Background The large caliber of head hair in hair transplantation imparts a coarse hairline, whereas natural hairlines are typically softer. In hirsute individuals, transplantation of leg hair to the hairline may result in a superior aesthetic appearance.
Observation A total of 1025 leg hair follicles in 1 patient were grafted to an area 0.5 to 1.0 cm in front of and 0.5 to 1.0 cm internal to the vanguard hair of the original hairline and temporal recesses; the other patient received approximately 1000 leg hairs and 600 head hairs to advance and soften his hairline and to create a custom widow's peak. Transplantation resulted in a fully grown and soft-looking hairline after 9 months in the first patient, with growth of 75% to 80% of the transplanted leg hair. The mean length of the transplanted leg hair was longer than the length of the original leg hair, with less curliness but similar hair width. Transplanted leg hair width was significantly finer compared with existing head hair width. After 4 years, results were sustained, minimizing concerns that subsequent hair loss might result from leg hair cycle variations. In the second patient, similar results were observed at 3 years.
Conclusion The use of leg hair in transplantation provides additional options in patients with hairlines that need to be refined.