Abstract
Hair restoration surgery (HRS) is typically a safe outpatient or office-based procedure
when physicians follow high ethical standards and uphold community practice standards.
Patients' clinical outcomes are mostly operator dependent, and temporary and permanent
complications rarely occur. Follicular unit excision (FUE) donor harvesting, in particular,
is a challenging harvesting technique requiring a long learning curve, physical stamina,
higher than average hand–eye coordination and manual dexterity. The types of complications
associated with FUE are comparable to linear strip excision (LSE). Similar to LSE
donor harvesting, FUE complications may occur irrespective if standard precautions
are followed by the physician. As in any skin and scalp procedure, injuries and poor
cosmetic outcomes occur despite appropriate preoperative precautions and intraoperative
technique. In increasing and greater instances, however, FUE complications are observed
when the physician fails to follow hair restoration practice standards and routine
surgical precautions. Physician induced, or iatrogenic complications occur more often
when untrained licensed surgeons perform HRS, and who fail to meet practice standards
and best practices. In the last decade, physician-influenced FUE complications, or
iatrogenic cause of FUE injuries are increasingly observed which results in poor aesthetic
outcomes. Higher than average FUE complication rates occur in cases involving inadequately
trained physicians, as well as in cases where improper delegation of the FUE hair
transplant procedure is performed by unlicensed and untrained individuals. In this
chapter, we described commonly encountered HRS complications, as well as physician
influenced, or iatrogenic causes of FUE complications.
Keywords
donor depletion - low unnatural and age-inappropriate hairline - scalp necrosis -
FUE donor scaring - unnatural hairline - linear strip excision - arteriovenous fistula
- synthetic hair fibers
