mark photos was to illustrate the absence of donor scarring.  A few weeks earlier, our patient came in and Dr. Cole examined the donor with loops and lighting for follicle regeneration.  At that point, Dr. Cole could barely find the extraction points even with magnification.  He didn't know, but I videotaped him with my Samsung Galaxy S3 for six minutes locating the extraction sites.  Below are screen grabs from the video where he marked extraction sites that were regenerating follicles.

Dr. Nigam saw my post in the other forum, and responded:
"I admire dr cole for his work..and would be more than glad to share my work..and i am ready to be tested/scrutinized by any tight control methods..
would gladly welcome an email from your end..dr.rahul1970@gmail.com
convey my best wishes to dr cole..for his innovative and pioneering work since many years.."

35YrsAfter also posts as CITNews and works at Dr. Cole's office
www.forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

----------


## FearTheLoss

> I posted photos in another forum illustrating the healing benefits of ACell.  The progress photo was taken 3 months after surgery.  We generally check for follicle regeneration at 10-12 months post op.  My photo alignment was a little off, but my purpose of showing these three month mark photos was to illustrate the absence of donor scarring.  A few weeks earlier, our patient came in and Dr. Cole examined the donor with loops and lighting for follicle regeneration.  At that point, Dr. Cole could barely find the extraction points even with magnification.  He didn't know, but I videotaped him with my Samsung Galaxy S3 for six minutes locating the extraction sites.  Below are screen grabs from the video where he marked extraction sites that were regenerating follicles.
> 
> Dr. Nigam saw my post in the other forum, and responded:
> "I admire dr cole for his work..and would be more than glad to share my work..and i am ready to be tested/scrutinized by any tight control methods..
> would gladly welcome an email from your end..dr.rahul1970@gmail.com
> convey my best wishes to dr cole..for his innovative and pioneering work since many years.."
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> www.forhair.com
> ...


 
Yes, 35Yrs..I did see that post and was impressed with it. I really appreciate the advances Dr. Cole and Dr. Nigam are both hopefully making and I wish them both the best of luck. I think these two meeting could potentially bring a new era to the field of hair restoration. I hope Dr. Nigam can back up his claims, I don't know why he would be so willing to have a doctor, with the status that Dr. Cole has, come over to see his work first hand if he wasn't sure that he could back them up....so let's hope for the best of this. 

I'm thankful for both of these doctors. Dr. Cole, I wish and pray for a safe trip to and from for you.

Best, FTL.

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## sausage

my beard hair is thick, dark and coarse whereas my head hair is not as thick and dark....

My leg and arse hair is more like my head hair.

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## didi

> Patients learn more from open honest exchange and can make better decisions when those in the industry worry less about being politically correct.  Being politically correct is what has been doing most of the harm to patients when it comes to these forums.  One would need to ask why is anyone here if is not to help the actual patient make an informed decision with open honest information.
> 
> I love to see brutal honesty because it is good for the patient, its a breath a fresh air in a very polluted industry. I also agree it cannot be done alone and those that can should at least try.
> 
> The same goes for patients when you don't come back to help others most especially when things have gone wrong then you help perpetuate what has happened to you.


 

Topcat
I agree with you, we need more brutal honesty and less political correctness.
Also you need to understand when patients disappear you cant always blame them, when someone have bad result they tend to hide and suffer in silence, its not easy to come out on public forum and show your miserable results.
Another thing is forums are censored, sponsoring doctors have control of information, 
also there are legal issues, I know that HT doctors threaten legal action(defamation, etc) if you say something bad about them.

what we see on forums is pretty much what Drs want us to see, when something goes wron its laways patient who had unrealistic expectations..even though only half of grafts grew like it the case with dr woods patient.
yet they always guarantee 97%+ growth rate.

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## 35YrsAfter

> Topcat
> I agree with you, we need more brutal honesty and less political correctness.


 Political correctness is always lopsided and is basically a philosophy of accepting standardized and homogenized opinions into one's heart as a kind of "religion".  The reality is, political correctness is simply an intolerance of non-standardized opinions.  The standardized opinions are in my view the result of media social engineering promoted by control freaks who see a need to regulate society and free thought.


35YrsAfter also posts as CITNews and works at Dr. Cole's office
www.forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

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## John P. Cole, MD

Dear Gillenator,

Thanks for mentioning Francine.  She is not a PA (Physicians Assistant) with child and doing quite well.  That was an all star bunch we had back in those days.  I have a pretty good crew now, as well.  A physician is only as good as his team, but his team is only as good as the physician demands.   Everything in life takes the path of least resistance.  It does not matter if it's dog training or people training.  You have to set the standard and keep insisting on that standard every day.  If you don't, it all fall apart.  And no!  I'm not suggesting that assistants are dogs.  I train hunting retrievers and I love all of them to death.  I would take a bullet for them.  I'm simply implying that if you want anyone to perform at their best every day, you have to set the standard every day and maintain it.  I see everything in my office and the second one slight mistake is made I'm on top of it.  This way the standard never drops.  If you let your standard down with your dogs, they get sloppy too.  

