Corrective Long-Hair FUE in a Failed Beard and Eyebrow Transplant
Case Description
History: This young, adult male patient came to see Dr. Bernardino Arocha at Arocha Hair Restoration following a failed beard and eyebrow transplant at a different clinic in Houston. His main concern with the original outcome was that it was sparse and unnatural looking.
Physical Examination: This patient was otherwise healthy. The growth from his first eyebrow and beard transplant was not remarkable. And, the first transplant at a different clinic meant that any work that Dr. Arocha did would need to be conservative in the use of grafts so as not to further deplete his donor.
Plan: The goal for this patient was to restore a natural eyebrow using long-hair FUE so that the improvement would be immediately visible. For the beard, the patient had unwanted neck beard hair that Dr. Arocha used as donor to repair his prior failed facial beard transplant.
Procedure: Dr. Arocha used a tiny, .75 internal diameter long-hair Trivellini punch for long hair FUE extractions. He placed approximately 250 follicles in each eyebrow giving the patient more density, which he desired and more importantly, proper angle and direction so the eyebrow hairs would lay down and look natural. The decision to use long-hair FUE in the eyebrows meant that patient would have immediately visible results.
Then, Dr. Arocha extracted the unwanted neck beard hair using a .6 mm internal diameter Trivellini punch. He extracted approximately 1003 follicles in a first procedure to fill in the residual gaps and add additional density. The patient came back for a second beard procedure of 500 grafts. These grafts were also taken from unwanted neck beard hair. He had a third beard transplant of 487 grafts.
Results: This patient is shown in the before photos with a mature result following his initial failed procedure at a different clinic. The after images were taken 18 months following his corrective transplant with Dr. Arocha. As you can see in the after images, the eyebrows and the beard have much more density, and looks much more natural than in the before images.
Discussion: This case study highlights the importance of educating patients on how to discern reputable hair restoration surgeons from those who use deceptive marketing practices and lower prices to get patients in the door.
This patient had his original procedure at a clinic that markets itself as “the leading hair transplant clinic” in Houston. When fact, the doctor who performed the surgery on this patient, did not receive education in hair transplantation, did not complete a fellowship in hair restoration, nor is he a board certified hair transplant surgeon. In fact, he is not involved in the surgery, instead he delegates the surgery to his medical assistant. Dr. Arocha continuously sees patients needing repairs from this clinic because their job was done poorly and depleted precious donor. Patients might have originally chosen this clinic because they lure them in the door with promises of a cheaper price and deceptive marketing practices, such as fake reviews.
The dangers in this is that we all have a finite amount of donor hair. One surgery can deplete this precious resource, leaving little behind for a decent repair should a patient need one down the line. It also makes it more difficult for a second surgeon to come in to complete the repair. Not to mention the cost of repair/corrective procedure. This can all be avoided if patients are educated on ways to discern legitimate hair restoration surgeons from the rest. We always tell our patients that there are only approximately 200 board certified hair restoration surgeons in the world, and Dr. Arocha is proud to be among them. Most of the time, cheaper price costs more in the long scheme of things. It is far less expensive follicularly, but also financially!
