Hair transplantation relocates hair follicles from a dense area of the body to a balding or thinning area. The traditional donor site is the back of the scalp, where follicles are genetically resistant to the hormones that cause male pattern baldness. When this primary source is depleted or insufficient, specialists use alternative donor areas, known as Body Hair Transplant (BHT). Beard hair is the most common and effective non-scalp source for patients with advanced hair loss.
Beard Hair as a Secondary Donor Source
Beard hair is selected as a secondary donor source due to unique biological characteristics well-suited for adding density to the scalp. The follicles from the chin and upper neck area are resistant to the balding process, similar to those on the back of the head. This resistance ensures that the transplanted beard hairs will grow permanently in the recipient area of the scalp.
Beard hair’s high follicular unit density and thick caliber are significant advantages compared to other body hair. Beard hair grafts are coarser and have a larger diameter than most scalp hairs, making them excellent for creating the appearance of fullness and volume. This coarse texture allows a smaller number of grafts to provide a greater visual impact of coverage.
Patients with extensive hair loss, often classified as Norwood grades IV and above, are ideal candidates for using beard hair because their scalp donor supply is limited. Surgeons can harvest a substantial number of grafts from the beard area, ranging from 500 to 2,500 follicular units. Utilizing this secondary source allows surgeons to conserve scalp grafts for more visible areas, such as the frontal hairline.
Extraction and Placement Techniques
Harvesting beard hair is almost exclusively performed using the Follicular Unit Extraction (FUE) technique, which extracts individual follicular units one by one. This method is preferred because the small, circular micro-scars it creates are nearly imperceptible on the face, allowing for rapid healing of the donor area. Any slight thinning of the beard is usually well-distributed and difficult to notice.
The extraction process from the beard is technically demanding and requires a higher degree of skill compared to harvesting from the scalp. Beard hairs emerge from the skin at a much more acute and oblique angle, which can vary significantly even within a small area of the jawline. To avoid transection, specialized small-diameter punch tools are used to carefully follow the curved trajectory of the follicle beneath the skin.
Once extracted, the beard grafts are strategically placed into the recipient area of the scalp to maximize the aesthetic outcome. Due to their thick caliber, beard grafts are used to add density and coverage to the mid-scalp and crown, areas that require maximum fullness. They are not used to create the delicate, soft look required at the frontal hairline, which is better suited for finer scalp grafts.
Aesthetic Differences and Long-Term Results
The biological differences between beard hair and scalp hair are important considerations for the final aesthetic results. Beard hair grows primarily as single-hair follicular units, whereas scalp hair often grows in units containing two to four hairs. The anagen, or active growth phase, of beard hair is shorter than that of scalp hair, meaning transplanted beard hair may not grow to the same long lengths as surrounding scalp hair.
The thicker diameter and potentially different color or curl of beard hair mean that the surgeon must meticulously blend the grafts with existing scalp hair. Placing these grafts at a lower density, often less than 20 grafts per square centimeter, and interspersing them among scalp hairs prevents a visually jarring patch of coarse hair. This careful blending ensures the added volume integrates seamlessly with the surrounding hair.
The long-term results of a beard hair transplant are considered permanent, as the transplanted follicles retain their original genetic resistance to hair loss. Patients must understand that the hair will maintain the characteristics of beard hair, including its texture and growth cycle. This means the hair will need regular trimming to maintain a uniform length if the surrounding scalp hair is kept short.