This section describes information about the complications of hair grafts and transplants, plastic surgery, cosmetic surgery and cosmetic plastic surgery as performed by Patrick Hudson MDPA, a board certified plastic surgeon, in Albuquerque, NM, USA..
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HAIR TRANSPLANT
problems and complications of hair graft transplantation related articles
- All operations have some risk. The risks of hair graft transplantation fall into two groups: those that are seen in all operations and those that are unique or special for this operation. In the first group, the main risks are swelling, bruising, bleeding, infection, a scar and numbness or change in feeling. The main problems specifically associated with this operation are: the need for multiple operations, the scars which can stretch, a poor result and numbness.
- Bleeding: it is most common to see bleeding from the donor site, which may ooze for several hours after surgery. Slight oozing may also occur around the graft recipient sites. In most cases careful but firm pressure applied for about 5-10 minutes will usually stop the bleeding. In rare cases firm compression bandages or even surgery may be needed to stop the bleeding.
- Infection: serious infections are rare but local areas of inflammation around a hair, called folliculitis, can occur a few days after surgery. It usually responds well to antibiotics and removal of the hair.
- Scarring: sometimes the scar at the donor site on the back of the head may stretch or become noticable This may be due to a large amount of hair being removed or damage to adjacent hair follicles. True keloid scars are uncommon but hypertrophic scars can occur especially when the donor site is quite low.
- sensory changes: some patients experience numbness while others may have an increased sensitivity to pain. These problems usually resolve but persistent pain may suggest a neuroma has formed and further surgery may be needed.
Arteriovenous fistula: several months after surgery a swelling that pulses may be felt on the back of the head. This can represent an abnormal joining together of veins and arteries in the area. Further surgery may be needed.
- In the grafted area, the donor site, several problems may occur and produce a poor result.
- With older techniques and larger plugs an abnormal "pluggy" appearance can develop. This may resemble doll's hair. At its worst the grafts and scars may make a cobblestone appearance. In large plugs the center of the graft may thin or atrophy and lose hair, this produces a donut like appearance with a central, depressed, hairless area surrounded by hair.
- Sometimes the graft may sink below the surrounding skin and appear depressed.
- When slits are used without removal of bald scalp the addition of grafted hair may create compression and a build up of tissue. Another similar problem is ridging along the front of the hairline.
- A number of problems can arise as a result of poor planning and positioning of the follicles. Many are difficult to completely avoid. Hair can be misdirected and the hairline can be too high or low. It can also be too harsh and defined.
- It is not uncommon for patient to have had hair transplanted into the lateral areas or front when they were younger, and then return with an abnormal appearance as they lose more hair.
- In some patients hair loss seems exaggerated after surgery and especially if the hair goes into a resting phase. Poor hair growth may also occur in the graft .
- An unusual problem is the burying of a part of the bald skin underneath the grafted area. Several months later this may form a cyst (dermoid cyst) which can be seen or felt.
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