Last Updated on July 17, 2021 by Dr Sanusi Umar MD

Alex is the remarkable young man who is presented in this patient case study. He overcame a very noticeable facial congenital defect through a series of cosmetic surgeries performed during early childhood. These procedures replaced a large facial nevus (i.e. mole) with skin grafts taken from his Jaw and neck areas (beard zone) and forehead. Although the operations succeeded at removing the dark, discolored areas, they also left the teen without a Right eyebrow and abnormal beard hair growth on the right side of his face. Inspired by Alex’s story and infallible spirit, Dr. U took Alex’s case as an eyebrow and facial hair transplantation patient on a pro bono basis, through his charity organization, the Hair Peace Foundation. The teen underwent a very specialized procedure using Dr.UGraft ™ technology to harvest leg and nape hair as the most ideal and natural matches for reproducing normal eyebrow and beard hair growth needed to create an outcome that is optimally symmetrical with the left side of the patient’s face.

A Remarkable Hair Transplant Helps Teen Achieve the Beard of His Dreams

Check out Dr.U’s official site – https://dru.com/Learn more about this teenager’s beard hair reconstruction procedure here – https://dru.com/how-a-beard-hair…

Background On Balloon Expansion Skin Graft Surgery To Replace Congenital Facial Nevus

Large, congenital nevi are generally harmless for the most part. Yet, since they are very noticeable, individuals who are born with them tend to feel extremely self-conscious and set-apart from others. School-aged peers, and even adults may not always know how to react appropriately. They may stare, make insensitive remarks, or worse yet, even bully those with expansive facial moles. It is estimated that large, congenital nevi occur in one out of every 20,000 newborns.

As a very young child, Alex had cosmetic surgical procedures performed to eliminate his dark facial mole and to replace it with skin grafts taken from his face and neck. The process of acquiring these grafts required expanding the donor skin surface areas to provide for the affected (recipient) areas on his face while leaving enough skin behind to cover the original areas.

Los Angeles patient was born with a congenital nevus, undergoing several plastic surgeries to remove sections of the darkened skin.

Los Angeles patient was born with a congenital nevus, undergoing several plastic surgeries to remove sections of the darkened skin.

 

These goals were achieved for Alex using a tissue expansion technique using a balloon expander. This method is commonly used to repair skin surfaces affected by burns and other disfiguring wounds. The balloon expander is placed under the skin causing it to stretch and enlarge its original surface area.

Patient shown undergoing balloon expansion which aims to stretch the skin and create extra tissue for replacing the congenital nevus mole areas on the face

Patient is shown undergoing balloon expansion which aims to stretch the skin and create extra tissue for replacing the congenital nevus mole areas on the face

 

Alex’s surgeons first removed the nevus so that scar tissue could form and take its place.  The skin grafts derived from the tissue expansion were then used to cover the remaining scarred areas left behind from the nevus removal.

Facial Hair Transplantation Before Photos-  Facial Asymmetries Due To A Missing Eyebrow and Abnormal Beard Growth on Right Cheek

The balloon expansion technique was performed on the neck and the upper part of Alex’s forehead. Replacing his facial nevus with these tissue areas eliminated his right eyebrow. Also, the grafts derived from the beard area continued to produce hair. However, this growth occurred on his cheek, instead of the normal beard region. The patient had to constantly shave the right side of his face, as a result.

Dr.U recommended the use of laser to permanently remove the undesired hair growth. Laser energy is applied to the hair follicle, causing it to enter a permanent telogen resting phrase. Not only does this eliminate unwanted hair, but it also prevents new hair from growing.

Next, Dr. U Decided to reconstruct the patient’s right eyebrow and normal beard hair patterns so that they would be identical to his left side. Not only does this involve inserting follicles at the appropriate angles and orientations, but also making sure that the hair thickness is accurate.

Regular head hair is actually very noticeably thick, compared to the thinner hair type that already exists in Alex’s eyebrow and beard region on the left side of his face.

Dr. U recommended using leg and nape hair to replicate a natural looking thickness to help achieve the most optimal symmetry possible for this patient’s facial hair transplantation. However, the ability to safely acquire these unconventional hair follicles for permanent, long term growth requires a specialized approach to overcome the issues that prevent their application through the usage of conventional FUE hair transplant punches.

