Abstract: Camouflage of Scarring Alopecia By Using Follicular Unit Transplantation

Abstract

INTRODUCTION: Scarring alopecia usually results from trauma, burn and previous surgery in the aesthetic units of head and neck.1,2,3,4Various treatment options that anti-scar ointments, laser treatments and scar revisions surgeries have been used for treatment of these scars. However, it is difficult to destroy the existing scar with these treatment methods; it is not possible to treat alopecia. In this study, we present our result about the camouflage of the scarring alopecia with follicular unit transplantation in the head and neck area. METHODS: Between 2015 and 2016 years, 27 patients who were treated for scaring alopecia after 13 trauma (4 scalp, 2 sideburn, 3 eyebrows and 4 beard) and 14 cleft lip repair(6 unilateral, 8 bilateral) were included in the study. Firstly the recipient areas were assessed for scar width and maturity, the number of needed donor grafts, the angle and direction of the existing hair around scar. The occipital and post auricular scalp area were selected as donor sides for scalp, sideburn and eyebrow scars. If there were adequate follicular unit in the submental beard region, it was selected as donor side for moustache and beard scar; if were not, scalp was selected again. Two teams that extraction and implantation worked together for shortening the duration of ischemia. Çeviri hatasýAll patients were discharged on the same day with analgesics and antibiotics. The patient was called for control at the 2nd week, 1st, 3rd, 6th, 12th months and digital photographs were taken. Graft survival and patient satisfaction were assessed with Photoshop program and the patient satisfaction scale (1: not satisfied, 0: neutral, 1: moderate,2: good, 3: very satisfied) at postoperative 1 year. RESULTS: There were no major complications in the early postoperative period, transient edema due to tumescence infiltration and pain responding to simple analgesia. In the late period, one epidermal inclusion cyst developed, treated with excision. Mean survival rate of grafts was 86%. 20 patients were very-well satisfied (3), 7 were good (2). CONCLUSION: The scarring alopecia is a challenging problem to deal with affects the social and psychological condition of the patient in the aesthetic units.2,3 Focal unit extraction technique(FUE) hair and beard transplantation is an easy, low cost, minimally invasive and alternative treatment with high success and satisfaction rate in scar camouflage.2,4 Reference Citations: 1. Umar S. Use of beard hair as a donor source to camouflage the linear scars of follicular unit hair transplant. J Plast Reconstr Aesthet Surg. 2012 Sep;65(9):1279–80. 2. Barr L, Barrera A. Use of hair grafting in scar camouflage. Facial Plast Surg Clin North Am. 2011 Aug;19(3):559–68. 3. Epstein J. Facial hair restoration: hair transplantation to eyebrows, beard, sideburns, and eyelashes. Facial Plast Surg Clin North Am. 2013 Aug;21(3):457–67. 4. Barrera A. The use of micrografts and minigrafts in the aesthetic reconstruction of the face and scalp. Plast Reconstr Surg. 2003 Sep;112(3):883–90.