I never discredit the work of Dr. Shapiro.  He does great work.  I'd just prefer he did not allow a layman to cut his FUE and you know how I feel about the robot, at least at this point.  Maybe they will surprise me with that gadget and we will all be getting one some day.  Who knows.  For now, I really don't like the thing.  He knows how I feel.  I've told him.  Still, he's a great physician and a great guy too.  Anyway, I'm pretty sure the bad grafts you had were the handy work of another doctor.  There are only two ways to conceal a bad hair line.  One is to take it out and build a new one.  The other is to build a better one in front.  sometimes you can't go lower so you have to take out first.  Then again, sometimes it takes a combination of both.  Don't get me wrong.  Your hairline was not terrible.  It was a near miss.  Frankly, I'm surprised you needed a top off because you were looking pretty good last time I saw you, but perhaps you lost a bit and also I'm sure that Dr. Shapiro complemented your hairline in follow up.  He is damn good in my opinion.  

At a meeting someone gets up and says something.  Most of us sit in the back of the room and we scratch our heads in disbelief.  Nobody says anything and so the whole crazy notion begins to take on a life of it's own.  Then before long we all start to believe it simply because no one had the resolve to stand up and ask the tough questions.  I ask the tough questions usually when I see something that just does not properly mix.  I did not when I was younger, but I do now mainly because no one else will and it matters.  This sort of thing never makes you the most popular guy in the room.  That does not matter really at this point in my life.  I will go out with some colleagues loving me and some hating me.  I focus on doing what is right and getting to the bottom of something that does not seem valid.  Sure, I make mistakes, but I make them with one perspective in life.  That is to make certain I deliver the best possible outcome for my patients and I steer them clear of things that are not in their best interest.  Sometimes it sounds possible so you have no choice other than to say that something sounds promising, yet I would not really recommend that you be the first guy to give it a shot.  

Anyway, nice to chat with you.  I hope we get an opportunity to spend some time together in the near future.

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## John P. Cole, MD

Didi, if you get 97% of BHT to grow you just plain got lucky.  I've had some 100% growth with beard and chest when i injected Acell, but i'm not convinced the Acell was the reason.  With my humbling experience on BHT, I'd say that luck very well may have played the predominate role.  I'm pretty uptight about this BHT issue because the last thing we need to be passing along to patients is a heightened sense of confidence in BHT. Some times it just does not grow at all.  Then again, beard grows good, but I've has tests of 10 beard hair grafts in a strip scar that grew their accustomed 60%, but the patients hated the appearance of the beard hair.  They wanted nothing more to do with them.  Some love the beard hair and some hate it.   If Dr. Woods told this patient that 97% of his body hair would grow, then he was vastly exaggerating and perhaps delusional.  I know that Dr. Umar wrote a paper where he said that 87% of leg hair grew for him across the board.  I happened to be the moderator on a panel where he presented this.  Now as a moderator, it's pretty tough to be critical, but I did ask him how he got 87% when I sometimes get zero percent and never more than 60%.  His response was graft selection.  Now having done enough leg hair to know that graft selection such as anagen hair makes a difference, but there is no way to pick out the 87% that will grow.  It was just rubbish.  I asked him to be more descriptive of how he chose the ones that will grow and the best response he could give was the same response again.  

Don't go into body hair thinking it will grow.  Go in expecting it not to grow and if it does grow, well you are just plain lucky.

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## wylie

> And those of us who have character do not make grandiose statements that they are the best at this and that, nor do they take pot shots at their colleagues as you do repeatedly.  You were rightfully called out on that too by another forum member remember?
> 
> You see a true professional does not have to disrespect others in order to make a point.  The very best are humble individuals.  They do not have to repeatedly come on a public forum insulting their colleagues and others in order to gain market share.


 True dat.

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## John P. Cole, MD

I don't see it that way Wylie.  The true professionals never said a word about plugs, scalp reductions, mini grafts, or strip scarring. How did that benefit the hair restoration patient or the field?  

While the potential is much better for an aesthetic result today, procedures like FUE are much harder.  Doctors and patients can get into a whole lot of trouble quick.  

I don't mean to be disrespectful to you.  if everyone sticks their head in the mud, sees no evil and speaks no evil, then you hear no evil.  Then you wind up without progressive thought.   Remember there are alot of guys trolling these forums who work for doctors that promote procedures and equipment that create the most potential problems.  I don't know whether they get behind these methods and instruments because they are paid to get behind them or whether they just don't know any better.  I do know, however, and I suspect you recognize that I'm not bashful about expressing my opinion, when something bad might happen if I don't. Now if you want to have a strip, which is done in perhaps 60% of all hair restoration surgery procedures, I'd be happy to steer anyone in a direction that I think is best.  I personally don't do strips any longer so I would be one of your worst choices and I'd tell you that.  Now if you want FUE, I happen to be an expert in that.  I know there are all sorts of guys trying to do FUE these days because it is popular.  That does not mean you will get a great result. In fact, just as I would not recommend that you have a strip with me, I would expect the physician who does very little FUE to recommend the same to their patient - go somewhere where they do a lot of FUE.  I'd also recommend you steer clear of any robots because those docs have no idea what the robot is doing.  

Any way, I hear you.  I simply don't in any way agree with you.  

