Contemporary Management of Alopecia: A Systematic Review and Meta-analysis for Surgeons
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The decision of surgical approach for hair restoration often involves evaluation of the type of alopecia; however, the impact of surgical hair restoration from existing techniques in specific population subsets has not been comprehensively investigated.
The authors sought to systematically review the literature on micrografts, minigrafts, mini-micrografts, tissue grafts, tissue flaps and expanders, as well as evaluate graft survival and satisfaction within specific populations in a meta-analysis.
PubMed and Scopus literature searches between 1980 and 2018 yielded 57 articles for systematic review and 34 articles for meta-analysis. Study design, mean patient age and gender, patient alopecia type, surgical hair restoration technique, number of treatment areas, mean follow-up, graft survival rate and satisfaction rate were extracted from each study, and a meta-analysis was performed.
The pooled rates of graft survival were 84.98% (95% CI 78.90–91.06) using micrografts and 93.11% (95% CI 91.93–94.29) using micrografts and minigrafts in nonscarring alopecia patients, as well as 88.66% (95% CI 80.12–97.20) using micrografts and 86.25% (95% CI 74.00–98.50) using micrografts and minigrafts in scarring alopecia patients. The pooled rates of satisfaction were 89.70% (95% CI 82.64–96.76) using micrografts and 97.00% (95% CI 92.48–100.0) using micrografts and minigrafts in nonscarring alopecia patients, as well as 97.80% (95% CI 94.59–100.0) using micrografts and 88.70% (95% CI 66.49–100.0) using micrografts and minigrafts in scarring alopecia patients. Dot plots depict rates of graft survival rate from micrografts and satisfaction from micrografts and minigrafts.
Surgical hair restoration for nonscarring and scarring alopecia yields high graft survival and satisfaction rates.
Level of Evidence III
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KeywordsSurgical hair restoration Hair transplantation Follicular unit transplantation Alopecia Graft survival Satisfaction
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest to disclose.
Human and Animal Rights Statement
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, informed consent is not required.
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