Aesthetic Plastic Surgery

, Volume 35, Issue 1, pp 19–23

Oxidative Stress in Follicular Units During Hair Transplantation Surgery

  • Márcio Rocha Crisóstomo
  • Sérgio Botelho Guimarães
  • Paulo Roberto Leitão de Vasconcelos
  • Marília Gabriela Rocha Crisóstomo
  • André Nunes Benevides
Original Article

DOI: 10.1007/s00266-010-9549-z

Cite this article as:
Crisóstomo, M.R., Guimarães, S.B., de Vasconcelos, P.R.L. et al. Aesth Plast Surg (2011) 35: 19. doi:10.1007/s00266-010-9549-z



Hair transplantation surgery currently is a well-established procedure in plastic surgery. It consists of harvesting a strip of scalp from the back of the head, then obtaining grafts called follicular units (FUs) from this strip and implanting them in the bald area. The FUs undergo oxidative stress during cold ischemia and after their implantation.


Surgery was performed for 18 patients between April and July 2008. Follicular units were preserved in solutions containing different growth-stimulating hormone (GSH) concentrations (5, 10, and 20 mmol). Saline solution was used as a control condition. Spectrophotometry was used to measure the thiobarbituric acid-reactive substance (TBARS) and GSH concentrations before ischemia (control group) in the FUs preserved in the four proposed solutions, then after 30 min of cold ischemia and 30 min after grafting. The data obtained were submitted to analysis of variance, t test, and linear regression analysis.


The TBARS (μmol of malondialdehyde [MDA]/g) and GSH (μmol/g) concentrations were not significantly different between the four solutions in either the ischemia or grafting group. The GSH concentration did not differ significantly between the control (59.801 ± 30.639 μmol/g) and ischemia (56.284 ± 28.404 μmol/g) groups. The GSH concentrations were significantly greater (p < 0.05) in the postgrafting group (63.815 ± 28.404 μmol/g) than in the group subjected to ischemia.


Increasing the GSH concentrations used in FU preservation solutions does not reduce the oxidative effects of cold ischemia and reperfusion injury during hair transplantation surgery.


Cold ischemia injury Follicular units Hair transplantation surgery Oxidative stress Reperfusion injury 

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010

Authors and Affiliations

  • Márcio Rocha Crisóstomo
    • 1
  • Sérgio Botelho Guimarães
    • 2
  • Paulo Roberto Leitão de Vasconcelos
    • 2
  • Marília Gabriela Rocha Crisóstomo
    • 3
  • André Nunes Benevides
    • 4
  1. 1.FortalezaBrazil
  2. 2.Surgery DepartmentUniversidade Federal do Ceará (UFC)FortalezaBrazil
  3. 3.Dona Libânia Dermatology CenterFortalezaBrazil
  4. 4.Universidade Federal do Ceará (UFC)FortalezaBrazil

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