Hair Restoration Surgery in Patients with Hypotrichosis of the Pubis: The Reason and Ideas for Design

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Hypotrichosis of the pubis is not an uncommon condition, especially in oriental women. Besides the aesthetic problem, this condition may cause low self-esteem, social embarassment, and psychologic problems to patients. There have been many efforts to correct this condition medically and surgically for decades. Among them hair restoration surgery is thought to be the only definitive therapeutic modality at present.


Our purpose was to show the importance of preoperative evaluation of what type of pubic hair patterns the patients may seek and thereafter to make a design based on the patients’ desire and physiologic feature of pubic hair for the natural-appearing results and satisfaction of the patients.


Ten female patients were enrolled in this study aged between 23 and 48 years with pubic hair maturity index class I–III. For selection of a patients’ favored pubic hair pattern, we provided photograph samples of pubic hair patterns that consisted of four types as previously documented: horizontal, sagittal, acuminate, and disperse. We restored hairless mons using a conventional one- to three-haired mini-micrograft technique.


Five patients belonged to the pubic hair maturity index class I, four to class II, and one to class III. Seven of 10 patients wanted a horizontal (inverted triangular) type, which is most commonly seen in young females, 2 patients wanted acuminate, and 1 wanted sagittal. Eight patients underwent a single-session operation, while two others underwent operations twice. The two patients requiring two operation sessions belonged to a group of class I pubic hair and desired acuminate-type hair. Most patients were satisfied with the results of their operations.


In designing a pubic hair graft, it is important to know the patients’ desire and to make a design based on it for the satisfaction of the patients and for natural-appearing results. Before the procedure, dermatologic surgeons should have to consider a grafted hair line, the distribution, density, and directions of the hair shaft, and the angling of the hair to the skin.

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