The following is a transcript of Episode 10 of the Hair Restoration With Dr. Daniel A. Danyo podcast.
Dr. Danyo: I’ve had people that have had multiple hair transplants. They come to me, they want more taken from the back and a lot of times they need, say 2000 more grafts to complete the hair restoration. And oftentimes I can only get 1,000 grafts safely. And that’s when we have the discussion that, you know, we could use beard or body hair, you know, from the chest or abdomen to basically have the extra paint for painting in the room.
Clark: That was the voice of Daniel A. Danyo M.D, Founder, and physician at North Atlanta Hair Restoration, a boutique medical practice solely dedicated the diagnosis and treatment of male and female hair loss. You’re listening to Hair Restoration with Dr. Daniel A. Danyo. I’m your host, Clark. And all season long, we will speak with Dr. Danyo about how he and his team at North Atlanta Hair Restoration are helping his patients transform their everyday lives for the better. In this episode, Dr. Danyo and I discussed the incredible and surprising use of chest, beard, and body hair as part of the hair restoration process. Dr. Danyo shares some patient success stories he’s achieved using this technique and as a result, how it’s offered some of his patients a better, fuller head of hair. There’s so much to talk about. So let’s dive in. Dr. Danyo, it’s great to be back here on the line with you. How are you?
Dr. Danyo: I’m doing great, Clark. How about you?
Clark: I’m great. I’m excited because we had a topic in mind for today, a topic that you were thinking about but then you basically said, you know, something else has really been on not only your mind but also it’s been something you’ve been getting a lot of inquiries about right now, especially. So the topic is using beard and body here replacement, for balding areas on the head. This is something I did not know you could do.
Dr. Danyo: Yes. And it’s exciting, especially for people that have just a huge need for hair, especially if there’s full hair loss, or I’ve also seen where people have had prior procedures and their donor site is just really depleted. And it just gives an option to continue the process of hair restoration through transplantation using other areas such as the beard, chest, or abdomen.
Clark: All right. So how many places…? So beard, chest, abdomen, are there any other places that you’ve moved it from or those are the main three?
Dr. Danyo: Yes. You can move it even from arm and leg. It’s been done, but the hair has to be very coarse to do that. It can’t be, you know, small and thin. I have attempted in the past rather unsuccessfully, and I’ve talked to multiple doctors as well, using back hair. The back is just very hard to graft from, and it’s kind of a difficult healing process. The skin just doesn’t contract as well. The grafts are just not all that sturdy. So, unfortunately, back hair is not a great option.
Clark: Okay. So in this case, when would someone explore this as one of their options? Because I was totally surprised when you told me this. So, you know, how does this kind of go into play, and can we walk through some of the options?
Dr. Danyo: Sure. Well, I think we can talk about maybe some of the patients that I’ve seen and treated recently.
Clark: Yes. Some examples would be great.
Dr. Danyo: So I have one individual, we’re about 7,500 grafts into the coverage of his head. Now, he was a Norwood 7, completely bald and very low on the sides in the back. And I told him it’s gonna take about 9,000 grafts to do the complete hair restoration. And he was in a situation where he’d lost his wife and he just did not wanna go through life bald and dating. So he had the means to do it financially and said, “You know, I’m willing to go through the process and get it done.” So what we did with him, because obviously beard hair is a lot more coarse than the head hair or typically so. And chest hair, can be coarse in some people, but it can be a little bit more fine, but it can have a different curl and texture compared to the head hair. So I actually would schedule him for two-day sessions where we would obtain grafts from the back of the head. So the first round we did 2,000 from the back of his head, 1,500 from his beard, and then 1,000 from his chest. So that got him to 4,500 grafts right off the bat. And six months later…
Clark: You know, which side’s that target zone? And when you say grafts, these are individual hair, like individual little pockets where each hair is like…
Dr. Danyo: Yes. And it could be one hair or a grouping of hairs up to about four. Now, in the beard, it’s mainly one and two hairs as well as the chest. Occasionally you’ll see a three-hair graft. But in the head, it’s between one and four hairs. So in his case, we put all head hair upfront on the frontal hairline to soften that up. But then I mixed in, you know, the full canvas that we were doing along with the remaining head hair, beard hair, and chest hair. So basically the texture and the contour was all the same quality and the same look. It’s not like I did head hair and then a strip of beard hair and a strip of chest hair. And when you do it that way, it’s very hard to do, but it really creates a consistent look.