Just curious, why Joe Biden for your Avatar?  He is a NW 7.  From the side or rear it's obvious something is not right.  From the top down he is totally thin too.  Guys like that are not good candidates for a HT because the results can look as unusual as his result appears.  Now, Joe had plugs and it was obvious he had plugs.  Then over time his hair began to thin and he had a bit of corrective work.  Now the hairline look ok due to thinning and corrective work, but it's still pretty obvious that it's a hair transplant from the back, sides, and top.  Joe is a guy who could have benefited from someone saying, "don't do it, Joe".  Boy was it obvious during the VP debate.  Wasn't he also the guy who was telling folks that they (Mitt Romney and Republicans) want to put you back in chains?  Wasn't it is some southern evangelical delivery?  Now that's something that didn't seem right to me regardless of political affiliation.  Well come to think of it, it seems most politicians are misleading at times.  Hmmm.  Seems many doctors are too.  

What we do in the hair restoration surgery field affects the lives of people from the first day forward.  We need truth and honesty in this industry. My comments are not political.  My comments are flat in your face fact.  

I'm glad you had a positive experience with beard hair.  It can be a real life saver for many.  Thanks for sharing those comments.  Just remember that not all like the appearance of beard hair.  Some hate it.

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## didi

_'I WARMLY WELCOME... Dr.Cole's announcement, that he would visit my DOUBLING/HM CLINIC.

I firmly believe, only by sharing and scientifically debating..we can decode the puzzle of MPB cure_.

In 2013,
First constructive visit, was from the Berlin team of, dr gerd,dr umax..who visited me and we both were benefited by the visit.

Next was the my visit to WCHR,edinburgh,

where jahoda,stenn,phillipot,raus,randell and others ..really shared each others experience like a selfless and true scientist..whose goal is not just to make money..but a bigger goal TO BE A PART OF CURE..
Like a game of soccer..no individual alone can win the game.

Nature does not love monopoly...

I firmly believe..

A HARMONIUS COORDINATION AMONG MINDS ..FOR A CHIEF DEFINITE GOAL...IS THE WAY..TO ACCESS THE INFINITE INTELLIGENCE OF THE UNIVERSE..

SOLUTIONS EXISTS IN THE UNIVERSE..WE NEED TO DISCOVER THEM...'-*Dr Nigam*

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## sausage

arghhh website i tried to post won't work.

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## ukcali

Dr Cole,

One last quick question. Obviously as you've said if your experience you find bht very hit or miss but I was just wondering what about nape hair (the hair on the back of your neck)? Is that just like body hair or is it more like scalp hair and therefore something that cold be used? 

Thanks again  :Smile:

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## John P. Cole, MD

You know some are worried about my admonitions about other physicians, but I also point the finger at myself.  I'm the guy who listened to the great body hair results that Dr. Woods was having and decided to try them.  Granted, my first few cases were great successes, but I subsequently had some cases with poor growth.  Who is to blame for these cases of poor growth?  I have to blame myself.  So....I warn all people and physicians about large cases of body hair.  

There was a study done by Tommie Hwang around 2004 where he moved leg hair to the scalp and it grew longer than leg hair.  Then he moved it from the scalp to the back of his hand and it behaved like body hair and grew shorter.  Then he moved it to the nape of the neck and it grew like body hair.  Nape of the neck or the stuff your barber shaves is body hair.  It behaves like body hair meaning sometimes it grows and sometimes it does not grow at all.  This has been my experience with hair from the nape of the neck.  I've seen some very poor results from nape of the neck hair.  I wish it were better, but it is not.  

What one must be careful of with body hair is that you can poison the scalp and nothing grows well when you do very high body hair densities.  I guess it's an autoimmune reaction, but sometimes it happens.  I did a low density session on a guy and it grew well.  Then he had another doctor do a larger session with high density and it did not grow.  It also shocked out alot of what I had gotten to grow.  Then he came back to me and I had trouble getting anything to grow after that.  Don't be aggressive with body hair.  I wish I had better news about body hair, but it is just the most frustrating source of transplant hair.

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## 35YrsAfter

I participated in one of Dr. Cole's body hair studies.  The study was to determine the optimal body hair density during graft placement.  Leg hair was used.  It grew well for a while and faded over time.  On the other hand, (not literally) I had chest and stomach hair placed that continues to grow well to this day.  I remember the square of dense packed leg hair.  Not a single hair grew when the grafts were placed too close together.  The less dense areas of leg hair grew, but as I mentioned, the hairs faded over 6 years.  I can still see them but they provide cosmetically insignificant coverage.  Beard hair is a different story.  We had a patient yesterday who told me that it seemed to take forever (over a year for him) for his beard grafts to grow, but to date, they are proving the best coverage yet.  My 750 beard grafts are growing after 6 months and look natural because of the low density placement.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant - Atlanta Clinic
Toll Free 1-800-368-4247
Phone 678-566-1011

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## baldozer

> I participated in one of Dr. Cole's body hair studies.  The study was to determine the optimal body hair density during graft placement.  Leg hair was used.  It grew well for a while and faded over time.  On the other hand, (not literally) I had chest and stomach hair placed that continues to grow well to this day.  I remember the square of dense packed leg hair.  Not a single hair grew when the grafts were placed too close together.  The less dense areas of leg hair grew, but as I mentioned, the hairs faded over 6 years.  I can still see them but they provide cosmetically insignificant coverage.  Beard hair is a different story.  We had a patient yesterday who told me that it seemed to take forever (over a year for him) for his beard grafts to grow, but to date, they are proving the best coverage yet.  My 750 beard grafts are growing after 6 months and look natural because of the low density placement.
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> Cole Hair Transplant
> 1070 Powers Place
> Alpharetta, Georgia 30009
> Phone 678-566-1011
> Please feel free to call or email me with any questions.


