Possible Hair Transplant Complications

If properly performed, hair transplant surgery is uniformly successful and very safe; however, surgery is not an exact science. Problems and unexpected occurrences can occasionally happen under ideal circumstances and in the most experienced hands. Most are not serious and most will not affect the final result, but it is better to be aware of the potential risks and complications before embarking on any surgery.

1. Poor growth. If poor growth occurs, usually there is no obvious reason. Since switching to 100% follicular units with microscopic dissection, this problem has largely been eradicated.
2. Slow growth. Rather than the transplanted hair growing at three to five months, occasionally it may take up to a year.
3. Infections. As with any surgery, infections are possible, but due to the blood flow to the scalp, infections with a hair transplant are rare.
4. Scarring. Scar formation is inevitable but should be minimal and hidden by the hair. In the donor area, expect a white linear scar along the excision line. The degree of scarring here depends on locating the excision in the appropriate area and closing the wound by precisely bringing the two edges of the wound together with minimal tension. Most patients heal in this area with very narrow scar formation. Even with thicker/wider scars, they should not be apparent as long as the patient leaves enough length to his hair in the back of his scalp to cover the scar. If patients cut their hair short enough to see through to the scalp, the scar may show. Scars are also possible in the recipient area, but since the advent of follicular units, they are extremely rare. Old-fashioned plugs and with minigrafts leave scar formation around each graft in the form of “bumps” (“cobblestoning”) or "dents” (“dimpling”). The shadowing from this 3-dimensional effect can be unattractive. Since follicular units are implanted in small needle holes, this problem has become very rare.
5. Pigmentary changes. Pigmentary changes in the skin are possible anytime the skin surface is disrupted, but it is much more common in people with more color to their skin. This tends to be darkening of the skin in the area of the transplant. Like many complications, this has become rare with follicular units. To help minimize the chances of hyperpigmentation, it is best to keep your scalp out of the sun for the first month.
6. Cysts and pimples. These can occur fairly frequently within the recipient area, especially in patients with more oily complexions. If they occur, typically they begin the first month after surgery. The patient may experience just a few isolated breakouts or, in some instances, frequent breakouts over a three to four month course. It eventually clears and does not interfere with the ultimate hair growth. If the patient is bothered by these, antibiotics may be prescribed just as in teenage acne.
7. Ingrown hair. Occasionally, an ingrown hair will form a cyst. The hair may be easily picked out with a sterile needle and gentle pressure.
8. Swelling. Just like with any surgery, swelling is possible, but rather than affecting the scalp, it tends to affect the softer tissues of the face like the lower forehead, brow, and especially the eyelids 24-48 hours after the procedure. This is not dangerous, just mildly embarrassing. Certain patients will be more prone to it, especially those in whom significant work is done in the hairline.
9. Hair Loss. After a transplant, it is possible for the preexisting hair in the recipient area to go into a resting phase and then fall out due to the shock of the surgery. If this occurs, it is usually in the first few months. If the preexisting hair that fell out was healthy, it will regrow four to eight months after surgery.
10. Numbness. When the donor strip is excised from the back of the scalp, the small sensory nerves that supply the sensation to the top and back of the scalp may be transected as they pass superficially in the skin. If so, the patient will note a numb feeling in this area of the scalp. Usually after six months, that sensation begins to return.
11. Disappointment. The last complication is patient dissatisfaction due to misunderstandings on the finished result of a hair transplant.  Here, selecting the right provider and seeking an honest appraisal of the results are vital.
    
    
    

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