Beard Reconstruction Using Hair Grafts in a Free Flap

The document reports a case where a 56-year-old male patient underwent successful beard reconstruction using micrograft and minigraft hair transplantation into a free osteocutaneous mandibular flap, following head and neck cancer treatment that involved the mandible and chin. The patient had previously experienced a failed fibula free flap and subsequent reconstructions, leading to a stable but hairless cutaneous external paddle that was considered unsightly. To address this, the patient received two sessions of hair transplantation, each with 200 follicular units, spaced 11 months apart. The procedure mimicked natural beard hair angulation and distribution, resulting in a satisfactory outcome for the patient, with stable results and excellent camouflage of the flap and scars. The case demonstrates that micro- and minigraft hair transplantation is a safe and effective method for beard reconstruction in free flap skin paddles, achieving good aesthetic outcomes and high patient satisfaction.