68 Follicular Unit Excision to Harvest Beard

Aman Dua, Kapil Dua, and Renu Kothottil

Summary

The use of beard hairs as a donor source in hair transplantation is an alternative when the recipient requirement far exceeds the scalp donor supply, such as in higher grades of androgenetic alopecia. They are the most preferred nonscalp donor source due to their close similarities with scalp hair, and follicular unit excision (FUE) technique to excise the grafts produces minimal scaring. It is quite important to plan a beard hair transplant in detail, from selection of the right patient with good beard hair and patient counseling regarding the differences between a beard and scalp transplant to the proper techniques and steps of the transplant procedure. After giving local anesthesia as a ring block, the grafts are taken out from the shadow area (below the mandibular line) of the beard. The skin of the beard area is very lax and proper traction and countertraction are important. Superficial scoring using sharp punches of 2.5 to 3 mm length just to a depth of 1 to 1.5 mm into the surface of skin helps increase the yield and reduce transection rates. The punch should be focused on the exit angle of the beard hairs or the anagen blush, if it could be appreciated like in Caucasian skin, to get intact grafts. During implantation, these grafts are usually placed behind the hairline zone for better aesthetics. Postoperative hypopigmentation or white spotting is one of the most common side effects seen after the procedure. With the right skills and proper planning, beard hairs help overcome the limitation of scalp donor availability.

Key words

beard hair transplant - beard hair harvesting - FUE - androgenetic alopecia - hair cycle - recipient area influence - donor dominance - wet shave protocol - punch - postinflammatory hypopigmentation

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