Surgical Pearls and Pitfalls

Abstract

Alopecia is a common condition with varying levels of severity that affects both men and women. Hair loss can have a negative psychosocial effect with detriments to self-esteem, social success, and perceived attractiveness. Recent evidence has proven a significant reduction in the quality of life (QOL) in patients with this condition. Health-state utility studies have demonstrated the value of treating alopecia and reveal the motivations for patients seeking treatment [1]. Surgical hair restoration is now among the most highly sought cosmetic procedures. According to the International Society for Hair Restoration Surgery (ISHRS), the number of surgical hair restoration patients increased by 109% from 2012 to 2016 and by 67% from 2014 to 2016 alone [3]. Hair restoration aims to stimulate regrowth of lost hair and unlike many medical therapies, is not limited to prevention of hair loss [2]. Tremendous advancements in hair restoration techniques have led to greatly improved outcomes since restoration was first attempted in the early 1800s [2]. Procedures in the current era include hair transplantation with follicular unit extraction (FUE) or follicular unit transplant (FUT), use of platelet-rich plasma (PRP), tissue expansion, local tissue rearrangement, and hairline lowering surgery.