**1. Introduction**

Hair bearing regions of the face have been the hallmarks of Manhood through the ages and the defects of these regions are psychologically traumatizing and sometimes demeaning for the male patients in several cultures. The reconstruction of these areas is very difficult due to scarcity of donor areas and the available donors such as scalp have anatomically different hair morphology and the hair follicles' proximity is quite different from the face, on the other hand the facial skin thickness and texture is another matter of concern making a "look alike" reconstruction almost impossible. In this chapter we will try to address this difficult recon‐ struction challenge.

#### **1.1. Terminology**

In humans, usually only pubescent or adult males are able to grow beards. [1, 2]

**The Beard or Barba** is defined as:


#### **Moustache or Mustache** refers to:


## **1.2. Historical background [3]**

Throughout the course of history, societal attitudes towards male beards have varied depend‐ ing on factors such as prevailing cultural-religious traditions and the fashion trends. Some religions (such as Islam and Sikhism and Judaism) have always considered a full beard to be absolutely essential for all males able to grow one. [4]

## *1.2.1. Ancient Egypt [3]*

The highest ranking Ancient Egyptians grew hair on their chins which was often dyed or hennaed (reddish brown) and sometimes plaited with interwoven gold thread. A metal false beard, or postiche, which was a sign of sovereignty, was worn by queens and kings. This was held in place by a ribbon tied over the head and attached to a gold chin strap, a fashion existing from about 3000 to 1580 BC. [5] Mesopotamian civilizations (Sumerian, Assyrians, Babyloni‐ ans, Chaldeans and Medians) devoted great care to oiling and dressing their beards, using tongs and curling irons to create elaborate ringlets and tiered patterns.

#### *1.2.2. Ancient Iran [3]*

The Iranians (Persians) were fond of long beards (Figure 1), and almost all the Iranian kings had a beard. In Travels by Adam Olearius, a King of Iran commands his steward's head to be cut off, and on its being brought to him, remarks, "what a pity it was, that a man possessing such fine mustachios, should have been executed." Men in the Achaemenid era wore long beards, with warriors adorning theirs with jewelry. Men also commonly wore beards during the Safavid and Qajar eras. [6]

**Figure 1.** A 19th century painting of an Old Persian man after lunch, note the full beard.

#### *1.2.3. Ancient Macedonia [3]*

**1.2. Historical background [3]**

*1.2.1. Ancient Egypt [3]*

*1.2.2. Ancient Iran [3]*

the Safavid and Qajar eras. [6]

absolutely essential for all males able to grow one. [4]

586 A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

tongs and curling irons to create elaborate ringlets and tiered patterns.

**Figure 1.** A 19th century painting of an Old Persian man after lunch, note the full beard.

Throughout the course of history, societal attitudes towards male beards have varied depend‐ ing on factors such as prevailing cultural-religious traditions and the fashion trends. Some religions (such as Islam and Sikhism and Judaism) have always considered a full beard to be

The highest ranking Ancient Egyptians grew hair on their chins which was often dyed or hennaed (reddish brown) and sometimes plaited with interwoven gold thread. A metal false beard, or postiche, which was a sign of sovereignty, was worn by queens and kings. This was held in place by a ribbon tied over the head and attached to a gold chin strap, a fashion existing from about 3000 to 1580 BC. [5] Mesopotamian civilizations (Sumerian, Assyrians, Babyloni‐ ans, Chaldeans and Medians) devoted great care to oiling and dressing their beards, using

The Iranians (Persians) were fond of long beards (Figure 1), and almost all the Iranian kings had a beard. In Travels by Adam Olearius, a King of Iran commands his steward's head to be cut off, and on its being brought to him, remarks, "what a pity it was, that a man possessing such fine mustachios, should have been executed." Men in the Achaemenid era wore long beards, with warriors adorning theirs with jewelry. Men also commonly wore beards during At the time of Alexander the Great the custom of smooth shaving was introduced. [7, 8] Reportedly, Alexander ordered his soldiers to be clean-shaven, fearing that their beards would serve as handles for their enemies to grab and to hold the soldier as he was killed. The practice of shaving spread from the Macedonians, whose kings are represented on coins, etc. with smooth faces, throughout the whole known world of the Macedonian Empire (Figure 2).

**Figure 2.** A coin depicting a cleanly shaven Alexander the Great.

Laws were passed against it, without effect, at Rhodes and Byzantium; and even Aristotle conformed to the new custom, unlike the other philosophers, who retained the beard as a badge of their profession. A man with a beard after the Macedonian period implied a philosopher, and there are many allusions to this custom of the later philosophers in such proverbs as: "The beard does not make the sage." [9]

#### *1.2.4. Ancient Rome 3*

Shaving seems to have not been known to the Romans during their early history (under the Kings of Rome and the early Republic). Pliny tells us that Ticinius was the first who brought a barber to Rome, which was in the 454th year from the founding of the city (that is, around 299 BC). Scipio Africanus was apparently the first among the Romans who shaved his beard. However, after that point, shaving seems to have caught on very quickly, and soon almost all Roman men were clean-shaven; being clean-shaven became a sign of being Roman and not Greek. Only in the later times of the Republic did the Roman youth begin shaving their beards only partially, trimming it into an ornamental form; prepubescent boys oiled their chins in hopes of forcing premature growth of a beard. [10]

### *1.2.5. The middle ages [3]*

In the middle ages, the beard had still an important role, figure 3 depicts the picture of El Cid or " The Mister" in Arabic. (Figure 3). [11]

While most noblemen and knights were bearded, the Catholic clergy were generally required to be clean-shaven. This was understood as a symbol of their celibacy. By the early 20th century beards began a slow decline in popularity. Although retained by some prominent figures who were young men in the Victorian period (like Sigmund Freud), most men who retained facial hair during the 1920s and 1930s limited themselves to a moustache or a goatee (such as with Marcel Proust, Albert Einstein, Vladimir Lenin, Leon Trotsky, Adolf Hitler, and Joseph Stalin). In America, meanwhile, popular movies portrayed heroes with clean-shaven faces and "crew cuts". Concurrently, the psychological mass marketing of companies like Gillette popularize short hair and clean shaven faces as the only acceptable style for decades to come. Those who grow beards are frequently either old, Central Europeans, members of a religious sect that require it or those who are in academia.

#### **1.3. Modern prohibition of beards [3]**

Professional airline pilots are required to be clean shaven to facilitate a tight seal with auxiliary oxygen masks. Similarly, firefighters may also be prohibited from full beards to obtain a proper seal with equipment. This restriction is also fairly common in the oil and gas industry for the same reason in locations where hydrogen sulfide gas is a common danger. Other jobs may prohibit beards as necessary to wear masks or respirators. [12] Isezaki city in Gunma, Japan,

**Figure 4.** An Asian scalp hair, note the roundness of the hair, reprinted by permission of The Society of Cosmetic Chemists

decided to ban beards for male municipal employees on May 19, 2010. [13] Brigham Young University generally requires its students and employees to be clean-shaven. However, Brigham Young himself was often seen with a beard. [14]