 Do you have pictures showing those 750 beard hair, or pictures of any other patient with beard hair transplant?

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## 35YrsAfter

> Do you have pictures showing those 750 beard hair, or pictures of any other patient with beard hair transplant?


 We have a patient who had 2,700 beard hair grafts placed all over his head along with scalp hair grafts.  He was a repair patient and needed hair from every available source. His hair appears uniformly curly and looks natural. We use beard hair only as filler to increase coverage.  In the case where the beard hair caliber is twice that of scalp hair, it provides 4x the coverage.  There is usually curl there as well that helps. Beard hair is always blended with scalp hair.  When done properly, it looks natural.  If one tries to cover a Norwood 6 head with only beard hair, the result will be odd and unnatural.  As far as my own result, It has just started growing.  It often begins growing much curlier and later straightens out a bit.  I'm one of those guys who had scalp hair transplants years ago.  As my scalp donor area thinned with age my grafts thinned.  Most everything on the top is now chest and stomach hair.  I was a difficult case and still a work in progress.

When a patient returns who has had beard hair blended with his scalp hair, I will part his hair and take a photo.

On our You Tube Channel (forhair) our repair patient progress photo is included in our video illustrating disadvantages of strip surgery.

35YrsAfter also posts as CITNews and works at Dr. Cole's office

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## ukcali

> You know some are worried about my admonitions about other physicians, but I also point the finger at myself.  I'm the guy who listened to the great body hair results that Dr. Woods was having and decided to try them.  Granted, my first few cases were great successes, but I subsequently had some cases with poor growth.  Who is to blame for these cases of poor growth?  I have to blame myself.  So....I warn all people and physicians about large cases of body hair.  
> 
> There was a study done by Tommie Hwang around 2004 where he moved leg hair to the scalp and it grew longer than leg hair.  Then he moved it from the scalp to the back of his hand and it behaved like body hair and grew shorter.  Then he moved it to the nape of the neck and it grew like body hair.  Nape of the neck or the stuff your barber shaves is body hair.  It behaves like body hair meaning sometimes it grows and sometimes it does not grow at all.  This has been my experience with hair from the nape of the neck.  I've seen some very poor results from nape of the neck hair.  I wish it were better, but it is not.  
> 
> What one must be careful of with body hair is that you can poison the scalp and nothing grows well when you do very high body hair densities.  I guess it's an autoimmune reaction, but sometimes it happens.  I did a low density session on a guy and it grew well.  Then he had another doctor do a larger session with high density and it did not grow.  It also shocked out alot of what I had gotten to grow.  Then he came back to me and I had trouble getting anything to grow after that.  Don't be aggressive with body hair.  I wish I had better news about body hair, but it is just the most frustrating source of transplant hair.


 Thanks again Dr Cole. As I'd said before I just wanted to see how feasible body hair was as a future option. I have wanted to look into having that laser hair removal done in a few areas at some point soon, so just wanted to make sure I wasn't away to destroy a potential future donor area! 

Thanks again for your help it really is appreciated!  :Smile:

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## John P. Cole, MD

Here is an interesting finding with body hair.  Some people grow back hair better than chest hair, some chest better, some leg hair better, and some abdominal hair better.  Nape of the neck never did well for me.  Then there is cosmetic benefit.  Don't expect leg hair to grow as long as scalp hair.  At best it will double in length.  Back hair is often fine and even though the yield might be good, you may not be able to see it across the room.  There are no certainties with this sort of body hair.  Axilla (underarm) hair and pubic hair are very difficult to remove so i quit trying.  Then there is beard hair.  It works well and it is visible though often too coarse and curly.

I think if you are looking a laser hair removal, first consider how much hair loss you anticipate.  If you are moving to a NW 6 or better, you might want to avoid removing these.  If you are going to a NW 3, I'd have no problem with you doing laser hair removal.  

I would avoid doing laser hair removal on the beard if you can help it because this is the best source outside of scalp hair.

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## ukcali

The human body never stops amazing me. They way how one thing works for one person and the total opposite works for another etc. 


if I'm being realistic my father is probably a NW 5 or 6, and I appear to be following the same pattern. I was on minoxidil foam for about a year but didn't notice any use and stopped using it a few months ago. I have (after a long time debating it in my own head) started taking propecia about a month & 1/2 ago so obviously way too early to see if it's working. 


In regards to laser, I would be looking at doing my hands, shoulders/back and ideally my chest. Although since reading this I guess I'll have to leave my chest alone. I also wouldn't be touching my beard area. That sound ok?

