Beard transplant: who it suits, how it is done and what the alternatives are

Who is a beard transplant suitable for?

For a man whose beard is permanently sparse, or who has an area without hair that will not fill in by itself. The International Society of Hair Restoration Surgery (ISHRS) describes two main types of candidates: those who want a fuller or wider beard, and those who have lost beard hair because of a scar or injury¹. The common situations:

• A beard that has been sparse since it first grew in, or one that never filled in on the cheeks, along the jawline or where the mustache meets the beard.
• Permanent gaps in the beard that have not changed for years.
• Scars from acne, surgery, injury or a burn, where no hair grows.
• A sparse mustache, or a mustache that does not connect to the beard.

A case series from Turkey described men who had an FUE beard transplant because of deficient beard growth and were examined at least a year after the procedure⁴. The technique is also described in reviews by physicians who perform many facial transplants³⁷.

When is it better to wait or try something else first?

When the beard is still developing, or when the thinning is caused by a disease. Beard hair depends on male sex hormones, and in many men it keeps thickening well into their twenties⁵. A young man whose beard is filling in slowly may find that it looks different in a few years. Details on the causes are on the page sparse beard (Hebrew).

• Alopecia areata in the beard: round, smooth patches without hair that appear suddenly. This is an immune condition, and no transplant is done while it is active². See alopecia areata in the beard (Hebrew).
• Minoxidil: in a small controlled trial, a minoxidil solution applied to the beard for several months led to a small improvement compared with placebo⁸. This is an off-label use, and the improvement usually lasts only as long as you continue. Full information on the page minoxidil for the beard (Hebrew).

Where is the hair for a beard transplant taken from?

Usually from the back of the scalp, and sometimes from the beard itself, under the chin. The ISHRS explains that hair from the beard itself matches the beard in thickness and curl, but the amount that can be taken from it is limited. Scalp hair is more available, so areas are chosen where the hairs resemble beard hair¹.

There is an important consideration here for men with balding: the ISHRS notes that extracting hair from the back of the scalp leaves small dots, and that every follicle taken for the beard is a follicle that will not be available in the future for a scalp transplant¹. Anyone likely to need a scalp transplant should plan both together. On the donor area, see the donor area in hair transplantation (Hebrew).

How is a beard transplant done?

Grafts of one or two hairs, at a very sharp angle and in the direction of the beard. The follicles are extracted with the FUE technique, one follicle at a time. When the hair is taken from the beard itself, the ISHRS notes that FUE is the only accepted method¹. In the experience of a physician who performed hundreds of beard transplants, what determines a natural look is small grafts with little tissue around them, a sharp angle and the correct direction of each incision, and aesthetic planning of the line³.

Direction is especially important in the beard, because the hairs change direction in almost every area: on the cheeks they point down and back, and on the neck sometimes upward. Before the procedure, the desired cheek and jaw line is drawn and checked together. The number of grafts ranges from a few hundred for a small gap to two thousand or more for a full beard¹. The procedure is done under local anesthesia, without hospitalization, and takes a few hours.

What does recovery look like?

A few days of small scabs and redness, followed by months of growth. A small scab forms around each graft, and sometimes there is mild swelling of the cheeks. In the first week you do not rub or shave the area, and you follow the instructions given at the end of the procedure. When you may go back to shaving is decided at the follow-up visit.

The timeline is similar to that of a scalp transplant: after a few weeks the transplanted hairs usually shed, new growth usually begins around the fourth month, and the full picture is seen after about a year, sometimes longer⁶. Once the area has healed, the new hairs behave like beard hair: you shave, trim and style them as usual. On scabs and redness, see scabs and redness after a transplant (Hebrew).

What are the risks?

Similar to the risks of a scalp transplant. The NHS notes that hair transplantation is usually a safe procedure, but as with any surgery there is a small risk of bleeding, infection, a reaction to the anesthetic, partial take of the grafts and scarring⁶. For the beard, it is important to add:

• Unnatural direction or density, when the grafts are inserted at the wrong angle³.
• A mismatch between hair types, when fine or straight scalp hair is very different from the existing beard¹.
• Partial take in scar tissue, where blood flow is lower.
• Small inflammations around follicles in the first weeks, which usually pass.

The ISHRS stresses that no physician can promise that every graft will take, so the possibility of a touch-up is sometimes planned in advance¹. More details: complications after a hair transplant (Hebrew).

How is it done at Dr. Dana Buchbut's clinic?

First the cause is clarified, then a beard is planned that suits the face. At the consultation, Dr. Dana Buchbut, physician (M.D.), examines the beard and the donor area under magnification, asks when the thinning began and what you have already tried, and makes sure there are no signs of alopecia areata or another problem that needs treatment first. When suitable, you can start with medical treatment and see how the beard develops. When a transplant is the right option, the line is drawn together, the number of grafts and the effect on the donor area are discussed, and you are told honestly what can be expected. The procedure is performed by Dr. Dana Buchbut herself, at the clinic in Ramat HaHayal, Tel Aviv, and at the follow-up visits healing and growth are checked. General information about transplants is on the page hair transplant.

The information on this page is general and for education only. It does not replace an examination, diagnosis or personal medical advice. Any decision about treatment is made only after an examination.