Hair transplantation by use of micrografts (one- to two-hair follicular unit grafts) and minigrafts (three- to four-hair follicular unit grafts) used in large numbers (>1000 grafts) in a single session was initially described for the treatment of male pattern baldness. More recently, the author has found many other applications, particularly in facial and scalp reconstruction. The most common causes for aesthetic hair restoration of those areas in the author’s experience include hair loss resulting from aesthetic facial rejuvenation surgery, revision of unsatisfactory results from previous hair transplantation, burn alopecia, congenital reasons, and hair loss after oncologic resections. The basic technique is described in detail, with variations given for each of the challenging anatomic areas, including the sideburns and temporal hairline, eyebrows, eyelashes, mustache, beard, and remaining scalp. Special attention is given to the direction of hair growth, hair texture, aesthetic planning, and absence of detectable scars, in order to mimic nature and to result in a minimal number of procedures. The use of micrografts and minigrafts in the aesthetic reconstruction of the face and scalp has been found to be safe and predictable, and has provided a high level of patient satisfaction.
From the Department of Plastic Surgery, Baylor College of Medicine.
Received for publication August 19, 2002;
revised November 4, 2002.
Presented at the 70th Annual Meeting of the American Society of Plastic Surgeons, Plastic Surgery Educational Foundation, and American Society of Maxillofacial Surgeons, in Orlando, Florida, November 3 to 7, 2001, and at the Symposium on Aesthetic Facial Reconstruction, American Society of Plastic Surgeons/Plastic Surgery Educational Foundation, in Nashville, Tennessee, February 14 to 17, 2002.
Alfonso Barrera, M.D.
Department of Plastic Surgery
Baylor College of Medicine
902 Frostwood, Suite 163
Houston, Texas 77024