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## didi

Dr Cole

Beard and chest hairs go grey faster than head hair, 
looking at my dad, he is 60 and his beard and chest hairs are white whereas back of his head is sill black...you see the problem if you do bht

What is the best way to get rid of them once it starts happening on your head (assuming you had an bht) 

Can you do reverse FUE targeting grey bht? laser is out I suppose
Do you have patients asking for bht removal

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## topcat

Here is a current picture of a tanned chest donor area, can you find any white dots.

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## topcat

Approximately 900 fue taken from a very small area over 3 procedures as evidenced by the missing hair on as it now appears on a tanned face 8 months post op. I would say by just using my own judgment and eyes the yield was 100%

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## John P. Cole, MD

Ucali, sometimes back hair works out well.  So can the hair off your fingers.  I bet most of the time these areas will not work well so a laser of these areas is probably fine.  

Yes, beard can turn white early on.  This can be an issue for some though I think most would prefer to have hair even if it is white.  One has to take into account personal differences, Didi.  Yes, any graft can be subsequently removed if you don't like it.  No, I've not had anyone ask to have the hair removed, yet.  

Beard grows fast like scalp hair.  Chest does not grow as fast as scalp hair.  If you cut the hair on the scalp short after a transplant expect the scalp hair to grow faster than the body hair.  The exception appears to be beard hair.  I have everyone wet shave the body hair 3 days in advance.  The exception is beard hair where i ask them to wet shave one day in advance.  This helps me locate anagen hairs or actively growing hairs.  Almost all beard hairs are in anagen, by the way.

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## didi

> Ucali, sometimes back hair works out well.  So can the hair off your fingers.  I bet most of the time these areas will not work well so a laser of these areas is probably fine.  
> 
> Yes, beard can turn white early on.  This can be an issue for some though I think most would prefer to have hair even if it is white.  One has to take into account personal differences, Didi.  Yes, any graft can be subsequently removed if you don't like it.  No, I've not had anyone ask to have the hair removed, yet.  
> 
> Beard grows fast like scalp hair.  Chest does not grow as fast as scalp hair.  If you cut the hair on the scalp short after a transplant expect the scalp hair to grow faster than the body hair.  The exception appears to be beard hair.  I have everyone wet shave the body hair 3 days in advance.  The exception is beard hair where i ask them to wet shave one day in advance.  This helps me locate anagen hairs or actively growing hairs.  Almost all beard hairs are in anagen, by the way.


 
Dr Cole


When are you planning to visit dr Nigam in Mumbai?
we don't need exact dates 

no pressure but better to act sooner , dr Nigam is waiting for you

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## Winston

> Dr Cole
> 
> 
> When are you planning to visit dr Nigam in Mumbai?
> we don't need exact dates 
> 
> no pressure but better to act sooner , dr Nigam is waiting for you


 Please keep this thread on topic. 
Thank you for your understanding in this matter.

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## wylie

I said I was going to post some pictures of what 5000 beard hair grafts (plus around 1000 scalp and 500 nape) look like on a repair patient, so here ya go:

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## sausage

yes, kind of looks silly, and does look like body hair as it is a completely different colour and less settled......

maybe it would help if he died his hair.

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## vinnytr

> By far beard hair is the best for growth and looks great.  Using a .9mm punch or a 1.0mm leave acceptable scars under the chin.  We have been able to get an extra 1,000 grafts from a fairly dense beard.  I use beard hair as filler, never on the hairline or temples.  Beard hair growth is very predictable.


 Dr Yates , how close to the hairline would you use the beard hair as a filler ?

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## topcat

I think that 5000 graft beard hair looks very good. Not sure on the yield would need to see a before picture but looks good overall.

Sausage judging by some of your comments and you being a NW6 I would definitely say that you are not a ht candidate. You would never be pleased with the result so it would be pointless.

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## wylie

> yes, kind of looks silly, and does look like body hair as it is a completely different colour and less settled......
> 
> maybe it would help if he died his hair.


 "Died" his hair? I really hope English is not your first language.

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## didi

Looks good, you cant tell diff between beard hair and native head hair. I cant tell much about yield. hairline looks natural, not too high, not too low.

your beard must be very similar to your hair

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## max4rmuk

Hi guys, just wanted to know since this thread is about body hair. I have been told that the leg hair is not really suitable for the scalp as it's growth cycle is very long about 2 years. Is this correct?

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## John P. Cole, MD

Leg hair summary.

1. Grows slower than head hair.  Grows shorter than head hair.
2. May grow for a few years on your scalp and then disappear.
3. Yields vary from 0% to 90%, but average is probably 40%. 
4. You will never know how you will respond to leg hair until you try it.  
5. Because the yield is so low, because it's duration of survival is unknown and variable, because it will not grow as long or as fast as a head hair you should use leg hair only as a procedure of last resort.
6. If you elect to try it, do a small test of 50 to 100 grafts, evaluate the result, and then proceed based on this response.  

Leg hair may be useful for things like building temple points, eyebrows, or softening hairlines, but leg hair can also be a complete failure.  One place i would not use it is in strip scars.  Though i've seen thigh hair work well here and last for years in a few instances, it often is a complete failure.  

Use head hair first.  Head hair is king.

