Topic: Hair transplantation into the cleft lip scar - revisional surgery in male patients Introduction: An upper lip scar often produces psychological discomfort in male cleft patients. They like to wear a mustache to improve profile and appearance and cover up the defect. For the first time Dieffenbach ( Würzburg/Germany) transplanted hair to himself in 1822. Crusius (Berlin/Germany) was the first to use single follicular units for grafting hair as an eyelash replacement in 1914. Today hair transplantation is a routine procedure in aesthetic surgery. Aims: To analyse the long-term outcome of hair replacement using double or single follicular unit hair grafting as the last step in touch-up surgery of cleft lips. Material and Methods: We performed hair transplantation to the upper lip in 10 male patients, 8 of these had an unilateral and 2 a bilateral cleft lip. Each one of these had a mustache with a visible scar.A thin strip of donor hair was taken from the back of the patients scalp and transferred to the lip. This was performed as an out-patient procedure under local anaesthesia. 20 to 70 single and double follicular hair units per patient were used depending on the size of the scar. The recipient area was prepared with a skin punch (diameter: 0.9 mm) and a drill. Results: 9 patients showed successful growth of hair after 6 months with a 'take' of 50 to 80 % . In one case there was only 20% growth. In 5 cases with a unilateral cleft one session was sufficient to achieve the desired result. In 3 unilateral and 2 bilateral cleft patients a second session was necessary to improve the hair density. In 3 scars donor hair shape and colour was obviously different; in 6 of 10 cases the direction of hair growth was different when compared to the mustache. Despite of all this, 8 patients were extremely satisfied. Conclusion: Hair replacement using donor hair from the back of the scalp is a new and successful touch up in cleft lip repair. It is a reliable treatment option to cover completely the upper lip scar. Keywords: Haartransplantation, Oberlippennarbe, Lippen-Kiefer-Gaumen-Spalte, hair transplantation, cleft, cleft lip scar