Preoperative Use of Follicular Unit Extraction–Assisted Hair Removal in Total Nasal Reconstruction With Paramedian Forehead Flap

Hair growth within the paramedian forehead flap remains a persistent challenge in total nasal reconstruction, often compromising esthetic outcomes and patient satisfaction. Conventional hair removal methods, such as electrolysis and laser therapy, are limited by inconsistent efficacy, procedural discomfort, and reduced effectiveness in certain skin and hair types. In this case report, the authors describe the use of preoperative follicular unit extraction (FUE) as a precise and minimally invasive approach for hair removal before flap transfer. A 24-year-old woman with a congenital melanocytic nevus involving the forehead, cheek, and nose underwent 2 sessions of FUE before nasal reconstruction using an expanded paramedian forehead flap. The procedure achieved complete hair clearance with minimal scarring and no regrowth at 1-year follow-up. This approach demonstrates the potential of FUE to enhance surgical planning, improve esthetic outcomes, and streamline postoperative care in nasal reconstruction.