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## max4rmuk

Thank you very much for the information Dr Cole.

So does thigh hair differ from hair from the lower leg? In terms of it's growth period etc or is it exactly the same principle?

And how about stomach hair Dr Cole, what are your suggestions for using that for the scalp is that also pretty much in the same boat as leg hair?

Thank you once again for your reply.

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## John P. Cole, MD

One advantage to leg hair is that it will heal with no perceptible evidence.  The extraction sites can take 3 to 6 months to loose their pink color, but they heal almost without flaw.  

Stomach hair and chest hair both tend to heal with white dots about 50% of the time.  I'd say that chest hair can grow longer than leg hair.  A good rule of thumb is that body hair will grow about twice it's length on the scalp.  

The upper leg to thigh can behave differently than the lower leg, but that is not to suggest that they always behave differently.  Thigh hair like lower leg hair extraction sites all heal beautifully.  

Back hair heals well most of the time, but i've seen white dots there.  they are usually not as noticeable as on the chest and abdomen, however.  

There are no absolute rules of thumb with body hair.  Those with the best body hair often get the worst results.  I wish we understood how to make it grow more consistently.  If you move body hair, make sure you wet shave 3 days before your procedure because anagen hairs grow better than resting hairs.  

The most predictable source of body hair is the beard, but some don't like the curly nature.

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## max4rmuk

Thank you Dr Cole for clarifying things for me much appreciated. 

Hopefully when and if Dr Wesley's Pilofocus comes out we won't have much to worry about with regards to scarring.

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## UK_

So leg hair is not viable but hair from the thigh may work...

Joking aside... but maybe the holy grail REALLY IS pubic hair... I mean, its the only thing that hasnt been tried... right? :Confused:

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## didi

Dr Cole

Do you still charge full price for bht as you said yield is unpredictable and sometimes theres no growth.
I know you do test but its possible that 50 graft test yield 80&#37; and then you go for big session of 2000 grafts and yield drops to 30% or less.


Does BHT grows well in crown, ive seen BHT case where patient had chest hair implanted into crown but there was no growth,

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## John P. Cole, MD

Leg and thigh hair can work.  It's just that you cannot predict the growth of either.  What i'm saying is that i've seen leg hair that stopped growing years after a successful transplant.  

Since all forms of BHT other than beard are highly variable in terms of yield, I don't encourage them.  They are worth trying if you have no other option, but make sure you try them in limited quantities.  

Generally, when a small session works, a large session will work.  However, nothing would surprise me with body hair.  It truly is the most unpredictable source of transplant hair available.  

Also, low densities work better than high densities.  I've also seen better yields when Acell is injected, but again, I would not bank on any result with body hair.  I'd try Acell injections if you do BHT, but keep us posted on how you grow.  

Body hair can also grow in thinner or finer in diameter than the source hair was on the body.  I don't know why.

Pubic hair has been used.  It can grow, but it is very hard to remove because it is firmly planted in very "rubbery" skin.  It's the same with underarm hair.  I've given up trying to get them out for now.  Also both pubic and underarm and variable in terms of yield.  

Yes, we are all looking for new options that offer additional hope since the scalp donor supply is limited.

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## ukcali

Thanks again envy body and especially Dr Cole for your continued input into this thread! I have another question if you wouldn't mind. What do you think of this scenario? Is it a possibility? 

Could you FUE the sides and back of the head until you have taken as much is aesthetically possible or maybe just a bit less than that. Then do a "strip style" procedure whereby removing a line of grafts exactly as you would with FUT however you would be using FUE. Now you could then transplant some body hair grafts, into the "strip scar". This would give the benefit of having more "donor head hair" to transplant up top. As well as*
hopefully giving a more natural appearance because although you could use a decent amount of body hair it would hopefully blend well into the back.

I suggested using a "strip style scar" instead of just implanting body hairs into little FUE "dot" scars purely because I thought it wild be wiser not only to do but also to track the growth of the body hairs.*

I have started another threads with this question but thought it would be worthwhile posting it here to. 

Thanks again!

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## gallovolador

Body hair dense packing endangers body hair graft survival. It poisons the scalp and growth might be zero.
It makes me really worry because I just had 1000 beard hair + 300 scalp fue transplanted over a surface of 38 sq cm on my scalp. Which is around this limit of 36 body hair grafts per sq cm that has been stated here by Dr Cole.
I wonder how he got this conclusion of maximum 36 body hair grafts per sq cm. I guess it is coming from his observation and experience.

Anyhow I really trust my Dr, a well known specialist in FUE who dominates all techniques including BHT, specially beard. I have seen several of his cases with Beard and all seemed well satisfactory. Regarding scarring I can confirm that my face after wet shaving three weeks after procedure is absolutely clean of any sign of anything. No scars at all!. Nobody could imagine what was harvested from there. I am extremely pleased and happy in this point.

I would also like to ask about waiting time to see this new transplanted beard hair breaking the skin. Is it similar to scalp hair ( around 3-4 months), shorter or longer?. I read one case where the patient was writing that most of his beard hairs did not fall out and started to grow straight after surgery. In my case most of them fell down around 1 month post like scalp hair do. 

