Facial, Beard, and Moustache Hair Transplant

This audio podcast has been transcribed using an automated service. Please forgive any typographic errors or other transcription flaws.

This podcast is on facial hair restoration or facial hair transplant. I performed quite a few of them. In fact, I’m performing one today. When we talk about facial hair restoration, it really is talking about making beards thicker. We call that the strap beard across the face. We’re talking about mustache thickness. We’re talking about a goatee thickness and that strap can continue along the border of the jawline or mandible from the beard strap, going to the middle. That’s most of what we talk about when we talk about hair restoration of the face, it can be done for either transgender, female to male individuals, or for individuals that just genetically lack a lot of hair in the beard area. So there are different ways to perform a facial hair transplant.

You can either perform a beard to beard transplant FUE or you could do FUE from the scalp or FUT from the scalp. I’m going to talk about each of those three methods, and then I’m talking about little bit the aesthetic goals and the technique of making the design. So the FUE from the beard has a lot of benefits because it is the exact caliber and size for the beard distribution. So that’s one thing, very, very nice in terms of designing it. The benefit is that if you’re losing hair on the scalp and you need to shave your scalp, there’s always risk of hypopigmented dots on the back of the scalp after scalp FUE. Whereas interestingly enough, after beard FUE significant loss of skin color is pretty rare. So even in darker skin individuals, I feel very comfortable to do a beard FUE but I still always say there’s always a risk of loss of skin color, but in general, it’s not very common to have that situation even in darker skinned individuals.

So beard to beard is great. Limitation of beard to beard transplant really involves the number of hairs that are available below the jawline. Oftentimes you can pull about maybe 500 sometimes up to a thousand and there’s limitation. And also when you harvest, you don’t want to harvest them too close together. And that’s where you risk hyperpigmentation. So you want to leave a little bit of distance between the harvesting areas cause the surrounding hairs allow for pigmentary regrowth. So if it’s a small area, like an area near like the mustache, or I could goatee and there’s enough density in the beard area below the chin, that can be a perfect candidate for a beard to beard FUE transplant. The patient that is not a good candidate for beard to beard FUE transplant is usually someone that wants a very big strap beard and that would be a limitation in terms of the number of hairs available from FUE perspective for the back of the scalp or let’s say the scalp in general, first, the scalp, the biggest limitation with a scalp is whether the beard and the scalp hairs match similarly in terms of the density and the caliber of the hair.

Sometimes even the color could be different. If there’s a big mismatch between the scalp hair and the beard hair, then it may not be ideal to undergo a hair transplant using scalp hair, torso hair, or chest hair is even worse because the variability of growth compared to the beard, it just doesn’t grow well. And usually is very stringy and short, so it doesn’t have the quality of scalp hair. If the scalp hair is reasonably similar to the beard hair, then we can perform a scalp to beard transplant in terms of FUE, there’s certain benefits. One is the fact that there’s no linear scar. The negative of it is that I have to harvest from a very wide area of the scalp to get the graphs that I need to do the transplant slightly more expensive to perform that procedure.

Also, you have to shave the back of your head for me to harvest some people don’t like to do that. If they have longer hair also by doing FUE after harvest over a wider area, if you have any crown thinning, that’s a risk of going into what’s called a non-safe donor area, which is genetically programmed for hair loss. So I may recommend a strip procedure FUT instead. One nice thing with the FUE is I can cherry pick the one to two hair grafts that would be ideal for the beard. With FUT or strip procedure I just split those grafts into one to two hair grafts to fit the transplant. So that’s easily. The way that I do it with a strip procedure. The FUT, the benefit is there’s no shaving of the scalp. The total donor capacity available for future hair transplants is better preserved.

Whereas with FUE it takes up more available grafts for future transplantation. And so I know this is a very complicated discussion. A lot of this is going to be talking to you as a person about what’s the ideal way, and there’s many ways to do it. So the technique of doing this is I look at what it needs to be. I do what’s called a lateral slid or coronal sites, which allows the hairs to shingle or lay flat which looks much more natural and appearance. I also follow the natural world and the natural shape and contour of hair grafts to get them to shingle well, which means that they actually layer themselves on top of one another like a rooftop like roof tiles. I have to stagger them down so that each one layers, next to another one. So you get maximum density per graft placed. The area that is a no fly zone that can cause little bumps is the area called the soul patch, which is the area right between the lower lip and the chin mound where it starts to become concave in that area.

You can put grafts there, but oftentimes it leads to little bumps that are hard to eradicate. A cautery can get to them a little bit better, but in my opinion is not the ideal place to do it. You can do it on the strap zones, across the sides of the mustache coming down. You can do it across the jawline. You can do it across the lateral beard area, outer beard portions, or sideburns zones. But I would not do it right in that little soul patch area. So this is a general primer on this. I encourage you to watch my other virtual consultations I have on, they’re usually a video format on hair transplantation, but hopefully it’ll give you some ideas of the pros, cons limitations and techniques for facial hair restoration or facial hair transplantation.