Macro Photography-Based Comparison of Follicular Unit Extraction and Follicular Unit Transplant Techniques for Correction of Mustache Alopecia in Cleft Lip Patients

Scars on the hair-bearing mustache area can be cosmetically disfiguring and interfere with adult male cleft patients social lives. Mustache reconstruction animates a male face, provides confidence, and interrupts the cycle of self-pity, providing a sense of completion. The purpose of this study was to examine and evaluate hair regrowth in the mustache region after hair restoration utilizing follicular unit extraction and follicular unit transplant procedures in individuals with secondary cleft lip scars.

This was a prospective, double-blind, randomized controlled trial included 40 male patients presenting with either unilateral or bilateral cleft lip scars. Patients were randomly assigned to one of two groups: follicular unit extraction or follicular unit transplant. Macro Photographs were taken before surgery, as well as immediately after, 1, 3, 6, 9, and 12 months thereafter to evaluate the hair using the Madura et al. 10-point objective scale.

At the end of the 1st month (p < 0.0001), 9th month (p < 0.0001), and 1 year (p < 0.0001), a statistically highly significant difference was observed between the compared groups, with higher values reported with the follicular unit extraction group at the 1st month (7.50 ± 1.581), 9th month (6.80 ± 1.229), and 1 year (7.50 ± 1.179). At the end of the 3rd month [p = 0.012] and 6th month [p = 0.002], a statistically significant difference was observed between the compared groups, with higher values reported with the follicular unit extraction group at the 3rd month (6.70 ± 1.337) and 6th month (7.20 ± 1.476).

The follicular unit extraction group has significantly better clinical changes and less adverse effects than the follicular unit transplant group.