I really want to thank Dr Cole for sharing his honest opinion and huge experience with us in such an opened attitude. This gives only good for science and affected people. 

Once again, thanks a million Dr Cole for all your dedication, well known great work and honesty.

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## thinkingaboutit

I haven't read all the replies to the thread. However, I assume you would only want to consider using body hair if you ran out of donor hair from your head, correct? I would also assume your level of baldness is very high or you have extremely low levels of donor hair to want to even consider getting donor hair from body. 

I am curious, is it possible for another person, another human being to donate you grafts? I realise that the hair type could be slightly different. Let's just assume you are similar hair type, could it cause any other issues, like your system rejecting it because it's from someone else's body? I don't know the correct terms to use, as I am no science expert and have very limited knowledge on this, but I wanted to know if scientists or hair experts have looked at getting grafts from other human beings who would be willing to donate their grafts, and if it works?

I assume if science can move body parts like liver, kidneys etc from one human being to another, then hair may also be a possibility? I would love to hair some replies on this?

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## gallovolador

As far as I know and to make a long story short: it is not feasible to transplant hair grafts from one human to another, something that has been multiple times studied.

This might be the reason why body hair transplant does not work half of times: because body does not recognized body hairs like own hairs but like strange objects and they are rejected. It might be that those individuals whose body hair is very different from scalp hair are then bad candidates for BHT. And this might be the same reason why beard hair is more predictable because it is head hair and due to proximity not so different to scalp hair.

I also want to relaunch two questions: 
   Why this limitation of 36 graft per sq cm, already mentioned in some other post ?, why does scalp may be poisoned when dense body hair packing is done?. Any guessed reason for this?.
    What is the waiting time for body hairs and beard hairs to break the skin after shedding post surgery?, is there any difference observed with scalp hair in the "waiting game"?.

Well, many thanks in advance to all of you for reading and replying. It is very important to get clear conclusions about the last resource nowadays for those with limited donor scalp hairs, and we are many.

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## 35YrsAfter

> I wonder how he got this conclusion of maximum 36 body hair grafts per sq cm. I guess it is coming from his observation and experience.


 My head played a part in zeroing in on the realities of body hair growth.  I participated in one of Dr. Cole's studies where leg hair was transplanted in 1cm squares at varying densities to evaluate growth.  The area where the grafts were placed was slick bald, so it was easy to see and evaluate the growth.  The 1cm square of low density placement initially grew the best.  The dense packed 1cm square grew absolutely nothing! I can still see after 6 years the hair growing in the area of low density placement, but it is cosmetically insignificant because the hair caliber decreased over time.

- Chuck at doctor Cole's office.

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## gillenator

I have yet to see a decent result from using leg hair irrespective of the proximity of graft placement.

Definitely want to do test sessions no matter where the BH donor zone is located below the neck.

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## ukcali

I am planning on having a body hair test done when I get my hair transplant. I was thinking of doing either chest or arms? Anybody have any thoughts? Is chest normally quite successful? What about arms? Never hear much about arm hair. 

I was also taking maybe leg hair to soften my hairline as I know Dr Umar does this but I'm thing I'm probably just wasting my time & would be better to just use normal singled hair grafts? I just thought that I cold maybe lower my hairline slightly more if I used leg hair that was all

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## John P. Cole, MD

I've seen plenty of good responses to leg and thigh hair.  I simply have seen plenty of poor yields as well.  This is one example.  I still consider head hair first.  Beard hair second.  Then other sources of body hair.  When chest hair grows, it is probably a better source than leg hair.

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## John P. Cole, MD

i've used arm hair to soften temple points and the hair line.

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## John P. Cole, MD

I built this temple point with arm hair.  I soften the hairline with leg hair.

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## ukcali

Thanks Dr Cole! Those results look pretty good but I understand your point abut the pure uncertainty with body hair. 

For my test patch what's your advice about which area/s to use? I was thinking chest? But is leg or arm worth considering. 

Thanks again for your help!  :Smile:

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## John P. Cole, MD

The really funky thing about body hair is that you never what source is going to grow best on an individual.  In some people, leg hair grows best.  In others it's abdomen.  In others it's back, while in others it's chest.  If you do the test, pick a source or perhaps two sources in different areas and try them.  Oh, I forgot, in many none of them works well.  Good luck.

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## 35YrsAfter

> The really funky thing about body hair is that you never what source is going to grow best on an individual.  In some people, leg hair grows best.  In others it's abdomen.  In others it's back, while in others it's chest.  If you do the test, pick a source or perhaps two sources in different areas and try them.  Oh, I forgot, in many none of them works well.  Good luck.


 Leg hair grew best on my hairline but faded in my crown area.  I think it works well to soften a hairline that's too strong.  When I consulted with Dr. Cole about repairing my 4mm punch scars and grafts years ago, a "plug redistribution" was recommended.  I decided instead to go with grafting around the plugs.  It worked well enough that I can barely see any evidence of the legacy surgery that caused people to stare at my hairline.  For me, body hair was not good at adding much density.  It has helped in hiding a pluggy look and hiding scars.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

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## John P. Cole, MD

good point.  sometimes body hair grows great and solves a huge problem that you have.  other times it does not grow at all.  then other times, it grows well for awhile, but fades with time.  Propecia is known to decrease body hair in some people.

