ABSTRACT
Beard and moustache reconstruction has gained more popularity and acceptance over the last decade. The procedure is done for the correction of facial areas with hair density deficit and also for the cosmetic enhancement of pre-existing facial hair. The surgical technique includes the harvesting of grafts from the scalp by the follicular unit excision (FUE) or follicular unit transplantation (FUT) technique and then placing them in either premade slits or by stick and place method. The advancement and refinement of procedure over the years has aided in achieving the optimal aesthetic results, with minimal side effects.
ABSTRACT
BACKGROUND AND AIM: Facial defects with loss of hair-bearing regions can be caused by trauma, infection, tumor excision, or burn injury. The presented analysis evaluates a series of different surgical approaches with a focus on male beard reconstruction, emphasizing the role of tissue expansion of regional and free flaps. METHODS: Locoregional and free flap reconstructions were performed in 11 male patients with 14 facial defects affecting the hair-bearing bucco-mandibular or perioral region. In order to minimize donor-site morbidity and obtain large amounts of thin, pliable, hair-bearing tissue, pre-expansion was performed in five of 14 patients. Eight of 14 patients were treated with locoregional flap reconstructions and six with free flap reconstructions. Algorithms regarding pre- and intraoperative decision making are discussed and long-term (mean follow-up 1.5 years) results analyzed. RESULTS: Major complications, including tissue expander infection with the need for removal or exchange, partial or full flap loss, occurred in 0% (0/8) of patients with locoregional flaps and in 17% (1/6) of patients undergoing free flap reconstructions. Secondary refinement surgery was performed in 25% (2/8) of locoregional flaps and in 67% (4/6) of free flaps. CONCLUSION: Both locoregional and distant tissue transfers play a role in beard reconstruction, while pre-expansion remains an invaluable tool. Paying attention to the presented principles and considering the significance of aesthetic facial subunits, range of motion, aesthetics, and patient satisfaction were improved long term in all our patients while minimizing donor-site morbidity.
Subject(s)
Alopecia , Free Tissue Flaps , Maxillofacial Injuries/complications , Plastic Surgery Procedures , Postoperative Complications , Tissue Expansion , Adult , Aged , Algorithms , Alopecia/diagnosis , Alopecia/etiology , Alopecia/surgery , Facial Neoplasms/complications , Germany , Humans , Male , Perioperative Care/methods , Postoperative Complications/etiology , Postoperative Complications/surgery , Plastic Surgery Procedures/adverse effects , Plastic Surgery Procedures/methods , Reoperation/methods , Retrospective Studies , Tissue Expansion/adverse effects , Tissue Expansion/methodsABSTRACT
Objective To search for a good solution for aesthetic beard reconstruction and to explore the effect of the single-hair grafting in beard reconstruction. Methods Under the local anesthesia, a scalp strip (length range from 5～7 cm, width range from 1.0～1.5 cm) was harvested from the back of the head and then was divided into a series of single-hair micrografts. After the slits were made, the grafts were implanted into the holes, parallel to the original beard directions. The donor sites were directly closed. With this method, 18 sparse beard patients and 3 patients with upper lip scars were treated. Results The grafted hairs grew nearly in the direction of normal beard, which achieved 90 %～95 % survival in recipient areas. The patients were satisfied with the results, in which 19 cases received only 1 operation and 2 cases received another repeated operation. Conclusion Beard reconstruction by single-hair grafting technique is a good, safe and effective method.