 

Patient shown with missing left eyebrow due to the placement of a skin graft on his forehead

Patient shown with missing right brow, before his eyebrow reconstruction surgery, due to the placement of a skin graft on his forehead

Dr.U plans out the area where grafts will be inserted for the patient's beard and sideburn hair transplant

Dr.U plans out the area where grafts will be inserted for the patient’s beard and sideburn hair transplant

 

Facial hair transplantation on the left side of the face will advance and improve the contours of the patient's existing beard region

Facial hair transplantation on the left side of the face will advance and improve the contours of the patient’s existing beard region

Procedure Photos – Dr.UGraft ™ Technology Safely Harvest Leg and Nape Hair Follicles For Facial Hair Transplantation, Sideburn Hair Transplant and Eyebrow Reconstruction Surgery in Los Angeles Teen

Thus far,  head hair has been widely used as donor grafts in conventional hair transplantation procedures. Yet due to its thickness, it may not be the best choice for all applications. In Alex’s case where his right eyebrow and beard region must match the other side of his face, the selection of thinner hair types was absolutely necessary. Yet these donor follicles required more advanced means for their extraction.

The softer characteristics of leg and nape hair are certainly capable of helping the transplanted growth on the right side of the face look more like the left. However, as easy as it may be to simply choose these finer hairs, over regular head hair, it is more difficult to safely isolate them as viable donor grafts.

Photo of leg hair grafts safely extracted with the Dr.UGraft Intuitive FUE system. These were used for this patient's eyebrow reconstruction surgery and facial hair transplantation

Photo of leg hair grafts safely extracted with the Dr.UGraft Intuitive FUE system. These were used for this patient’s eyebrow reconstruction surgery and facial hair transplantation

 

Dr.U's FUE Shave Test results show an even distribution of hair throughout the scalp. This patient, therefore, qualified for the long-term use of nape hair for his eyebrow and beard transplant procedure

Dr.U’s FUE Shave Test results show an even distribution of hair throughout the scalp. This patient, therefore, qualified for the long-term use of nape hair for his eyebrow and facial hair transplantation *

Why Leg and Nape Hair Must Be Extracted Through A More Advanced Form FUE Hair Transplant Surgery

In order to serve as viable hair transplant grafts, nape and nonhead hair follicles must be harvested using specialized forms of extraction technology. FUE punches to date are severely limited when it comes to removing hair grafts from atypical sources. This is why body and nape hair are not universally made available for most hair transplant procedures. Using basic FUE punch devices for these donor types will incur a significant risk of graft transection.

The explanation of transected grafts in FUE hair transplant surgery has been widely attributed to hair shaft curvatures. When considering this explanation using a basic cylinder shaped punch, straighter scalp hair which emerges more perpendicularly from the skin, offers a more direct route to the follicle, which is easier to determine. 

According to this view, any curvatures or bends in the hair shaft would present a winding unpredictable trajectory if the practitioner chooses to use a general FUE device. In this scenario, such a punch would be more than likely to cut the graft.

In theory, this paradigm seems make perfect sense. But in actual reality, it fails to explain why unexpectedly low transection rates are possible in patients with very tightly curled hair. Through his own direct experience across patients of many different ethnicities, Dr.U has concluded that the overlooked variable of skin thickness correlates much more strongly with graft transection compared to hair shaft curliness. A given speed and torque (i.e strength) for a rotary punch may not produce enough impact on very thick skin, causing the need for extra measures to free the graft which can end up damaging it. Likewise, on very soft skin, the established speed and torque can exert an excessive impact that tears the protective bulk surrounding the follicular unit.

These game-changing revelations formed the basis of the engineering behind his Dr.UGraft ™ Intuitive FUE technology. The effectiveness of this instrumentation for producing extremely low transection rates has been illustrated across Dr.U’s extensive history of successful patient outcomes, marked by high satisfaction due to the attainment of long term growth coverage.  

Dr.U’s intelligent punch device has been built to exhibit distinct behaviors in response to varying degrees of skin thickness. Not only are these phenotypes found in different ethnicities, but also within the same individual on different donor hair sources found throughout the body. Based on how the punch reacts when excising downward into different skin types,  the operator is then able to adjust the speed and torque parameters to determine a safe extraction mode that would reduce graft transection rates for the patient to the lowest possible levels.

Nape and Leg Hair Restores Eyebrow and Beard Symmetry for Facial Hair Transplantation

Once Dr.U harvested his targeted quantity of leg and nape donor hair grafts, the next phase of Alex’s facial hair transplantation procedure was to insert these follicles to reproduce natural contours and growth patterns by modeling these characteristics found on the left side of the face. Establishing a quintessential mirrored symmetry was the biggest challenge for this aspect of the surgery. Yet achieving this pivotal point would prove to be a major milestone towards a more normal and natural looking appearance for the patient.

