(0528) Post-Procedural Complications in Hair Transplantation for Non-Scarring and Non-Inflammatory Pathologies: A Systematic Review

Introduction: Hair transplantation has become increasingly popular as a cosmetic procedure. However, the incidence and characteristics of complications after these procedures is uncertain. We present a systematic review of post-procedural complications in hair transplantation with follicular unit transplantation (FUT) or follicular unit extraction (FUE) for non-scarring and non-inflammatory pathologies of alopecia of the scalp.

Methods: Systematic review conducted in January 2024, using the PubMed, Scopus, and EMBASE databases. Search terms “Hair Transplantation,” “Follicular Unit Transplantation,” “Follicular Unit Extraction,” and “Complications” were used. Articles were included for full-text review if there was documentation of post-procedural complications in FUE or FUT for non-scarring/inflammatory pathologies of the scalp. Case reports and case series were noted.

Results: After applying the search criteria, 551 abstracts were included for screening, and 46 studies were included for full-text evaluation. The final analysis included 25 articles totaling 5,778 patients, with 3,098 receiving FUE and 2,678 receiving FUT. Of non-case reports, four studies (n = 1,739) reported total complication rates, ranging from 4.9%-11.1%. Common complications reported included postoperative pain, periorbital edema, and folliculitis. Folliculitis rates ranged from 1.1%-53% of patient cohorts (9 Studies, n = 3,342). In aggregate, total complications did not differ between FUT (n = 1,030) and FUE (n = 709) (10.6% vs 10.5%, p > 0.9). A comparative study suggested that FUT had greater postoperative pain than FUE.

Conclusions: This represents the first systematic review of complications after hair transplantation. Rates are variable but around 10% of cases. Studies often only report a single technique (FUE vs FUT), precluding meta-analytic methods. Prospectively designed studies are required to further understand complications in hair transplantation and help inform patient counseling.