Abstract

Objectives: To provide accurate measurements of facial hair-bearing areas in a Caucasian male population, in order to predict the average potential of the facial hair-bearing areas as donor areas in FUE procedures, as well as establish an algorithm in hair transplantation in different areas of the face, based on their surface & the average expected density of these areas. Introduction: In recent years, facial hair-bearing areas have been recognized as valuable sources of hair follicles, especially in FUE procedures, in cases where the scalp donor area is poor or depleted or where additional density is required. In addition, in recent years, beard restoration increases in popularity, but there is no comprehensive approach on how many grafts are required per area or per patient for a typical beard restoration procedure. Furthermore, it is obvious that there are significant differences in coverage, density, number of hair follicles, in different individuals & different races. Materials / method: 58 Caucasian males, aged 22-65 years old, participated in our study. For the measurement of hair follicles, 9 different spots of 1 cm² were selected, representing the main, facial hair-bearing areas. Each area was marked & the counting of hair follicles & hairs/cm² were done by using Folisys®. The hair bearing areas in each individual were marked & separated into smaller areas representing the related aesthetic, in order to establish the relevant potential of each area. Then, the surface of each related area was measured in cm². The data was processed statistically with normal distribution. Results: A moustache may have more than 1340 hair follicles & a beard more than 2000. Sideburns combined may have 1200 hair follicles, whereas cheeks more than 2000. Neck may have more than 3300 hair follicles. These numbers bring the total potential facial hair donor area to more than 9840 hair follicles. With an estimated 30% harvested, it is possible to yield a total of approximately 3000 hair follicles from the face, for hair restoration purposes in the average Caucasian male. Contrary to common belief that facial hair is made only from single hair follicles, the actual ratio is 1.2-1.3. Conclusion: Beard hair is very reliable in FUE hair transplantation and if basic rules are followed, there is no significant scarring or visible extraction areas, whereas fast & uneventful healing takes place in the majority of cases. Facial hair coverage is a determining factor in FUE hair restoration, above & beyond FUT limits. Nowadays, beard hair is an important male style statement, as well as an alternative donor area for FUE hair transplant. Although the basic FUE principles apply in beard procedures, there are several specific technical aspects that require attention during a beard procedure.