ABSTRACT
Trichiasis is an acquired condition in which eyelashes are misdirected toward the ocular surface, resulting in eye irritation and ocular morbidities. Different treatment modalities have been described, including surgical and non-surgical methods. The goal of this article is to present a novel technique for treatment of trichiasis, with a brief review of treatment options. Through a supratarsal incision, each misdirected eyelash follicle root was reached and freed from surrounding tissues by meticulous dissection. Then, hair shafts on the lid margin were redirected upward and glued to 2 bars extending horizontally across the upper eyelid. Two years after operation, the corrected eyelashes maintained their normal upward direction. To the best of our knowledge, this is the first reported case of chronic trichiasis treated by this technique. The main advantage of the technique, unlike most of the other treatment methods, is that follicles of the affected eyelashes are not removed or destroyed, which is appreciated from the aesthetic point of view, especially in female patients. We believe that any plastic surgeon with basic knowledge of blepharoplasty and hair transplantation can perform this technique without much difficulty. So far, there is no recurrence; however, long-term follow-up with a large series of patients is required for drawing better conclusions.
ABSTRACT
BACKGROUND: Burn scar and alopecia on hair-bearing areas can severely affect the social life of patients. Unlike healthy skin, poor biological and mechanical properties of scar tissue in the recipient area can reduce the survival rate of hair graft following hair transplantation. OBJECTIVES: The authors sought to determine if combined non-ablative fractional laser (NAFL) and microfat injection could improve the survival rate of hair grafts on post burn scar. METHODS: Thirteen patients with alopecia resulting from burn scar in hair-bearing areas of the scalp and face were treated with combined NAFL and microfat graft and subsequent follicular unit extraction hair transplantation. Cicatricial alopecia occurred on the scalp, eyebrow, mustache, and beard areas. Patients were treated with 3 to 6 sessions of NAFL and 2 to 5 sessions of microfat graft injections, followed by 1 session of hair transplantation employing the follicular unit extraction technique. RESULTS: Hair transplantation was successfully performed with good to excellent results. The survival rate of transplanted follicular units ranged from 76% to 95% (mean, 85.04%), and the density success rate per square centimeter ranged from 76.9% to 95.2% (mean, 84.54%). All patients expressed high satisfaction with the results and no complication was encountered. CONCLUSIONS: Hair transplantation, after combined NAFL and microfat injection, is a promising treatment for post burn alopecia.
