Case Reports
26 May 2025
Early Access
https://doi.org/10.4081/dr.2025.10426

Successful hair transplantation following repeated lipostructure in a case of morphea en coup de sabre: a multidisciplinary and regenerative approach

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Morphea en coup de sabre, hair transplantation, scarring alopecia, lipostructure, follicular unit extraction
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Piero Tesauro
https://orcid.org/0009-0000-2468-9226
Poliambulatorio Gioia, Milan, Italy.
Paolo Tesauro
Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Italy.
Ilaria Cremonesi
Poliambulatorio Gioia, Milan, Italy.
Guido Cornegliani
Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Italy.
Nicolò Rivetti
rivetti.nicolo@gmail.com
https://orcid.org/0000-0001-7623-7184
Dermatology Outpatient Clinic, Istituto Clinico Beato Matteo, Gruppo San Donato, Vigevano, Pavia, Italy.
Simona Muratori
Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.

We describe the successful combination of repeated autologous lipostructure and hair transplantation in a case of morphea en coup de sabre, highlighting the regenerative benefits of a multidisciplinary approach. A 40-year-old woman with long-standing, stable frontoparietal and frontotemporal atrophy and alopecia underwent four fat grafting sessions using the Coleman technique over five years. Nine months after the final procedure, she received follicular unit extraction (FUE) hair transplantation with 1,600 grafts. The postoperative course was uneventful, with rapid and stable regrowth observed from the third month. At 12 months, the aesthetic outcome was excellent, with nearly complete graft survival and high patient satisfaction. This is the first reported case of FUE transplantation following multiple lipostructure sessions in morphea en coup de sabre. Fat grafting may enhance graft take by improving dermal quality and vascularization. This combined approach offers a promising solution for scarring alopecia in selected, stable patients.

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1. Kreuter A, Moinzadeh P, Kinberger M, et al. S2k guideline: Diagnosis and therapy of localized scleroderma. J Dtsch Dermatol Ges 2024;22:605-20. DOI: https://doi.org/10.1111/ddg.15328
2. Weibel L, Sampaio MC, Visentin MT, et al. Evaluation of methotrexate and corticosteroids for the treatment of localized scleroderma (morphoea) in children. Br J Dermatol 2006;155:1013-20. DOI: https://doi.org/10.1111/j.1365-2133.2006.07497.x
3. Zulian F, Martini G, Vallongo C, et al. Methotrexate treatment in juvenile localized scleroderma: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2011;63:1998-2006. DOI: https://doi.org/10.1002/art.30264
4. Ayoub R, Saba SC. Treatment of linear scleroderma "En coup de Sabre" with single-stage autologous fat grafting: a case report and review of the literature. J Cosmet Dermatol 2021;20:285-9. DOI: https://doi.org/10.1111/jocd.13490
5. El Omari M, Debbarh M, Lakhdari MA, et al. Adipose tissue grafting for the treatment of morphea en coup de sabre: a simple filler or an emerging cellular therapy? Cureus 2022;14:e30358. DOI: https://doi.org/10.7759/cureus.30358
6. Pierre-Louis M, Sperling LC, Wilke MS, Hordinsky MK. Distinctive histopathologic findings in linear morphea (en coup de sabre) alopecia. J Cutan Pathol 2013;40:580-4. DOI: https://doi.org/10.1111/cup.12124
7. Klinger M, Marazzi M, Vigo D, Torre M. Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reduction. Aesthetic Plast Surg 2008;32:465-9. DOI: https://doi.org/10.1007/s00266-008-9122-1
8. Tremolada C, Colombo V, Ventura C. Adipose tissue and mesenchymal stem cells: state of the art and Lipogems® technology development. Curr Stem Cell Rep 2016;2:304-12. DOI: https://doi.org/10.1007/s40778-016-0053-5
9. Debuc B, Gendron N, Cras A, et al. Improving autologous fat grafting in regenerative surgery through stem cell-assisted lipotransfer. Stem Cell Rev Rep 2023;19:1726-54. DOI: https://doi.org/10.1007/s12015-023-10568-4
10. Coleman SR. Structural fat grafting. Aesthet Surg J 1998;18:386-8. DOI: https://doi.org/10.1016/S1090-820X(98)70098-6
11. Park SW, Wang HY. Survival of grafts in coup de sabre. Dermatol Surg 2002;28:763-6. DOI: https://doi.org/10.1046/j.1524-4725.2002.02021.x
12. Dai Y, Xu AE, He J. A case report of coup de sabre patient with hair transplantation. J Dermatolog Treat 2017;28:546-8. DOI: https://doi.org/10.1080/09546634.2017.1282103
13. Ekelem C, Pham C, Atanaskova Mesinkovska N. A systematic review of the outcome of hair transplantation in primary scarring alopecia. Skin Appendage Disord 2019;5:65-71. DOI: https://doi.org/10.1159/000492539
Paolo Tesauro, Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria of Bologna

Department of Anesthesia, Surgery and Interventional Medicine, Gustave Roussy Institute, Villejuif, France.

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Successful hair transplantation following repeated lipostructure in a case of morphea en coup de sabre: a multidisciplinary and regenerative approach. (2025). Dermatology Reports. https://doi.org/10.4081/dr.2025.10426
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