Recipient-Site Influence in Hair Transplantation

Abstract

The authors have indicated no significant interest with commercial supporters. D r. Norman Orentreich provided the scientific basis for the field of hair transplantation, stating that the transposed grafted skin maintains its integrity and that characteristics such as texture, color, growth rate, anagen period, and the majority of these transplanted grafts behave independent of the recipient site. 1 The concept of ''donor dominance'' that he discovered formed the foundation of hair restoration surgery. We suggested that the recipient site influences the growth characteristics of transplanted hairs such as growth rate and anagen period when transplanted scalp hairs were transplanted to different recipient sites such as the lower leg, neck, palm, hand dorsum, and eyebrow. 2,3 The purpose of this study was to evaluate whether the body hairs would keep their original growth characteristics when the body hairs were transplanted to the scalp area. Case ReportIn 2005, a patient with male pattern baldness gave his consent for this study. Donor hairs were harvested from the chest area and the occipital scalp using the elliptical excision technique. We transplanted nine chest hairs (single-hair follicular units) to the right side of the frontal scalp ( Figure 1A, yellow circle) and the occipital hairs to the vertex ( Figure 1A, blue circle) using a KNU implanter. We tattooed one point on the right frontoparietal recess where no residual terminal or intermediate hairs were growing and kept a copy of the transplanted points on the cellophane adhesive tape. One year after the operation ( Figure 1B), iris scissors were used to cut nine transplanted chest hairs from the scalp and 14 original chest hairs. The length and caliber of each cut hair was then measured. Hairs were cut as close to the skin surface as possible to measure total hair length grown for 1 year. After the hairs were cut, they were allowed to grow for 4 weeks, and the length of the hairs was again measured. The difference in the hair growth rate per 4 weeks of the transplanted chest hairs and original chest hairs was analyzed.The transplanted chest hairs grew longer than the original chest hairs, 56.3 mm versus 28.5 mm, about two-fold increase in mean length after the 1-year follow-up period ( Figure 2). The hair growth rate also increased slightly after transplantation from the chest to the scalp: 10.4 mm/4 weeks for the transplanted hairs to the scalp and 8.9 mm/4 weeks for the original hairs. Mann-Whitney U test was used to analyze the difference between the transplanted and original chest hairs, so the value of p was less than .05 in the mean length and hair growth rate. The transplanted chest hairs showed several different growth characteristics. However, there was no

Androgenetic alopecia: An update

“…'Recipient dominance' has also been described where the recipient site also has some influence on the transplanted hairs. [79] 'Safe donor area' is a horse shoe shaped (horizontal) area in the occipital region. The lower limit is the nuchal ridge and the anterior limit is the line drawn vertically from the pre-auricular region.…”

“Combination grafting” of scalp and body hair to enhance the visual density of hair transplant and coverage of higher grade of baldness

“…As per the studies conducted by Hwang et al ,[ 12 ] Hwang et al ,[ 13 ] and Lee,[ 14 ] when body hair is implanted on the scalp, the thickness remains unchanged, but the length and hair growth change. They become longer, and the growth rate also increases.…”

The Transplanted Hairline

“…Although the maintenance of transplanted hair caliber is in accordance with the principle of donor dominance, first defined by Orentreich 13 as the retention of donor hair characteristics at recipient sites, the observation that transplanted leg hair grows longer and straighter on the head may also be the result of some influence of the recipient site as demonstrated by several studies. [14][15][16] While published reports of the use of nonhead hair for transplantation to the scalp are still scant, 3,5,6 the present cases further emphasize the possibility of a new pool of donor supply for situations in which a patient has extensive baldness and insufficient head donor hair due to the extensiveness of the baldness, previous surgical procedures, or accidents, such as burns. Moreover, the variety of types of nonhead hair available enables a tailoring of the transplantation to match the desired characteristics of the target areas of the head.…”