FUE (Follicular Unit Extraction) hair transplant surgery is a minimally invasive technique that has become increasingly popular due to its minimal scarring and rapid recovery time. However, despite its benefits, several complications can arise from the procedure. In this article, we will discuss the most common complications associated with FUE hair transplant surgery.

Donor-Site Depletion: Donor-site depletion is a common complication of FUE hair transplant surgery. The risk of depletion of hair from the donor region due to aggressive and nonuniform harvesting is observed, resulting in a moth-eaten or pseudo-syphilitic appearance. This complication can occur irrespective of whether scoring was performed by manual, motorized, or robotic punches.

Pinpoint Scarring: Pinpoint scarring is another common complication associated with FUE hair transplant surgery. It is a misconception that FUE is a scarproof technique. The punch used to harvest each follicular grouping may create pinpoint white atrophic macules, which can be visible on close inspection with short hair. Patients with skin color types 4–6, common in India, are more prone to hypopigmentation, which can be very apparent on shaving, negating the perceived benefit of minimal scarring by FUE.

Postoperative Effluvium: Postoperative donor hair effluvium is a possibility that can occur after FUE hair transplant surgery. The condition may appear after a few days to a few weeks of surgery and show diffuse hair loss. It is mostly temporary and resolves within 3–4 months in most cases. The most common cause can be overharvesting and/or hampered blood supply.

Buried Grafts: Buried grafts are a common complication that occurs when blunt punches are used during the FUE procedure. If the punching is performed in a hurry or proper alignment of punch along with hair follicles is not carried out, then the graft is pushed into the dermis leading to a buried graft.

Overharvesting: Overharvesting is another complication that may occur during FUE hair transplant surgery. It can lead to permanent damage to the donor area, thinning, and patchy hair loss. Before starting the extraction process, a safe donor area should be demarcated, and overharvesting should be avoided. It is preferable not to exceed the extraction of more than 1:4 follicular units.

Necrosis: Cutaneous necrosis after FUE is uncommon but has been reported in the literature. It can lead to cicatricial alopecia, which is a permanent form of hair loss.

Subdermal Cysts: Subdermal cysts present as multiple, slow-growing nodular, painless swellings in the scalp donor area. Lack of due diligence while performing FUE can lead to subluxation of the grafts into the subdermal layer of the scalp.

Keloid: Keloid or hypertrophic scar formation at the donor site following FUE is a rare complication. It is important to note that a thorough search of the literature found only two case reports of this complication.

In conclusion, FUE hair transplant surgery is a minimally invasive technique with several benefits. However, it is essential to be aware of the possible complications associated with the procedure. Patients should discuss these risks with their surgeons before undergoing the procedure to make an informed decision. With proper planning and execution, most complications can be avoided, and patients can achieve satisfactory results.

Follicular Unit Transplantation (FUT), also known as strip hair transplant, is a popular hair restoration technique that involves removing a strip of skin with hair follicles from the donor area and transplanting them to the balding area. While this method has helped many people regain their hair and confidence, it's essential to be aware of potential complications and how to prevent them.

1. Donor-site wound dehiscence:

Wound dehiscence, a rare complication, occurs when the surgical incision reopens after surgery. Factors like diabetes, high-tension closure, suture line infection, premature suture removal, and excessive early physical activity increase the risk of donor-site dehiscence. Preventive measures include layered wound closure, post-operative local wound care, delaying suture removal, and patient counseling on avoiding rigorous physical activity.

2. Necrosis and wound dehiscence:

Necrosis of the wound margin is caused by ischemia and can lead to permanent hair follicle damage. Technical errors during closure that create excessive tension along the incision line can cause localized microcirculatory collapse, resulting in necrosis. To prevent this, avoid excessive tension during closure, especially near the mastoid process area and during wide strip procedures for mega sessions. Preoperative daily scalp massage can improve scalp laxity, and using a multilayered closure technique is advised.

3. Donor hair effluvium (shock loss):

Temporary hair loss, or donor shock loss, can occur above and below the incision line due to factors like surgical consequences, edema, inflammation, and suture line vascular compromise. Local wound care with daily cleaning, topical antibiotics, and measures to control post-operative inflammation are recommended. Topical minoxidil can also help with faster recovery.

4. Scarring:

Various types of scarring can occur after strip excision, such as wide scar, crosshatch scar, visible scar, and keloid and hypertrophic scar. To prevent these, ensure proper surgical techniques and patient compliance. Neck flexion restrictions should be followed to avoid wide scars. Avoid tight closure that results in pronounced edema, causing crosshatch scars. Place strip excisions carefully to prevent visible scarring, and be cautious with patients prone to keloid or hypertrophic scarring.

