Next

FUE – BHT Using Head, Beard and Body Hair

33 of 568

Was this photo helpful? {{ voteCount + ' other' + (voteCountOthers == 1 ? '' : 's') }} found this helpful

Hair Loss Level: The patient who is NW6 destined for NW7 was inappropriately transplanted by another clinic with 1800 grafts using the strip method. He was left still bald, with a strip scar and unfortunately with an odd hair placement. 1800 grafts in the middle of such huge bald area looked very unnatural. The patient does not have the head donor supply to pursue further transplants to take away the acquired odd look. He went to me for repair.
Surgery: I used 12000 head, beard, chest and stomach area hair to cover the entire NW6 area to camouflage and remove the oddly placed grafts. Only about 2000 grafts of the 12,000 came from the head. Because the patient is destined for NW7, I avoided the nape hair. The patient anticipated adding even more hair in the future. 
Lessons: Barring the use of non head hair, patients with this degree of baldness should never have been transplanted. Doing so risks creating a dilemma such as the one this patient was faced with. He has been forced by this first surgery to have to undergo many more graft surgeries using non head hair to just take away the odd look created by the first surgery. Of course there is also the option of wearing a hair piece which many patients do not want to do. Surgery on severely bald individuals should be avoided by clinics and doctors that are not experienced in performing non head hair transplantation. Also, the use of nape hair in this kind of patient is not advised. Patients destined for NW 7 should not have nape hair transplanted. If in doubt, the future hair loss pattern can be better elucidated after shaving the donor area. Upon doing so, the future pattern of hair loss becomes evident as can be seen in the shaved picture of this patient. The donor area shaved reveals a distinct band (wreath) of dense hair corresponding to the safe zone which is what the donor might be reduced to in the future. In this patient the plan for the future would include reconstructing / reconstituting the nape and periaural areas. Traditional/regular hair transplant methods (often strip) rely solely on the transfer of hair from the sides and back of the head to the balding areas. The number of available hair by this method is limited to 5000-6000 (in most individuals). This number is not enough to compensate for the hair loss in severely bald individuals who often would have lost 25,000-50,000 follicles. When 5000-6000 follicles are used to make of for this loss as would be the case with traditional hair transplantation, the result is a very thin look. Alternatively traditional hair restoration surgeries have prioritized the front (called framing of the face). In this case the 5000 follicles are placed in the top and front 9often with a high receding hairline) while the top back (Crown) is left largely unaddressed. The severely bald individuals are thus compelled to settle for a bald pate (crown) and an aged higher hairline with the best traditional transplants can offer. At which point they would have run out of head donor and options. Using the "Umar procedure", I am able to expand the available donor supply by adding hair from the beard and body areas into the head donor pool. The result is that even severely bald individuals can be conceivably restored globally without sacrificing the crown or settling for an aged higher hairline. The boosted donor supply also implies a higher density than what can be achieved with fewer follicle. This is an option for severely bald individuals or those that are donor depleted until hair cloning cell based hair multiplication technology becomes available in the future. I perform BHT using a process he calls Single Follicle Extraction and Transfer (SFET) or Umar Procedure. SFET is my version of the procedure commonly referred to as Follicular Unit Extraction ( FUE ).

By uploading this photo, Sanusi Umar, MD has agreed with RealSelf.com policy that they've secured proper patient consent.