Clark: It sounds it’d be very [Inaudible 00:06:38]
Dr. Danyo: Yes. Because…
Clark: How is it different from what we’ve talked about in the past where you’re maybe just relocating hair on, you know, from the backside of your head to the front side of your head, because that’s pretty much all the same, I would imagine.
Dr. Danyo: If you’re taking from the back and then placing on the head, you have a certain density that you’re working with based on the area that you’re trying to fill. And usually, we’re putting about 30 follicles per square centimeter as a goal. Sometimes it’s more, sometimes it’s less. And that generally gives a very good density, especially if somebody has coarse hair. So what you do when you’re doing that combination treatment, especially over the two days with this individual, I pick an area that I, you know, measure out to have 4,500 grafts. And like I said, I put a little bit more of the head hair up front and I took the remainder and I took all those grafts and just spread them out over the whole area that I was trying to fill 4,500 grafts with. And then I took the beard hair and I placed grafts in between the head hair grafts and then I did the same thing with the chest hair.
Clark: It’s sort of that thought process of the forest and the trees so when you kind of zoom out, it all sort of blends together. It’s kind of the visual I’m seeing.
Dr. Danyo: Exactly.
Clark: Now, when you remove hair from a place, from let’s say from the chest, so is that gonna come back? How does that work?
Dr. Danyo: It does not come back. So when you move that follicle, it’s like, you know, uprooting a tree and then moving it. The tree is gonna grow where you planted it. So, you know, a lot of people with the chest, they shave their chest anyway, and they literally say, “Just take them all.”
Clark: Right. Yeah.
Dr. Danyo: So the crazy thing with the chest, because the growth cycle is a little bit different than on the head, so it has longer dormant period because hair goes through a growth phase, and then it gets shed and then it goes through a dormant phase. So I’ve taken every hair off of somebody’s chest. Usually, it’s about 1,500 grafts to 2,000 grafts, and then six months later when they come back, I say, “Can I take a look at your chest?” And it’s not quite as full as before, but there is a significant density more than you would ever imagine, especially since you took almost every visible graft, you know, in that first session.
Clark: So after your first session you took, you said most of the hair from the chest or all of it?
Dr. Danyo: Yes. Well, it all depends how dense and compact the hair pattern is in the chest. Some people have hair that’s just more in the sternum area. Some people have it all over, you know, the packs and extending down into the abdomen. So you know, if it’s really, you know, hairy and diffuse and we’re only getting 1,500 grafts say, then I won’t take everything, you know?
Clark: Take all of it. Right. Okay.
Dr. Danyo: Yeah. So I’ll try and make it so it’s more diffused and not as noticeable.
Clark: Yes. Are people sometimes surprised when you pull from an area that’s not on top of someone’s head? It’s not from their head, but it’s still planted there. If you’re relocating hears from the chest, in my mind, my first thought is, “Is that gonna still seem natural? Is that still gonna look natural?” Are people surprised by that? Or what kind of response did you get?
Dr. Danyo: Well, it does create a natural look. And a lot of it is just on the execution of how you do it, especially if you’re using head hair in combination, you know, with it. But, yeah, I see a lot of patients that have very severe hair loss and a lot of times the only option is to do the frontal hairline and maybe backfill about three to four inches and potentially have enough to cover, you know, the back crown area, you know, on the back top portion, not with full density, but with partial density, because the back of the head, for most people, the maximum amount of grafts that you can take is about 4,000 to 6,000, keeping in mind that the number of follicles in the back donor area’s about 10,000 to 12,000 and you can take about 40% to a maximum of 50% before there’s just too much thinning and then the donor side looks thinned out. And that’s definitely something that you don’t want to happen because people almost look sick when the donor side is over-extracted in the back of the head.
Clark: It really is. Now, are you just eyeballing it as you go? Like, how do you know when one area is like, “Okay. This has been maxed out. We don’t wanna take any more because of that reason.” How do you keep track of that as you go?
Dr. Danyo: Well, a lot of it is eyeballing. And especially as I’m harvesting from the head, you know, from the donor site in the head. The last thing that I wanna do is over-harvest somebody. And quite frankly, I never have. I’ve had people that have had multiple hair transplants. They come to me, they want more taken from the back, and a lot of times they need, say 2000 more grafts to complete the hair restoration, and oftentimes I can only get 1,000 grafts safely. And that’s when we have the discussion that, ‘You know, we could use beard or body hair, you know, from the chest or abdomen to basically have extra paint for painting in the room.”
