complication and treatment in hair transplant

ABSTRACT:

Surgical complications in hair transplant procedures can pose significant challenges. Following a one-year post-operation follow-up, various complications were identified, including post-operation edema, pruritus, numbness, paraesthesia, bleeding, a wide donor scar, and sterile folliculitis. Successful hair transplant outcomes with minimal complications rely on effective communication between the patient and surgeon, thorough clinical and lab assessments, and the implementation of precise surgical techniques by a trained surgical team.

Definition:

A complication is defined as an adverse event that is uncommon and necessitates a change in methodology. These complications can arise from errors in the surgeon’s planning and technique or due to the patient’s physiology or compliance.

Surgical Technique:

The procedure involves a ring block in the donor area under aseptic conditions in a patient with a stable medical condition.

FUT (Follicular Unit Transplant):

A strip of skin with hair is cut from the donor area, and the hair is then divided into grafts. The gap in the donor area is stitched using Trichophytic closures. The graft is then implanted in the recipient area with the help of a needle and forceps.

FUE (Follicular Unit Extraction):

Extraction is performed from the safe donor area using motorized blunt punches or sharp Titanium manual punches. The graft is extracted and implanted in the recipient area with the help of needles, forceps, or an implanter.

Complications and Discussion:

1. Post Operation Edema (most common complication):
   • Swelling occurring around the eyes and face can be reduced with steroid use in tapering doses and limited use of tumescent anesthesia.
2. Bleeding (second most common complication):
   • To minimize the risk of bleeding, patients are advised to stop certain medications and supplements before the procedure.
3. Pruritus (third most common complication):
   • Antihistamines are recommended to control itching that may persist up to 12 weeks post-operation.
4. Numbness and Paraesthesia:
   • Neuralgia and hypoaesthesia may occur due to nerve damage, more commonly in FUT.
5. Wide Donor Scar:
   • The use of the Mayers Paul scalp elasticity scale helps estimate the safe closure of the donor area to avoid hypertrophic scars.
6. Sterile Folliculitis:
   • Infections can be prevented with proper asepsis, sterilized materials, and post-operation care.
7. Poor Hair Growth:
   • Factors like rough handling, prolonged out-of-body time, and infection can affect hair growth.
8. Cosmetically Unacceptable Result:
   • Circumventing cosmetically unacceptable results involves careful graft placement, especially in crown areas.

Conclusion:

Achieving successful hair transplantation with minimal complications hinges on effective communication, meticulous clinical and lab evaluations, precise surgical techniques, and a trained surgical team. Rigorous post-operation evaluation and patient compliance further contribute to positive outcomes.

References

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   • Konior’s research sheds light on complications in hair restoration surgery, providing valuable insights for practitioners. (PubMed ID: [insert PubMed ID])
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   • David’s comprehensive work outlines complications in hair restoration surgery, offering a thorough understanding of potential challenges. (PubMed ID: [insert PubMed ID])
3. Musgrave R Gradinger G – Symposium on Problems and Complications in Aesthetic Plastic Surgery of the Face. St. Louis: Mosby; 1984. pp. 3-5
   • Musgrave and Gradinger’s symposium addresses complications in aesthetic plastic surgery, providing a historical perspective on challenges faced in facial procedures.
4. Lam SM – Facial Plast Surg Clin North Am. 2013;21:675-80. [PubMed]
   • Lam’s contribution to facial plastic surgery literature delves into complications in hair restoration surgery, offering updated insights for practitioners. (PubMed ID: [insert PubMed ID])
5. Coleman WP. 3rd, Kllein JA – J Dermatol Surg Oncol. 1992;18:130-5. [PubMed]
   • Coleman and Kllein explore the utilization of the tumescent technique in scalp surgery, dermabrasion, and soft tissue reconstruction, with potential implications for minimizing complications. (PubMed ID: [insert PubMed ID])
6. Unger WP, 3rd ed. – New York: M Dekkaer; 1997
   • Unger’s comprehensive third edition provides a detailed examination of complications in hair restoration surgery, serving as a valuable resource for practitioners and researchers.