FACIAL HAIR TRANSPLANT

September 11, 2017

Facial hair transplant is a procedure to restore hair in the area of facial growth (like moustache, beard, side burn, cheeks, eyebrow and eyelashes).

Reasons for facial hair transplant

Desire for stronger facial appearance.
Improving symmetry.
Improving shape and density.
To hide a scar due to automobile accident, cleft lip, thermal, chemical or electrical burn.
Loss of facial hair due to local or systemic disease.
Congenital anomaly to grow facial hair.
Permanent loss of facial hair due to reshaping or other procedure.
Trichotillomania (TTM) (obsession to pluck hair)
Facial hair loss due to medical or surgical treatment like radiation therapy, chemotherapy, surgical removal of tumour, laser hair removal, electrolysis.
Female to male transgender patients.
Some points to evaluate before facial hair transplant

Some young patient enquire about beard and moustache transplant. It is important to check their genetic growth pattern as they may develop beard and moustache after a few years.
Trauma, burns or surgery may have resulted in formation of scar tissue. Reconstructive surgery may be necessary before eyebrow/eyelash restoration.
Systemic or local disease must be under control.
Trichotillomania must be treated to assure that the restored hair will not be plucked again.
In case of burn or accident, skin atrophy may occur. Chances of success are very less in such case. Therefore, test grafting of 50 to 100 grafts is advisable in such cases.
BEARD HAIR TRANSPLANT / MOUSTACHE HAIR TRANSPLANT

For full beard moustache goatee transplant, almost 2000 to 3000 grafts are required.

350-500 grafts for the moustache
600-700 grafts for a full goatee.
200-250 grafts for each sideburn (400 to 500 for both side).
300-700 grafts for each cheek beard (600 to 1400 for both sides).
Sometimes, a second procedure may be required to improve density or reshaping.

PROCEDURE

The procedure is carried out under local anaesthesia.
The follicular unit, harvesting is done from the head donor area either by FUT or FUE method. The follicular unit epidermis are trimmed and individual follicles are created. The follicular units are then transplanted as per required design. The placement angles and direction should be proper to obtain a very natural look. The usual density of transplant is 30 per square cm.
Spray by normal saline – Start hourly normal saline spray for 7 days on transplanted area. It helps with dissolving the scabs faster and speeds up the recovery period. spraying also keep the grafts moist and may reduce itching.
POST BEARD TRANSPLANT CARE AND EVENTS

It is similar to FUE hair transplant
Additional Point

Some swelling may be observed on face from second day onwards. It will subside by fifth day.
Use antiseptic soap or face wash to clean the transplanted area.
Studies have shown that by 10th day, grafts are fixed in place. It will be safe to trim the hair from the 15th day. Start shaving after a month.
Start Minoxidil and Finasteride by 10th day to reduce shock loss.
Some red discolouration will be there till a month and half. It will subside with time.
Good result will be visible by 6th month.
Complete result can be observed by 12th month.
EYEBROW HAIR TRANSPLANT

The hair similar in thickness and texture of eyebrow is harvested by FUT or FUE method. Grafts epidermis are dissected and prepared to single hair follicular unit. They are transplanted with a goal to recreate the natural eyebrow with proper direction of the follicular unit.
The outline of the eyebrow area is created by mutual understanding of patient and doctor as per the natural symmetry of the patient’s face. Depending on the size of the area to be transplanted, sometimes more than one transplant session may be required; two or more sessions after a several years enhances the hair density.
As the transplanted hair grow in their new position, they will require occasional trimming as well as ‘training’ with gel.
EYELASHES HAIR TRANSPLANT

Eyelash surgery is a very specialized procedure that is performed with a lot of precision.
It should be done by a physician who understands eyelash anatomy and aesthetics, and has excellent training and experience in methods of donor hair harvest and eyelash graft placement.
In this process, finer hair from nape of neck or side of head are harvested. All grafts are single hair meticulously placed into the lid. Punctures are made on the eyelid margin by surgical needle and a single hair graft is placed into it. Grafts are spaced equidistant to prevent trichiasis.
A session may take up to one to three hours. A desirable result may be achieved in one to three sessions. The number of sessions is dependent on patient characteristics, desired result and the surgical technique.
Six to nine hair per lid may be adequate to create a natural effect.
Itching is a common and troublesome post operative complication. The chances of dislodging of graft and subsequent infection may occur if scratched. Eyeglasses may be worn to avoid scratching. Wear goggles while sleeping to prevent accidental eyelid scratching. This is the reason some doctor recommends keeping the eyes bandaged for the first 24 postoperative hours.
Medications are usually prescribed to relieve itching. 1-2 weeks are required for complete recovery.
Training of transplanted hair into eyelash orientation is done by regular use of lash oil and an eyelash curler. Regular trimming of eyelash hair is required to maintain required length.
Possible Complications

Eyelid infection.
Bruising and swelling.
Graft displacement when patient scratches the eyelid (It may cause failed growth).
Ectropion: eversion and downward pull of the lower eyelid may cause the eyelid to fall away from the eye.
Entropion: turning in of the upper or lower eyelid margin.
Poor placement or poor quality of eyelash grafts because of the use of coarse hair as grafts, or placement of grafts that fails to achieve the desired aesthetic result.

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