Use of Nape and Peri-Auricular Hair by Follicular Unit Extraction to Create Soft Hairlines and Temples: My Experience With 128 Patients
Background Hairlines and temples can look unnatural due to coarseness of the safe donor area of transplanted scalp hair. Although the thinner caliber of nape and peri-auricular (NPA) hair would be ideal to create softer hairlines, they have not been used mainly because of concerns that they are nonpermanent.
Objective We assessed the outcome of NPA hair transplanted to hairlines and temples in selected patients.
Methods During November 2006 to November 2011, follicular unit extraction (FUE) transplantation using NPA hair was conducted in 128 patients following a shave test involving the visual evaluation of hair density and caliber of shaved head donor areas. The test was used to determine permanent versus nonpermanent donor areas. A questionnaire was sent to patients to assess satisfaction with their restored hairlines, with a follow-up questionnaire sent to those who initially responded.
Results Three-quarters of patients are good candidates for use of NPA hair to the hairlines and temples based on the shave test. Of 128 patients transplanted, 71% responded and reported a mean overall satisfaction of 8.3 (scale, 1-10). Patients saw full hair coverage at the recipient area at a mean of 9.6 months after surgery. Nineteen patients reported lost grafts. Thirty-three patients responded to a second survey and reported a mean overall satisfaction of 8.5 at an average of 4.6 years after surgery; only 5 (15%) new instances of graft loss were reported.
Conclusions Soft, natural-looking hairlines can be created in select patients using NPA hair as a donor source by FUE hair transplantation.
These are just my (Dr. Rassmans’s) opinions (regarding the Press release which may be more exaggerated than he original publication as one reader rightfully points out):
Taking neck hair, which is often finer than scalp hair, has problems with it. These problems include:
(1) more prominent scarring occurs in the neck and the neck area is very visible so such scars will be detectable as punctate scars
(2) neck hair is often not permanent hair as scalp hair is, so if one transplants the frontal hairline with these finer hairs, they may disappear with age.
This is a warning to those who see this press release. They must know the risks associated with a neck hair donor area.
Actual article is posted here: https://asj.oxfordjournals.org/content/early/2015/09/22/asj.sjv137.full?ijkey=X8GZ55Qz4zRGY4J&keytype=ref