Houston Plastic Surgery Clinic Cosmetic Surgeons of Houston Plastic Surgery Houston plastic surgery and Houston plastic surgeon in Texas providing liposuction breast augmentation enlargement and facelift or face-lift cosmetic surgery by Board Certified cosmetic surgeons. Houston Texas plastic surgeon providing liposuction breast augmentation enlargement and facelift cosmetic surgery Board Certified.

	The Use of Micrografts and Minigrafts in the Aesthetic Reconstruction of the Face and Scalp Traditionally, little attention has been given to fine details in hair restoration, especially in reconstructive surgery. The techniques used most frequently in the past include tissue expansion, scalp flaps, hair plugs, and scalp strips.^1-7 Some of these techniques are still used in hair restoration, especially tissue expansion and flaps. The introduction of micrografts (1 to 2 hair grafts) and mingrafts (3 to 4 hair grafts) was a significant advancement in the treatment of male pattern baldness and female androgenic alopecia. Finally, natural and aesthetically pleasing results were possible.^8-11. Subsequently, micrografting and minigrafting were used to correct unfavorable results from previous hair transplantation,^12,13 sideburns lost following rhytidectomy,¹⁴ and burn alopecia.¹⁵ In addition to the use of these grafts to treat male pattern baldness and female androgenic alopecia, many other applications have been found in the aesthetic reconstruction of the face and scalp. In my experience, micrografts and minigrafts have been used in aesthetic reconstruction of the face and scalp in the following order of frequency: 1. To restore hair lost as a result of (iatrogenic) postsurgical causes (i.e., after facial rejuvenation procedures or procedures involving incisions on hair-bearing facial skin or scalp; Figs. 1 and 2). 2. To correct unfavorable results from previous hair transplantation, to eliminate the “plug look” caused by the old hair plugs technique, and to camouflage scars from flap procedures or scalp reductions (Fig. 3). 3. To restore scalp and facial hair lost as result of burns or traumatic injuries (Figs. 4-6). 4. To restore hair loss attributable to congenital reasons, such as complete bilateral cleft lips (no mustache hair in the prolabium) and triangular alopecia, or to remove congenital nevi or arteriovenous malformations (Figs. 7-8). 5. To restore hair loss after oncologic resections (i.e., resection of melanoma and other skin malignancies) (Fig. 9).



	Figure 1. (Left) A 42-year-old woman with frontotemporal hair loss resulting from a forehead lift. (Right) One year after a single session of a total of 512 micrografts and minigrafts bilaterally.



	Figure 2. (Left) A 48-year-old woman with significant loss of sideburn and temporal hairline resulting from aesthetic surgery (face lift procedure). (Right) Two years after a total of 750 follicular unit micrografts and minigrafts in two sessions (bilateral sideburns and temporal areas). Notice the direction of the hair growth.



	Figure 3. (Left) A 26-year-old patient with a history of hair transplantation elsewhere. Notice the clumpiness and unnatural appearance, before. (Right) One year after a revision megasession of 1400 micrografts and minigrafts to camouflage the deformity.

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