Liu Rui Han, Xu Lucy J, McCarty Justin C, Xiao Roy, Chen Jenny X, Lee Linda N
Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
Department of Surgery, Division of Plastic and Reconstructive Surgery, Harvard Medical School, Boston, MA, USA.
Aesthetic Plast Surg. 2025 Feb;49(3):585-595. doi: 10.1007/s00266-024-04316-3. Epub 2024 Aug 23.
Hair restoration surgery (HRS) is a commonly performed elective procedure but to date lacks a review of the full scope of complications.
To provide a comprehensive overview of observed complications associated with follicular unit extraction (FUE) and follicular unit transplantation (FUT).
Randomized control trials, cohort studies, case series, and case reports published in 1985 or later on adults (age>18). Nontraumatic or autoimmune etiologies of alopecia were excluded as procedure indications.
PubMed, EMBASE, Cochrane databases (last search December 31, 2022).
Data-charting and extraction were independently performed with two reviewers using Covidence.
Forty-three publications were included. Two large series reported the overall complication rate to be 1.2 and 4.7%. Common complications included bleeding requiring intervention (up to 8%), persistent numbness (up to 11%), infection (up to 11% with two reports of Kaposi varicelliform eruptions and one of mucormycosis), effluvium at donor and recipient sites (up to 4.1% and 6.5%, respectively). The most common donor-site complication was hypertrophic scarring/keloid formation after FUT (up to 15.1%). Complications at the recipient site, including crusting (up to 54.8%), frontal edema (up to 50%), and sterile folliculitis (up to 53.3%), tended to be poorly defined with a broad range of incidences.
Serious complications associated with HRS are rare in the hands of experienced providers. However, comprehensive discussions of risk must be had with prospective patients as any complication in the context of an elective procedure may be significant and psychologically devastating for the individual patient.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
毛发移植手术（HRS）是一种常见的择期手术，但迄今为止，尚缺乏对其所有并发症的全面综述。
全面概述与毛囊单位提取（FUE）和毛囊单位移植（FUT）相关的观察到的并发症。
1985年或之后发表的关于成人（年龄>18岁）的随机对照试验、队列研究、病例系列和病例报告。排除非创伤性或自身免疫性脱发病因作为手术指征。
PubMed、EMBASE、Cochrane数据库（最后检索时间为2022年12月31日）。
两名审阅者使用Covidence独立进行数据制表和提取。
纳入43篇出版物。两个大型系列报道总体并发症发生率分别为1.2%和4.7%。常见并发症包括需要干预的出血（高达8%）、持续性麻木（高达11%）、感染（高达11%，有两例报告为水痘样疹，一例为毛霉菌病）、供体和受体部位的脱发（分别高达4.1%和6.5%）。最常见的供体部位并发症是FUT后肥厚性瘢痕/瘢痕疙瘩形成（高达15.1%）。受体部位的并发症，包括结痂（高达54.8%）、额部水肿（高达50%）和无菌性毛囊炎（高达53.3%），其定义往往不明确，发生率范围广泛。
在经验丰富的医生手中，与HRS相关的严重并发症很少见。然而，必须与潜在患者进行关于风险的全面讨论，因为在择期手术中任何并发症对个体患者来说都可能是严重的且在心理上具有毁灭性。
证据级别V：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
