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J Stomatol Oral Maxillofac Surg 000 (2025) 102266

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Technical Note

Reconstruction of large thermal burn areas by hair transplantation

Lotfi Benslama
Sorbonne Universite
, Department of Oral and Maxillo-Facial Surgery, Pitie
-Salp^etriere Hospital, Assistance Publique des Ho
^pitaux de Paris, 47-83 Boulevard de
^pital, 75013 Paris, France
l’Ho
American Hospital of Paris, 63, Boulevard Victor Hugo, 92202 Neuilly-Sur-Seine
69 rue de la Tour, 75016 Paris, France

A R T I C L E I N F O A B S T R A C T

Article History: Introduction: Alopecia resulting from burns represents a surgical challenge, with significant functional, physi-
Received 10 December 2024 cal, psychological and social consequences. Current management is based on various techniques. However,
Accepted 24 January 2025 the results are most often very disappointing. Hair transplantation could be an option.
Available online xxx
Clinical case: A 51-year-old soldier, victim of a plane crash with more than 40% of his body surface burned,
was treated with hair autograft.
Keywords:
Conclusion: Hair transplantation could prove to be one of the significant solutions to reconstruct alopecia
Burns/surgery
caused by thermal burns.
Alopecia/surgery
Hair follicle/transplantation
© 2025 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and
Eyebrow reconstruction similar technologies.

1. Introduction Given the existence of a donor area in good condition, the surgical
solution chosen was autograft [1]. Preliminary tests were carried out
Post-burn alopecia is a surgical challenge because of the sig- with a few grafts (Figs. 6,7). The grafts were harvested using the Fol-
nificant aesthetic, functional, psychological and social consequen- licular Unit Transplantation (FUT) method (Figs. 6,7). This technique
ces. Its current management is based on various techniques: scar increases the preservation of the donor area, allowing on the one
reduction (associated or not with a flap), skin graft containing hand iterative grafts, and on the other hand avoids shaving this area.
hair follicles, or scalp expansion. However, the functional and The target density was 40 to 50 gr/cm2. After conclusive tests, grafts
aesthetic results are most often very disappointing. The use of of 1 or 2 hairs were taken and then transplanted (Figs. 8-11). Implan-
hair transplantation could prove to be one of the significant solu- tation at the eyebrow level was carried out using ChoïÒ implanter
tions for this pathology.

2. Clinical case

In 2015, a 51-year-old soldier presented with polytrauma related

to a plane crash: survived a plane crash: deep thermal burns on
approximately 40% of his body surface including the head and neck.
Initially, he was treated with iterative skin grafts. For the scalp,
tissue expansion reconstruction was performed in October 2017 and
February 2018.
In January 2019, the sequelae were as follows: residual fronto-
parieto-occipital alopecia of the scalp, almost complete alopecia of
the right eyebrow, partial alopecia of the tail of the left eyebrow, alo-
pecia of the sideburns (Figs. 1-5). These scar areas were inhomoge-
neous (some very thin) and dyschromic related to skin grafts over a
total surface area of more than 120 cm2).

Abbreviations: FU, Follicular Unit; FUT, Follicular Unit Transplantation

E-mail address: lbenslama@me.com Fig. 1. Sequellar alopecia: front and top.

https://doi.org/10.1016/j.jormas.2025.102266
2468-7855/© 2025 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Please cite this article as: L. Benslama, Reconstruction of large thermal burn areas by hair transplantation, Journal of Stomatology oral and
Maxillofacial Surgery (2025), https://doi.org/10.1016/j.jormas.2025.102266
Téléchargé pour Lahcen KHALFI (khalfi.l@hotmail.fr) à Mohammed V Military Instruction Hospital à partir de ClinicalKey.fr par Elsevier sur mars
05, 2025. Pour un usage personnel seulement. Aucune autre utilisation n´est autorisée. Copyright ©2025. Elsevier Inc. Tous droits réservés.
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L. Benslama Journal of Stomatology oral and Maxillofacial Surgery 00 (2025) 102266

Fig. 2. Sequellar alopecia: profile.

Fig. 5. Residual eyebrow alopecia.

