Last Updated on November 17, 2020 by Dr Sanusi Umar MD

A recent beneficiary of my volunteer organization, The Hair Peace Foundation was a young adolescent man named Alex.  He was born with a congenital facial nevus (i.e. mole) and had it surgically replaced with skin grafts taken from his neck and skin. Following these procedures, however, he no longer had a right eyebrow or normal looking beard hair growth on the right half of his face. Due to the fact that Alex was about to graduate high school and getting ready to embark on a brand new phase in his life, I decided to accept him as an eyebrow and beard hair restoration patient on a pro bono basis.

I first met Alex through a Harbor UCLA program where he was seeking treatment for acne, After sitting down to have a conversation with him, I was rather inspired by his inner spirit which he radiated through his confident, but gentle and congenial demeanor. He seemed very mature for his age and displayed very genuine and remarkable confidence in his own skin, far more so than many adults.  

It was also clear that Alex was already inwardly fulfilled and content in his own right. He didn’t depend on his physical appearance for his identity or sense of worth. Because of how he was able to project the best in himself, he was very well liked by his classmates and able to have a typical, normal social life.

At the same time, being able to achieve a more standard appearance with a right eyebrow that mirrored the left one would certainly further improve how Alex felt about himself. And with beard and facial hair being popular among today’s group of young adults, I knew that succeeding at recreating a complete beard on both sides of his face would also make a huge difference for this rather amazing teenager. Not only would this help to draw attention away from the linear edges of his skin grafts, but also help him feel more in line with the popular aesthetic trends of his peer group.

Why Leg and Nape Hair Was Necessary For Alex’s Eyebrow and Beard Hair Restoration

The main challenge for Alex’s eyebrow and beard hair restoration was to produce an ideal symmetrical end result so that the right eyebrow and beard region would mirror what is seen on the left half of his face. Major considerations would not only include how the grafts are inserted to recreate appropriate contours and growth patterns, but also the actual thickness of the hairs used.

Alex before his facial hair restoration for the right eyebrow and bear

Alex before his facial hair restoration for the right eyebrow and beard


For this reason, I decided that a combination of leg and head hair would most closely match what is already seen on the left side of his face.

While eyebrow and beard hair restoration surgeries are widely offered by many providers around the world, the current general methodologies used involve harvesting regular head hair follicles. However, hair from the scalp tends to be very thick.

From a close look at Alex’s left eyebrow and beard, it is evident that the hairs in these regions are comparably much thinner. Transplanting thick head hair on the right side of his face would certainly not produce the most natural looking result possible.

Alex’s leg hair offers a more accurate match. And the inclusion of nape hair would help provide the right degree of coarseness that mirrors the hair found on the left side of his face.

Safely Harvesting Leg and Nape Hair Follicles With Dr.UGraft™ Intuitive FUE Technology

The use of leg and nape hair follicles is certainly not a standard practice in mainstream hair transplant surgery. This is due to the capabilities of existing FUE punches which are are not built to overcome the primary cause of graft transection (i.e. surgically induced damage).

Within the field of FUE hair transplantation, it is widely assumed that transected grafts are due to the curliness of the hair.

It would seem that hair with a high degree of curvature would be harder to locate using a basic punch. And it would also be more difficult to surround within the confines of its cylinder shape.

So instead of safely encompassing the graft, the punch would be expected to cut through it.

However, throughout my work on patients of different ethnicities, I’ve found that skin thickness correlates much more closely with graft transection rates, far more so that hair shaft morphology.

I developed my Dr.UGraft™ technology with this in mind. Although it also has features which surmount the difficulties of hair curvature and angulation, the low transection rates and successful patient growth outcomes have mostly been the result of overcoming different skin thicknesses. Not only do these discrepancies exist across different ethnic groups, but also with different donor areas in the same person, such as the scalp, leg, nape and other parts of the body.

In Alex’s case, the leg and nape regions are much softer and penetrable than then scalp area. With Intuitive FUE technology, it is then possible to adjust the settings of the Dr.UGraft ™ device so that the impact of the rotary punch, in terms of speed and torque does not end up damaging the grafts. This makes it possible to harvest desired quantities of viable leg and nape hair follicles by reducing their transection rates to the lowest occurrence levels possible.

Recreating Right Eyebrow and Beard Region To Mirror the Left Side of the Face

With a harvested supply of grafts representing the right hair thickness, the next phase of Alex’s procedure involved inserting each of these follicular units to recreate appropriate contours, angles and directional growth for his beard and eyebrows.

I carefully studied these attributes on the left side of his face in order to reproduce them symmetrically on the right side. Here is a series of before and after photos which illustrate his eyebrow and beard hair restoration outcomes.

Los Angeles eyebrow and beard hair restoration - before and after photos showing the results of nape and leg hair transplant

Los Angeles eyebrow and beard hair restoration – before and after photos showing the results of nape and leg hair transplant *

Eyebrow and facial hair restoration mirrors right side with the existing contours on the left side

Eyebrow and facial hair restoration mirrors the right side with the existing contours on the left side *


This is due to the capabilities of existing FUE punches which are likely to injure the grafts taken from these areas since these devices are not built to overcome the primary cause of transection (i.e surgically induced damage). So instead of surrounding the graft, the punch would be expected to cut through it.