Clark: Yes. I like that. That makes sense when you say it like that.
Dr. Danyo: You know, the donor site is some people have a gallon and some people have a court and the people that, you know, are generally, maybe shorter than have like a, not as long of ahead because their donor site will be shorter will have just a naturally lower density in the donor area. They maybe have less than 4,000 hairs that they could take, you know, lifetime from the donor area. The other thing is some people have extremely thin hair, to begin with even though they may have a lot of density. And so the hair that you move is, is not quite as valuable as say a coarse hair. So I just had a patient that called me. He came from Florida and I did 1,000 from his beard and he had had three hair transplants before with pretty good coverage, but his hair is naturally thin and I took 1,000 beer grafts and just spread it out over top of his head. And he said, “Man, you need to do 1,000 more.” He’s like, “I’m loving it. I love the volume. You know, it’s a little bit more wavy than the rest, but people are commenting now.” And he actually said, “You should be doing beard hair on everybody.” And I’ve had that comment multiple times.
Clark: Wow. I guess that makes sense because the visual I first had was like short beard hair, but I guess if someone just keeps that growing, it does start to look like just normal hair that you’d have on top of your head. And so spreading it out is gonna give it more depth and heavier feel and look. Now, do you–?
Dr. Danyo: Yes.
Clark: Go ahead.
Dr. Danyo: Well, I was gonna talk about another patient. And I’ve had multiple…
Clark: Yeah. Let me ask you that. So that’s a great example. So tell me about another patient example.
Dr. Danyo: So I’ve had a number of patients that they’ve been doing hair transplant for decades, and I’m talking where they had the old plugs. Some people have even…
Clark: That’s a good distinction right here. If someone’s first time listening to this, you do not do that. That is an old ancient technology.
Dr. Danyo: Yeah. And that’s, you know, that was a full-thickness, 5-millimeter graft that left a large hole that was then sewn up. But the problem was there’s just…
Clark: It’s very different.
Dr. Danyo: Well, and there’s so much scar tissue that happens and you get alopecia in the donor site because of all the previous coring or people have had scalp reductions with significant scarring. And those were all, you know, done in kind of the 80s and early 90s. But they were happy at first, but as they got older and kind of lost hair behind where those plugs were placed, the plugs became very obvious, almost like doll’s hair. And they had, you know, just a huge need for getting a large number of grassroots, their donor site, it just wasn’t there. So I’ve done… I have one patient that I did 7,500 grafts, not from the donor area with that type of scenario, where I took 1,500 from the beard one time. I took another 1,500 from his beard. He never wants to actually have a beard, so he was happy to get rid of that. So that’s up to 3,000 and I did 1,500 from his chest. And he’s got a lot of chest hair. I went lower down in the chest and got 1,500. And two weeks ago I took 1500 from his abdominal hair and we got up to 7,500 extra grafts. Now, with all this said, with everything else that he had done with the plugs, he has a full head of hair and he’s extremely happy.
Clark: And so we’re talking about the Shave-less FUE style. That’s the method that you use and that’s the same here, right?
Dr. Danyo: No. It wouldn’t be Shave-less. I mean, we would shave down the area that we’re taking, you know, taking the donor from. We had, you know, shaved the beard. I usually like to have it at a zero guard, so there’s a little length or the chest or the abdomen. Yeah. I have not had any issues with, you know, weird healing or weird pigmentation changes, although in the chest it’s been reported that some people can have some small white dots, but I just haven’t seen it.
Clark: Right. Okay. And so sometimes the method of Shave-less FUE, that’s just gonna be with just working, you know, above the shoulders, right? That’s the way to conceal and to be minimally invasive?
Dr. Danyo: Yes. Now, you can do a Shave-less FUE from the beard if they wanted to keep like a long beard for extraction, say it’s either to the head or we can even go from beard to beard. I did a consult tonight where he’s got some small patches of hair loss in the cheek and I’m just gonna take it from the undersurface of his beard and put it in his cheek. It’s not a huge case. And, you know, quite frequently I’m having discussions with people, especially, again, if they have a lot of need or they’re younger and I’m looking at their family history and kind of anticipating what their needs are gonna be for their lifetime with possible repeat hair transplant. And I’m going ahead and doing, say, 1,500 from the back of the head or 2,000 and 500 to 1,000 from the beard. And it saves the back of the head, which is really the main donor area. It gives that coarseness as we talked about, but it just starts the process of getting volume to the scalp, spreading things out, and potentially going back into the beard or chest later, you know, if those needs are required.