Fig. 3. Sequellar alopecia: rear and right 3/4 view.

Fig. 6. FUT graft test: temporo-parietal area.

Fig. 4. Sequellar alopecia: right profile. Fig. 7. FUT graft test: right eyebrow.

Téléchargé pour Lahcen KHALFI (khalfi.l@hotmail.fr) à Mohammed V Military Instruction Hospital à partir de ClinicalKey.fr par Elsevier sur mars
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Fig. 8. Test result: temporo-parietal area at 6 months.

Fig. 11. Grafting the temporo-fronto-parietal area.

Fig. 9. Test result: right eyebrow at 6 months.

Fig. 12. FUT of the eyebrow area.

Fig. 10. Performing the FUT technique.

Fig. 13. ChoïÒ implanter pens and loading of a 1-hair graft.

Téléchargé pour Lahcen KHALFI (khalfi.l@hotmail.fr) à Mohammed V Military Instruction Hospital à partir de ClinicalKey.fr par Elsevier sur mars
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Fig. 14. implantation of the right eyebrow area. Fig. 16. comparative results: front views.

Table 1
Results after eyebrow transplantation.

Date 1-hair grafts 2-hair grafts Total

July 3, 2019 745 1271 2016

January 21, 2020 478 1075 1553
Ocotber 23, 2020 520 1010 1530
May 25, 2022
September 14, 2022
Total 1743 3356 5099

Fig. 17. comparative results: right profile views.

Fig. 15. result: top view.

pens and ophthalmic forceps (Figs. 12 to 14). The details of the trans-
plants are presented in Table 1
There were no significant complications (necrosis, infection, graft
loss, etc.). Three years after the last transplant, the aesthetic results Fig. 18. comparative results: left profile views.
are very satisfactory for the patient (Figs. 15 to 20). Clinically, the

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05, 2025. Pour un usage personnel seulement. Aucune autre utilisation n´est autorisée. Copyright ©2025. Elsevier Inc. Tous droits réservés.
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L. Benslama Journal of Stomatology oral and Maxillofacial Surgery 00 (2025) 102266

recipient areas had regained normal trophicity and a hair density

close to the initial one. These results corroborate those of other
authors [2−5].

3. Conclusion

Hair transplantation could prove to be one of the significant solu-

tions to reconstruct alopecia caused by thermal burns.

Consent to publish

Written consent was obtained from the patient to publish their

data as a technical note.

Declaration of competing interest

The author declare no conflict of interest.

Fig. 19. comparative results: rear views.

CRediT authorship contribution statement

Lotfi Benslama: Writing − review & editing, Conceptualization.

References

[1] Unger WP, Shapiro R, Unger R, Unger M. Hair transplantation. 5th ed. Boca Raton:
CRC Press; 2011.
[2] Popescu FM, Filip L, Popescu M. FUE as the first surgical option for hair reconstruc-
tion on scalp and facial skin grafts - case report. J Med Life 2024;17(2):233–5 Feb.
doi: 10.25122/jml-2023-0492.
[3] C Civas E, Aksoy HM, Aksoy B, Eski M. Clinical Experience with Hair Transplanta-
tion for Secondary Cicatricial Alopecias. Turk J Plast Surg 2019;27(4):160–6. doi:
10.4103/tjps.tjps_79_18.
[4] Huang TT, Larson DL, Lewis SR. Burn alopecia. Plast Reconstr Surg 1977;60(5):763–
7 Nov. doi: 10.1097/00006534-197711000-00016.
[5] Unger W, Unger R, Wesley C. The surgical treatment of cicatricial alopecia. Derma-
tol Ther 2008;21(4):295–311 Jul-Aug. doi: 10.1111/j.1529-8019.2008.00211.x.

Fig. 20. results after eyebrow transplantation.

Téléchargé pour Lahcen KHALFI (khalfi.l@hotmail.fr) à Mohammed V Military Instruction Hospital à partir de ClinicalKey.fr par Elsevier sur mars
05, 2025. Pour un usage personnel seulement. Aucune autre utilisation n´est autorisée. Copyright ©2025. Elsevier Inc. Tous droits réservés.