While an eyebrow recreation and beard reconstruction procedure would complete his facial symmetry and help him reach greater strides towards a more typical looking appearance, I knew that these measures would only serve as secondary forms of enhancements to his life. Alex didn’t need or depend on my surgical help to reach a state of wholeness or happiness. He already had achieved this for himself, despite the challenges associated with his congenital nevus defect.

Out of 3500 students at his high school, Alex was awarded the title, Most Inspiring Student 2018 by the City of Long Beach Mayor, in recognition of his character, work ethic and overall dedication.

Alex displays his award with Dr.U at the Dr.U Hair and Skin Clinics in Los Angeles

Alex displays his award with Dr.U at the Dr.U Hair and Skin Clinics in Los Angeles


I am deeply humbled by my overall experience in getting to know Alex,  who has taught me a lot what it means to be content and fulfilled within. Many of us lose touch with the essence of these qualities. In our adult lives, becomes easy to lose touch with our ability to experience true inner happiness, especially when we become preoccupied with the constant pursuit of tangible external rewards. At best, these things can only provide rather temporary or fleeting forms of satisfaction if we are not whole or discontent with who we are, where we’ve been and what we currently have

From speaking with many hair transplant patients, I can say that no surgical outcome in the world can enhance your appearance to the point where you can attain a state of ultimate confidence and inner bliss. Hair transplantation can certainly make you happier with what you see in the mirror each day. But it cannot do the job of erasing your insecurities or painful past experiences that may have had a detrimental effect on your self-esteem. Nor can any cosmetic procedure help you refocus your perspective on the blessings and positive inherent qualities within you.

Although I feel fortunate to have helped many men and women regain a sense of pride in their appearance, there are still many patients, unfortunately, who were lucky enough to have been born with a normal appearance and despite surgery after surgery, which continually enhanced their appearance, still found it difficult to be content with who they were.

To me, Alex exemplifies the reality that happiness and self-esteem is ultimately an inside job. It does not come from your appearance. Any form of physical or external reward that you desire can only complement the level of happiness that you have within. Otherwise any sense of happiness they offer only becomes fleeting, much like a rather disposable shiny new object.  How others react to you is not exclusively based on your appearance, but your confidence and the positive inner qualities that you project. If your cup is full, you can give in a balanced fashion to others and have this be reciprocated in a way that feels authentically fulfilling to you.

Alex is an exemplary young man who is certainly an inspiration, not just for his classmates, but also for many others who have the pleasure of meeting him.

Alex is an exemplary young man who is certainly an inspiration, not just for his classmates, but also for many others who have the pleasure of meeting him.


If you are interested in discussing questions having to do with inner confidence and well-being related to hair loss and/or hair transplantation, submit your inquiry through our Ask Dr.U button below.


Frequently Asked Questions – Hair Transplantation and Self-Confidence

Does the Hair Peace Foundation only accept cases on a pro bono basis for individuals with birth anomalies or irreconcilable hair loss due to diseases? Under what circumstances can someone with general androgenic alopecia qualify?

The Hair Peace Foundation accepts hair transplant candidates based on the severity of their situation as well as financial need. While this may include birth anomalies and hair loss due to diseases, other examples include traumas due to accidents as well as burns. Individuals with androgenic alopecia may qualify if they are the victims of botched hair restoration surgeries where the results are considered impossible to repair through conventional approaches.

Are there actually studies on hair transplantation and self-confidence?

Yes, there are various studies which have been published on how cosmetic procedures affect the self-esteem of individuals. One research study, reported in the JAMA Facial Plastic Surgery Journal 2016 suggests that hair transplant patients tend to be perceived more positively by others in terms of attractiveness, age, success, and approachability. Therefore, surgeries to restore hair can help individuals shift the way they are regarded by other people which can improve their overall confidence. However, as noted in this post, the degree of confidence a patient experiences after their procedure is really contingent on their level of mental and emotional health that was already in place prior to their surgery. There are many examples of patients who remain dissatisfied with their results and their overall state of satisfaction, regardless of the number of procedures or grafts they have invested in. In worst case scenarios, if a patient is suffering from body dyspmorphic disorder, hair transplant surgery is likely to further contribute to their illness. The relationship between hair transplant surgery and self-confidence ultimately depends on the inner psychological well being of the individual.

What can hair transplant patients do to further improve their confidence and self-esteem following their procedure?

It is important for hair transplant patients (i.e. scalp, eyebrow or beard hair restoration etc.) to focus on their positive inner qualities which comprise their unique set of strengths and to develop these characteristics further. Spending time pursuing a hobby or other interest is also a healthy practice to incorporate into one’s lifestyle. Additionally, It may also help to find examples of real-life individuals who have demonstrated high self-esteem despite what others might perceive to be a setback. Our patient, Alex, is one illustration. But finding others to learn from is also an effective exercise to engage in. Taking the time to read self-improvement books, listen to audio or videos on this topic and Joining online community groups and forums where members are devoted to self-development are other ways hair transplant patients can improve their sense of inner confidence and worth. Speaking with a professional counselor, life coach, psychologist or a psychiatrist can also provide support for inner growth and personal development along these lines.

Further Reading

Learn about another Hair Peace Foundation candidate who used his hair loss journey as an opportunity to evolve the spiritual side of his life.

Read about this male patient of Dr.U who also had leg hair grafts inserted for his eyebrow transplant procedure.