Facial hair restoration using long hair follicular unit extraction – A case of beard to moustache transplantation

Facial hair plays a vital role in shaping an individual’s esthetic and cultural identity, and is often linked with masculinity. Alopecia in this area from scarring can have a significant psychological impact. Long-hair follicular unit extraction (FUE) offers the advantage of immediate visualization of transplant outcomes, making it a promising option for restoring facial hair. However, its application in moustache reconstruction has not been previously reported. This case describes a 32-year-old male with a postsurgical scar in the central moustache region following cleft lip repair. Using long hair FUE, 12 follicular units were harvested from the lower neck beard with the Zeus U Graft system, which employs a phased extraction technique to address the unique challenges of beard hair, including acute angulation and thicker shafts. The procedure avoided the need for shaving the donor or recipient areas, thereby enhancing patient comfort and aesthetic outcomes, and eliminating social downtime. Platelet-rich plasma and liposomal adenosine triphosphate were used as adjunctive measures to support graft retention and reduce effluvium. The patient reported high satisfaction with the outcome, with no complications and excellent healing observed during follow-up. This case demonstrates the feasibility and efficacy of long-hair FUE for mustache reconstruction, introducing a novel approach to addressing facial scarring and expanding the applications of hair restoration techniques.