Clark: And you’re saving them from having to, you know, keep shaving their chest or, you know, and whatever their preference is, it’s, you know, I feel like I often am seeing ads and messaging around, you know, doing some sort of laser removal or something like that. But in a case like this, you’re able to knock out a few things at once.
Dr. Danyo: Yes. And I’ve done FUE for just weird hair removal. I’ve had a number of women that have had, say, some hairs on their chin or a cheek that were dark and they tried laser hair removal, it didn’t work. Even women that have had laser hair removal on their, you know, their underarms or even around their nipples. I’ve had a couple of patients that have had just really dark hair that’s just been stubborn to get rid of. And we’ve been able to successfully extract those hairs and they’re gone.
Clark: Why do you think… And I know you don’t do laser hair removal, but why do you think sometimes that just doesn’t work for people and what you do with FUE does?
Dr. Danyo: Well, laser hair works best with dark hair. So if it’s a little bit more blonde, it may not work. And then sometimes individual hairs can just be extremely, you know, stubborn and not responsive.
Clark: They just resist the laser?
Dr. Danyo: Yes.
Clark: And your case you’re lifting that tree out, that branch, you know, you’re lifting it all out so there’s nothing there to [crosstalk 00:21:15.983].
Dr. Danyo: Yes. There’s nothing there. We’re taking the stem cells, we’re taking the follicle. It’s gone.
Clark: Wow. It’s so intricate. And as a reminder, you’re doing all of this. This isn’t something you sell someone and then you pass them off to a technician who just got out of school or something. This is all hand-done by you through. It really gives them a boutique experience.
Dr. Danyo: Yes. You know, the positioning that we have to put ourselves through to actually extract from, especially the chest and the abdomen, because you’re kind of leaning over the body and, you know, the hairs kind of come at a different angles and my hand has to be in a certain position. So it can be somewhat exhausting. But they come out quickly. You know, we really don’t have an issue with just, you know, difficulty getting the hair out, in most cases, unless the chest hair is super thin. And if it is, then I generally don’t even recommend that as a donor area.
Clark: Makes sense. How do you stay in such a weird position when you’re having to lean over or trying to find a different… You know, you’re super, super zoomed in on this and I’m sure…you know, I’ve heard some times whenever you’re doing like an exercise and the less you move, the harder it becomes. So how do you stay fit to be able to withstand so much endurance, so much time?
Dr. Danyo: Well, you know, I work out a lot. You know, I work on the core, keep my diet in check, do the cardio strengthenings. Recently not as much, but so I feel like I’m in generally good shape. I mean, the problem is I use loop magnification which are those magnifying glasses, you know, that you look through and the focal length is at about 10 inches. And if you’re at 9-1/2 inches, it’ll be blurry and if you’re at 10-1/2 inches, it will be blurry. So you have about an inch that your head has to be relative to what you’re looking at. So that’s where the positioning gets tough. So, you know, I generally will start on the left side of the chest. I’ll be on the right side of the patient. They’re obviously laying on their back and I’ll start on the far left after we do all the numbing and some kind of reaching and leaning. And then as I come more towards me, it’s closer and not quite as taxing. But it allows me to core everything and my technicians to easily extract the grafts.
Clark: Okay, cool. Very insightful. I’m glad that we took the time to unpack all of this. I know you’re getting a lot of individuals asking about it. And I think you were able to cover a lot of ground here with this conversation today. Is there anything else that we haven’t mentioned that you wanna share?
Dr. Danyo: Well, I think if you’re an individual that has a high need for coverage, whether you wanna get full coverage from the frontal hairline through the crown as a goal or whether you’ve had prior hair transplant or scarring and the donor site in the back will not support the area that’s that needs to be transplanted, I think you should really look into beard and potentially body hair. And I say potentially because, you know, the chest hair has to be coarse and it has to be able to grow at least an inch for it to be a productive means for transplantation.
Clark: Excellent. Dr. Danyo, thank you for the time. And I’m looking forward to talking with you soon.
Dr. Danyo: All right. Well, thank you.
Clark: Thanks for listening to Hair Restoration with Dr. Daniel A. Danyo. You can book your consultation today with Dr. Danyo by simply calling 678-845-7521 or online at nahairrestoration.com and be sure to subscribe, rate and review this podcast wherever you listen to your audio content.