Understanding Complications after FUT/Strip Hair Transplant and How to Prevent Them

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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. Suture extrusion:

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


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.

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