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Surgical Management for Hair Restoration: A Review of Contemporary Techniques

  • Review
  • Facial surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Hair loss can cause psychological distress for patients, regardless of the etiology or extent of the defect. Many conservative and pharmacological approaches are successful in management, but refractory or severe cases often mandate surgical treatment. Surgical techniques have been refined over the course of a century, and we aim to review the most contemporary strategies.

Methods

A review of the literature was performed using the databases PubMed, Web of Science, and Embase, in May 2020. Articles were included if they discussed techniques used within the past 10 years, in search of more contemporary strategies and the most widely used approaches.

Results

The use of local flaps, scalp reduction surgery, and hair transplantation techniques are all used for various indications. Modern hair transplantation can be further divided into follicular unit excision and follicular unit transplantation, each with its own advantages. Local flaps are most often used for post-traumatic and reconstructive indication, while hair transplantation can be used for smaller cosmetic lesions or in combination with a variety of other reconstructive techniques.

Conclusion

Hair loss continues to be a challenging pathology for both patients and physicians, regardless of etiology. When conservative treatment is inadequate, there exist multiple surgical techniques that can feasibly restore hair, though the exact degree of success may vary between patients. The proper technique is dependent upon etiology, patient specific factors, as well as surgeon experience and comfort.

Level of Evidence III

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwell Health, New York, NY, USA

    Sammy Othman

  2. Section of Plastic Surgery, Department of Surgery, St. Christopher’s Hospital for Children, Philadelphia, PA, 19134, USA

    Paul Glat

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  1. Sammy Othman
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Correspondence to Paul Glat.

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Othman, S., Glat, P. Surgical Management for Hair Restoration: A Review of Contemporary Techniques. Aesth Plast Surg 47, 2415–2424 (2023). https://doi.org/10.1007/s00266-023-03391-2

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