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## gillenator

> good point.  sometimes body hair grows great and solves a huge problem that you have.  other times it does not grow at all.  then other times, it grows well for awhile, but fades with time.  Propecia is known to decrease body hair in some people.


 I wonder how many men who had BH done in the past were on Propecia or taking another form of low dose finasteride.

So if a man is taking finasteride and wants BH done, should he come off of the med before surgery?  Yet at some point he would have to resume taking it or he would lose any benefit made in the scalp.

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## John P. Cole, MD

That's a great question.  DHT does a couple of things.  One is that it causes hair loss in susceptible men to a variable degree beginning at puberty.  Another is that it stimulates body hair growth at puberty.  When you block DHT, one would not assume that body hair, which is already growing, would succumb to DHT blockage.  At least that is what we initially thought.  Then, with body hair and finasteride we began to hear of a loss of body hair about 10 years ago.  Now, I've treated all kinds of guys with body hair and told them not to stop their Propecia or finasteride or avodart.  I think we have seen very few who had a loss of body hair on these medications.  Still, we have seen some that lost body hair.  So.it becomes a double edge sword for a few.  I think the risk for body hair loss is small as is the loss of sex drive with a DHT blocker.  Still, it only matters when you are the guy with the negative consequence.  

Every patient asks me the same question.  Doctor what do you suggest?  I always want them to have the best result with no complication.  What I ultimately suggest is the medications and procedures that accomplish their goals with the highest degree of probability.  If someone cannot accomplish their goal without body hair plus limiting progressive hair loss with DHT blockers, i'll recommend both.  Then if they begin to loose hair body hair and perhaps scalp hair and loose sexual drive, we recommend they consider dropping the DHT blocker so that they can have the most possible hair at a young age when it matters most.If their scalp hair thickens, their body hair does not decrease, and they have no side effects, of course we would recommend that they continue DHT blockers.  Both are degrees of extreme.  In between is what happens to the majority of the bell curve.  One must individualize treatment.  

the main thing is to recognize that DHT blockers can reduce sexual drive, etc., but it can also reduce body hair.  The impact can be significant in some.  Of course, i've not seen DHT blockers reduce beard hair yet.

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## gillenator

DHT blockers can indeed be a double-edged sword so as you stated Dr. Cole, overall treatment plans need to be individualized.  And I imagine that you may in some cases adjust the dosage of finasteride when side-effects become apparent.  Most of the men that I have conversed with want to immediately stop taking the drug when experiencing sexual side-effects.

Interesting point regarding the resistance of beard hair and possibly is congruent with all facial hair.

Thank you for this ongoing clinical feedback Dr. Cole because as much as we hair loss sufferers may want things to be exact and perfect, life is a road traveled in many different directions, some more uncertain than others.

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## pidda

> By far beard hair is the best for growth and looks great.  Using a .9mm punch or a 1.0mm leave acceptable scars under the chin.  We have been able to get an extra 1,000 grafts from a fairly dense beard.  I use beard hair as filler, never on the hairline or temples.  Beard hair growth is very predictable.


 That seems like a huge punch size for beard grafts.

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## pidda

> Hair transplantation is a surgical technique that moves individual hair follicles from a part of the body called the 'donor site' to bald or balding part of the body known as the 'recipient site'.


 when a large punch is used in the donor area in the scalp excessively, it will create an overharvested look pretty fast compared to a combination of different sized manual punches. Using only a large punch would create an unaesthetically pleasing donor shaving closer to the skin and make scars more visible. Many doctors have no problem with transecting with smaller punches, granted it depends on the size of the graft. Hair transplantation is hair transplantation no matter how you look at it, but the ability to camouflage with FUE is a nice tradeoff. It is important to choose wisely how you go about it no matter where the grafts are taken out including the beard and body hair because the idea is to not make the extraction too visible. Regardless, it depends on the healing characteristics and hair characteristics to find which tool is best.

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## yogeshjoshi

There are many types of hair transplant methods which are helpful for the bald person, talking about body hair for transplant is also a good technique which is known as Body Hair Transplant (BHT) method. The BHT method is very popular method and the best hair transplant in Indore.

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## vinnytr

Dr Cole , could you please confirm beard hair can be taken from the lower part of the neck / the area around Adam`s apple as well ?

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## GNX

the WHY is because its in the Telogen phase much longer. beard hair is closer to head hair as far as growth stages go but the remaining body hair other then pubic and underarm hair are different and stay in the telogen phase far longer.



> The growth cycles of BH are varying and quite unique to the scalp.  Why?  No one seems to know and why it is still in a "try and see what happens" stage.

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## gillenator

The longer telogen phase may be true "after" the BH has been transplanted however any studies to confirm this are far and few.  I have done my own observations of BH on my own body by counting total number of hair(s) and FUs in a defined region and the count has very little change at all.  So native BH IMHO remains in the growth phase for much longer periods, at least in my own case.

Results from beard graft donor still remains a mystery.  I have, like many others, been waiting to see more matured cases of beard donor yet there have been next to none that have come forth show-casing their results... :Confused:

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