5. Persistent pain: Neuralgias, neuromas, and hypesthesia:

Careless deep incisions can cause nerve damage, leading to persistent pain or hypersensitivity. To prevent this, avoid transecting major nerves during surgery. Regional infiltrations of local anesthetics and corticosteroids can be used to treat neuropathic pain or hypersensitivity caused by injured nerves.

6. Hematoma:

Rarely, donor-site hematomas can occur due to deep incisions and major artery transection. Prevent this by limiting donor-site incision depth and carefully exploring the wound bed for vascular damage. Address any active hematomas promptly to avoid donor-site necrosis and permanent hair loss.

7. Suture extrusion:

Though very rare, suture extrusion can occur post-surgery. Ensuring proper surgical techniques and wound care can minimize this risk.

Conclusion:

FUT/Strip hair transplant is an effective hair restoration method, but it's crucial to be aware of potential complications and take preventive measures. By understanding these risks and following the best practices during surgery and post-operative care, patients and surgeons can minimize complications and achieve better hair restoration results.

Hair transplant surgery has come a long way in the past few decades, with innovative techniques and technologies making it a popular choice for those looking to combat hair loss. But despite these advancements, not all hair transplant doctors are created equal. In this article, we'll discuss why it's essential to have your hair transplant performed by an ABHRS-certified doctor, highlighting the top-notch doctors in this field who are considered elite hair transplant surgeons. With only 250 doctors certified worldwide, you can be assured that your hair transplant is in the best possible hands.

Why ABHRS Certification Matters

The American Board of Hair Restoration Surgery (ABHRS) is a prestigious organization that provides certification to only the most skilled and experienced hair transplant doctors. These top-notch doctors have proven their expertise through rigorous examination and practical experience, ensuring they are fully equipped to handle even the most complex hair transplant cases. Here's why choosing an ABHRS-certified doctor is crucial for your hair transplant success:

1. Expertise and Skill

ABHRS-certified doctors have undergone a strict selection process to achieve their certification, which involves demonstrating their expertise in the field of hair restoration. This means that these elite hair transplant doctors have a thorough understanding of the latest hair transplant techniques and technologies, ensuring that they can deliver the best possible results for their patients.

2. High Standards of Care

One of the core principles of the ABHRS is to maintain high standards of care in the field of hair restoration surgery. This means that certified doctors are committed to providing their patients with the best possible care, from the initial consultation right through to post-operative support. When you choose an ABHRS-certified doctor, you can be confident that you'll receive top-notch treatment throughout your hair transplant journey.

3. Exclusive Network

With only 250 doctors certified worldwide, the ABHRS is an exclusive network of elite hair transplant doctors. This means that when you choose an ABHRS-certified doctor, you're not just selecting a skilled professional, but also someone who is part of a global community of experts. This network ensures that certified doctors are up to date with the latest developments in the field, allowing them to provide their patients with the most advanced treatment options available.

4. Trust and Confidence

Choosing an ABHRS-certified doctor for your hair transplant surgery gives you the peace of mind that you're entrusting your procedure to a highly qualified and experienced professional. By selecting one of these top-notch doctors, you can be confident that they have the expertise and skill necessary to deliver the best possible results for your hair transplant.

Selecting an ABHRS-certified doctor for your hair transplant surgery is a crucial decision that can have a significant impact on the success of your procedure. By choosing one of these elite hair transplant doctors, you can be assured that you're receiving the highest standard of care, giving you the best chance of achieving your desired hair restoration results. With only 250 doctors certified worldwide, the ABHRS represents the top-notch professionals in the field, making it the gold standard for hair transplant surgery.

Many patients who’ve had a hair transplant can become very concerned about the newly-transplanted hair. In the months following the procedure, you might start comparing your own hair growth to other people’s pictures posted online, and realize that you are falling behind.
Are these emotions unfounded? Very often they actually are.

When a harvested graft is transplanted into the recipient area, a process begins which takes several months, and it may not be what you’d expect. In the first 3 days post-transplant, the grafts begin working to regain their blood supply1,2. Because of this, the hair shaft is shed, starting from week 1 up until week 6 after the hair transplant surgery has been performed. What comes next is often called the “Ugly Duckling Phase”. Patients will often shed their hair in the weeks following surgery. Earliest hair growth starts generally from month 3.
Before we continue it is important to realize that every patients transplanted hair grows at a different rate. Some might be quicker than others. Every patient is unique and the final result should not be evaluated until 12 months in. Yet, we can give a rough estimation of how long it takes for the hair to start growing back, following a hair transplant.

Hair Regrowth After a Hair Transplant

First of all we need to differentiate between two important phases: The penetration of the new hair graft into the skin’s surface, versus the “maturation” of the new hair shaft. When a hair shaft has just has penetrated the skin it will still undergo many changes in overall appearance that will contribute to the end result. For a period of time it will remain very fine, weak and very light in color. This will gradually improve as time passes, until it is indistinguishable from your original hair."