Before and After Photos of Dr.U’s Right Eyebrow and Beard Construction For Countering Congenital Birth Defect

These side by side, before and after comparison photos of the facial hair transplantation highlight the final symmetrical effect achieved by Dr.U’s reconstruction of the patient’s right eyebrow and facial hair. 

The inclusion of nape hair helped to render a more true-to-life-coarse hair texture for the final facial hair transplantation results that are seen on the left side of the face.

Eyebrow and beard transplant patient before and after his Dr.UGraft procedure using nape and leg hair grafts

Eyebrow and facial hair transplantation patient before and after his Dr.UGraft procedure using nape and leg hair grafts *

 

Before and after photos of Dr.U's sideburn hair transplant on right side of patient's face

Before and after photos of Dr.U’s sideburn hair transplant on right side of patient’s face *

 

Top row shows the sideburn hair transplant results on the left side of patient's face. Bottom row shows how Dr.U replicated these contours on the right side

Top row shows the sideburn hair transplant results on the left side of patient’s face. Bottom row shows how Dr.U replicated these contours on the right side *

 

Before and after photos show excellent healing of patient's leg which helped supply donor grafts for this eyebrow and beard transplant procedure

Before and after photos show excellent healing of patient’s leg which helped supply donor grafts for this eyebrow and facial hair transplantation procedure *

 

Video – Eyebrow and Facial Hair Transplantation Procedure For Congenital Nevus Teen

In this video, you can learn more about this patient’s experience with Dr.U’s reconstruction of his beard and eyebrow.

Eyebrow and Beard Transplant With Leg and Nape Hair

Overall, the patient is immensely pleased with his new eyebrow and the refined mature look that his completed beard helped to produce for his appearance. If you are in the greater Los Angeles area and are considering a facial hair transplantation performed by Dr.U, send us your photos and the details of what you’d like to achieve through our complimentary online consultation form

 

Frequently Asked Questions – Facial Hair Transplantation

I’ve heard that nape hair may not last long term. Is this really a good choice for a hair transplant procedure, performed on the eyebrows, beard, the head or another area?

Conventionally, the use of nape hair has been generally avoided because it has shown to be non-permanent in some patients. On the other hand, however, nape hair has been able to last long term in other individuals. Dr.U has developed a reliable assessment, known as the FUE Shave Test which can be used to determine when nape hair can or cannot be used.

A study which illustrates the effectiveness of this evaluation has been published in the Aesthetic Surgery Journal. On a shaved male head, Dr.U has discovered that it is possible to observe hair distribution patterns in the nape area which accurately indicate whether or not it can be expected to last on a permanent basis for a particular patient.

Based on his own experience, Dr.U has also been able to conclude that the majority (i.e. 75-80%) of male hair loss patients are eligible for the usage of nape hair. With his FUE Shave Test, it is possible to more specifically determine who can or cannot qualify as candidates, rather than grouping all patients into the same category.

Why is the Dr.UGraft ™ technology considered to be intuitive?

The Dr.UGraft ™ intuitive FUE device, also known as the intelligent (i)  punch is regarded as intuitive because it’s performance behavior has been engineered to be customizable for the skin anatomy different patients, rather than operating through a single, one-size-fits-all modality.

Dr.U has found that skin thickness relates much more closely to graft transection than the straightness or curliness of the hair shaft. His Intuitive FUE technology is capable of being adjusted to safely perform excisions on different skin thickness levels to minimize transection rates to the absolute lowest possible levels.

What factors qualify a person who is suffering from hair loss to be eligible as a pro bono hair transplant patient at Dr.U’s Hair Peace Foundation hair transplant organization?

The Hair Peace Foundation organization selects pro bono hair transplant recipients based on financial need and the difficulty of the patient’s hair loss situation, as illustrated by Alex’s case, described above.  The impact of a procedure must be able to produce a significant improvement, not only in terms of the patient’s final appearance, but also their emotional, spiritual and mental well being.

Further Reading

Read more about Bill, another candidate of Dr.U’s Hair Peace Foundation who underwent a life-changing hair restoration procedure with body hair, after having suffered multiple failed hair transplant surgeries.

Discover how leg hair was able to recreate a natural-looking appearance for this man’s hairline, as the world’s very first use of leg hair in a hair transplant procedure