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Post-surgical hair loss, although rare, can be placed in one of two categories: accelerated hair loss and post-surgical effluvium.
Accelerated hair loss:
During the healing process post procedure, there is an increase in blood flow to the surgical site, which is why the recipient area is red and sometimes inflamed after surgery. This blood floods the area with DHT along with the necessary oxygen and nutrients required for healing and gives life to the transplanted tissue. However, this is not post-surgical shock loss, but accelerated hair loss. The risk of this occurring is dependent on the genetic predisposition of the hair in the recipient area and the extent of miniaturization of these hairs.
What is post-surgical shock loss or effluvium?
This type of post-surgery hair loss can result after the procedure and arises from trauma to the miniaturized hair, usually manifesting around 3 months post procedure. This trauma to the weakened hair in the recipient area occurs when the angling of the sites is inaccurate. It is imperative that the angle and direction of hair growth be followed precisely.
Significant post-surgical hair loss is rare due to advances in pharmaceuticals and surgery techniques.
Surgically:
Some surgical techniques that aid in the prevention of post-surgical hair loss include the creation of precise angles of the recipient sites, following the exact direction of hair growth. Secondly, the use of very small needles and cut-to-size blades minimizes the area of the created sites, reducing the extent of tissue and possible follicular injury when there is native hair remaining.
Pharmaceuticals:
The use of finesteride diminishes the DHT by 70%, protecting the native and transplanted hair from any post-surgical increase in circulating DHT. The use of minoxidil 5% acts synergistically to further protect the native miniaturized hair and possibly stimulate the growth of the transplanted hair. *All technical information from Dr. Bernard Arocha of Arocha Hair Restoration in Houston and Dallas, Texas.
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