Have you ever wanted a fuller beard of moustache? This is definitely a growing trend, which has been inspired a lot by observing men with bushier beards out there and also a lot of social media posts recommending it. Sometimes they are hilarious posts like men who have small chins who look great with a beard and then who don’t look so good shaven. Other posts show AI generated images of celebrities and individuals with and without beards to prove the point that facial hair is in.

But what if you can’t grow a beard and you really want more hair on your face. Some men have tried Rogaine (minoxidil) with limited results. You can grow a little more hair on the face but typically not a ton and most men give up after a few months because of the hassle and the lack of great results. Are there any other methods to grow facial hair short of surgery? The answer really is no. You cannot grow hair in areas where there are none except for the above-mentioned minoxidil, which can provide some limited, unpredictable, and temporary results. When it comes to surgery there are two major options for donor hair used to refill the face: beard and scalp hair. How about body hair? Long-term studies have shown that they simply don’t hold up after 5 to 7 years not to mention body hair usually does not provide an excellent match.

No doubt, beard hair is usually the preferred source of donor hair but where do you get it if the whole point is that you don’t have enough beard to begin with? If you have just some patchy hair loss or your beard is simply not full enough, you will usually have enough beard below your chin, an area where most men would shave that area anyways. You can then take the beard hairs from the area below the chin using FUE (follicular unit excision) method to replace the lost hair on the face. In fact, Dr. Lam’s specialty for which he has many fly-in patients is a so-called “beard-to-beard transplant” where he is stealing hairs from under the chin and placing those hairs on the face in a strategic manner. There are many advantages of using beard hair. They are as follows: (1) you do not need those hairs under the chin anyways (2) you do not use precious donor from the scalp that can be used to restore hair for the scalp (3) beard hairs are a perfect match for beard hairs since they are the same caliber, color, etc. (4) donor areas in the beard rarely present visible scarring even in dark-skinned individuals who want to stay shaven under their chin (5) if you wanted to shave your scalp (since FUE in the scalp is not entirely scarless since it cause some tiny dots visible with a shaved head) you can do so. So why doesn’t everyone just get a beard-to-beard transplant then? The answer is twofold. Technically, it is much more difficult to harvest since hairs grow in all different directions and are loosely attached compared with the scalp, but as mentioned Dr. Lam specializes in beard harvesting, all of which he performs himself. The second issue is limitation of beard hairs. As mentioned, especially in someone wanting a lot of beard hairs, that is the person who also does not have a plentiful supply of hair under the chin. Further, to limit the risk of visible scarring in the beard donor area, Dr. Lam does not take all of your beard hairs in a single pass. Your body requires surrounding or neighboring beard hairs to regenerate the color in the skin after collecting nearby beard hairs via FUE.

 

So how about scalp hairs as a donor source? Scalp hairs can be used to supplement beard donor hairs or be used entirely in replacement of them depending on many factors like skill of the surgeon, lack of beard donor availability, etc. The biggest limitation when it comes to scalp hair is ensuring a proper scalp-to-beard hair match. For example, if someone has fine, red hair on the scalp but bushy, curly, dark-brown hair in the beard, then using scalp hair would simply not work. That would be an extreme example. If the caliber and color match are close but not perfect then the answer sometimes is using scalp hairs and blending with beard hairs when the match is close but there are insufficient number of donor beard hairs. Scalp hairs can be harvested using FUE just like the beard but using scalp hairs for the beard in someone who is already losing hair on the scalp may be an unwise use of grafts since if you allocate say 1,500 to 2,000 scalp hairs for the beard, those are hairs that can never be used for scalp hair restoration. Further, as mentioned, if the person with thinning scalp hair wants to shave his head fully in the future, there could be donor scarring visible appearing as light dots on the back of the scalp.

This short blog only scratches the surface of the complexity of the subject. For example, Dr. Lam also uses beard hairs to reconstruct scalp hair loss in certain individuals. Only through an in-person or virtual consultation (in which you send in photographs) can Dr. Lam determine your candidacy and the method that would be most suitable for your facial hair restoration.

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