Complications after hair transplant

Although hair transplant methods and techniques have made significant progress in recent years, we must not forget that all these methods are still considered a type of surgery and all surgeries have complications and risks. But by hair transplanting in reputable and professional centers, most of these side effects and complication of hair transplant can be prevented.

Before going to complications of hair transplantation, we must examine some basic issues; It means to know what complications are, why these problems occur and how to prevent them.

What are the complications of hair transplant?

Complications are a group of events that cannot be considered a normal or usual event. When a complication occurs, it means that the treatment method used is not a good method or at least not compatible with the person being treated. Here we should mention that some complications of hair transplantation are known as natural complications; Things like swelling and redness at place of planting or harvesting grafts. Natural side effects are part of body's healing process and are not alarming.

The side effects of hair transplant are very important and should not be taken lightly. Because hair transplant is a cosmetic procedure and any complication in cosmetic surgeries can have very destructive effects on the result of procedure. For this reason, surgeons and medical staff should be well acquainted with complications and ways to prevent them.

Why do hair transplant complications occur?

Hair transplantation is a relatively new and rapidly growing cosmetic surgery. As we move forward, hair transplant methods and techniques become less invasive, less complicated, and their results become more natural and beautiful. However, hair transplant, like any other surgery, may have complications. Sometimes this issue confronts surgeon and hair transplant applicant with difficult challenges. In many cases, side effects are well managed and treated; But in some situations, they have unfortunate consequences.

With the increase in popularity among people, we see a significant growth in hair transplant applicants and the number of hair transplant surgeries is increasing day by day. The more important point is that with advancement of implantation techniques, many doctors with different specialties and without passing relevant courses and having sufficient skills, have turned to hair transplantation. The prevalence of hair transplantation and the arrival of doctors with unrelated specialties in this field have caused us to see more complications of hair transplantation.

How can side effects be prevented?

Two very important factors affect the complications of hair transplantation; The first one is hair transplant clinics and the other one is post-operative care. If hair transplant clinic uses up-to-date devices and tools, skilled surgeons and a professional treatment team, the possibility of hair transplant complications will be greatly reduced. Some complications, such as infections, occur due to non-observance of post-operative care instructions. These kinds of complications are either due to the negligence of patient or due to clinic not providing enough information. In following, by examining these complications in more detail, you will better understand the importance of two mentioned factors.

In order to minimize the occurrence of hair transplant complications, the conditions of each patient should be centrally examined and after necessary consultations, they should be operated on individually.

What are the real and dangerous side effects of hair transplant?

In general, the probability of most hair transplant complications is less than 1%. Of course, this number is mentioned according to statistical reviews of valid articles and the incidents that occur in non-valid clinics are also included.

All complications of hair transplantation can be divided into four general categories, which you can see in below table.

Regarding the above table, we should mention 3 points:

1. Do not worry! We did not write this list to scare you. Almost all hair transplant complications are preventable. Of course, if you go to reputable centers and also carefully follow the recommendations after operation.
2. "Complications of FUT method" and "Complications of FUE method" that you can see in table above, are mostly focused on the area of ​​hair transplant grafts. Because the difference between these methods is in the harvesting stage and planting stage is almost same.
3. You may wonder why we have not mentioned complications of SUT, Micro FUE and Super FUE methods. The side effects of these newer methods are almost the same as FUE method. In all three methods, follicles are harvested in a single or granular form, and the difference is in the tools, techniques, and devices used in process of hair transplantation.

General side effects of hair transplant

1. Sensitivity to local anesthesia

The body's reactions to local anesthetics can appear in several ways. Most of the time, allergy symptoms are caused by the patient's fear of receiving medicine and have psychological aspects. True and severe allergies to local anesthetics are extremely rare. To prevent this from happening, it is recommended that anesthetic sensitivity test be done for all applicants.

Head numbness after hair transplant may last until beginning of sixth month. In first months, if you have numbness in implanted area, there is nothing to worry about.

2. Operating room complications

Some side effects are not specific to hair transplant and are common in all surgeries. Sometimes, during injection of anesthetic, the patient experiences an increase in heart rate, which is usually a temporary complication. In this situation, if patient has cardiovascular problems, there is a possibility of more serious risks.

To prevent this complication, we advise all patients (especially patients over 40 years old) to take an electrocardiogram and make sure of health of their circulatory system before proceeding with hair transplantation. Also, during injection of anesthetic in operating room, your blood pressure and heart rate will be carefully monitored so that if there is a problem, doctor will know about it quickly and the necessary treatment will be done.

3. Postoperative complications

• Syncope is one of rare side effects of hair transplantation that is usually observed at end of procedure; Especially if hair transplant session is long. Syncope causes fainting or a temporary loss of consciousness and is usually not dangerous. This complication may be caused by pain, high blood pressure, dehydration, hypoglycemia, and more. Syncope can be easily prevented by adjusting body ions, proper hydration, not changing body position suddenly (such as standing up suddenly) and such care.
• Pain during or after surgery is one of most common side effects of hair transplant. By using correct surgical techniques as well as anesthesia and painkillers, this complication can be easily prevented. Factors that commonly cause pain in hair transplantation include harvesting extensive strip, bleeding, pressure on wound, and insufficient injection of anesthetic.
• The standard method of anesthesia is injection of local anesthetic along with adrenaline, which dilates blood vessels and distributes drug better. Sometimes vibrators and cold compresses are used for better anesthesia. Pain after hair transplant is well managed with help of oral pain relievers.
• Edema (swelling caused by the accumulation of fluid under skin) in recipient area is one of common side effects of hair transplantation, which usually improves spontaneously after a few days. This complication can be treated by taking oral steroid drugs.
• Post-operative itching in recipient area and hair bank is relatively common. This complication is mostly caused by drying and formation of blood clots. Spraying washing serum several times a day can reduce itching. Washing head and antihistamine drugs are also effective in reducing itching. To improve dry skin, topical aloe vera can be used. The most important prescription drug to prevent itching after hair transplant is Cetirizine 10.
• Coughing and hiccups are rare but annoying side effects of hair transplant. Because it can take up to 2-3 days. The cause of these side effects is still unknown, but it seems that they are caused by stimulation of the nerves of scalp. Branches of these nerves join phrenic nerve, which plays main role in causing hiccups and cough.
• Infection can occur in recipient area as well as in donor area. The chance of infection is very low and serious infections are rare (less than 1%). Non-observance of hygiene issues, sitting of scalp and underlying diseases (such as immune system deficiency) are among causes of infection. Symptoms of infection include swelling, redness, pain, and blisters.

To prevent this complication, you should take antibiotic drugs prescribed for you and wash your head according to doctor's instructions. Changing the dressing and not opening it early are important in preventing infections.

Complications of FUT method

1. Necrosis is one of rare side effects of hair transplantation, which is usually caused by surgical error. If the incision made in donor area is sutured in such a way as to put pressure on wound, it can reduce or cut off blood supply to that area. If the blood supply is reduced, the possibility of infection increases. If blood supply is interrupted, the tissues in that area die and skin undergoes necrosis (cell death).
2. Scars (scars, boils or scar tissue) are formed if damage to skin is not repaired well. In severe cases, the scar takes form of a fleshy or keloid scar. Although creating a scar does not threaten the patient's health, it does not look good at all in terms of beauty. In order to prevent this complication from complications of hair transplantation, 2 points should be kept in mind:
3. If a strip incision is made in lower or upper back of head, there will be more possibility of scarring.
4. The probability of scarring is much higher in applicants who have a history of scarring and keloid scars, and it is better for them to use other hair transplant methods such as FUE method.
5. Persistent pain and long-term numbness of donor area are among side effects of FUT hair transplantation. If the incision made on skin to harvest strip is too deep, it may damage the sensory nerves of donor area. Scar tissue can also put pressure on nerve and cause pain. If the surgeon has enough skill and experience, the complications caused by nerve damage will be minimized.
6. Shock hair loss, which is called effluvium in medical science, is one of side effects of hair transplant. This form of hair loss can be seen above and below the cut line. Hair growth almost always resumes 3 to 4 months after shedding. Changes in population of follicles, edema, inflammation, and blood circulation disorders due to sutures are among the causes of this complication. Using topical minoxidil is effective in growing hair faster.
7. Bleeding, opening of sutures and inflammation of follicles are other complications of FUT hair transplant that are rarely seen.

Complications of hair transplantation by FUE method

• Thinning of donor area is one of side effects of FUE hair transplantation, which is usually caused by unbalanced or excessive harvesting of follicles. In this case, parts of donor area are empty and parts are full.
• Point scars are among side effects of FUE hair transplantation that are usually ignored. You should know that there is scarring in FIT method and other similar methods (SUT, MFUE and Super FUE). In process of harvesting grafts, the surgeon makes small holes on your head using a tool called a punch. The scars of these holes, which are less than one millimeter in diameter, may become scars. However, these scars are size of a needle head and if your surgeon is skilled enough, they will not be visible to naked eye. Point scars are only visible when you cut your hair very short, and viewer examines your skin carefully.
• The burial of follicles is more common in FUE method, and this problem has been solved in newer methods. Sometimes the punching tool takes hair follicles deeper into the skin, in which case the follicle is said to be buried. More advanced tools and devices used in SUT, Micro FUE and Super FUE procedures have minimized this complication.
• Subcutaneous cysts are usually caused by buried follicles. If buried follicles are not removed from scalp, there is a high possibility of developing a cyst. Of course, removing buried follicle is not a difficult task. Subcutaneous cysts are usually swollen and painful.
• Over-harvesting can cause permanent damage, thinning of hair donor area. This complication is one of complications of hair transplantation in non-reputable centers. It is recommended to never harvest more than a quarter of follicles in donor area.
• Shock hair loss, which we explained in previous section, is one of other side effects of FUE hair transplantation.

Complications of recipient area

• Folliculitis after hair transplantation: It is a rare complication of hair transplantation in recipient area, which can be caused by lack of personal hygiene or underlying skin diseases. Sometimes it is caused by body's reaction to damaged hair shaft, and the resulting pus is not infected. In case of folliculitis, it is necessary to use antibiotics and local antibacterial drugs to prevent infections.
• Low growth of grafts: This complication can be caused by their damage during stages of harvesting, preparation or planting. For example, one of common errors in FUE method is incomplete follicle harvesting, which is less common in FUT method. Sometimes the improper growth of implanted hair is caused by low quality of hair. People who do not have quality hair are not good candidates for hair transplant. Smoking, diabetes, and sunburn are some of reasons for not growing transplanted hair.
• Improper growth line and unnatural or doll-like results: It is a very rare complication of hair transplantation, which is directly caused by the skill and lack of experience of surgeon. The better growth line is designed, the more natural results of your hair transplant will look.
• Edema or swelling: This case cannot be considered as one of side effects of hair transplant, rather it is more of a natural occurrence and disappears within 3 to 5 days. Swelling starts from forehead and may spread to eyelids and nose. To improve swelling, you can use a cold compress and place your head above body level while sleeping. Remember that the head compress should not be placed directly on recipient areas. Place it on eyelids and forehead.

Other complications of recipient area include blistering, bleeding, and shock hair loss, which are less common.