Morphological changes in transplanted hair in the treatment of cicatricial post-traumatic alopecia
DOI:
https://doi.org/10.14739/2310-1237.2025.3.332444Keywords:
alopecia cicatricial, hair transplantation, FUE, graft, hair follicleAbstract
The aim is to study the morphological changes in transplanted hair follicles to determine the effectiveness of the FUE method under conditions of ischemic and scar tissue.
Materials and methods. The study included 10 patients diagnosed with cicatricial post-traumatic alopecia or alopecia resulting from reconstructive surgical procedures. All patients underwent hair transplantation using the follicular unit extraction (FUE) technique combined with direct hair implantation (DHI). The structural characteristics of the hair follicle and hair bulb, as well as the degree of vascularization of the transplanted follicular units (grafts), were examined. The obtained results were compared with data from healthy hair follicles, serving as controls.
Results. Microscopic examination revealed that the transplanted grafts maintained their structural integrity and demonstrated successful engraftment at the recipient sites, indicating a high level of follicular adaptation within the altered (ischemic or scarred) tissues. During clinical assessment, patients reported excellent (80 %) and good (20 %) results. The degree of engraftment was on average 90 % of the transplanted number of grafts. Thus, when all the rules of the DHI hair transplant technique were followed, we did not observe an increased risk of hair follicle loss due to their damage.
Conclusions. Hair transplantation after extraction can be successfully used to restore the hair cover, to mask incisions on the scalp or to restore the anterior hairline. FUE hair transplantation with DHI implantation can be considered the safest and most promising method for preserving the viability of hair follicles, especially in conditions of ischemic scar tissue.
References
Kerure AS, Deshmukh N, Agrawal S, Patwardhan NG. Follicular Unit Extraction [FUE] - One Procedure, Many Uses. Indian Dermatol Online J. 2021;12(3):381-8. doi: https://doi.org/10.4103/idoj.IDOJ_522_20
Memon R, Avram M. The pros and cons of follicular unit extraction (FUE) versus elliptical donor harvesting (FUT). J Cosmet Laser Ther. 2022;24(6-8):63-5. doi: https://doi.org/10.1080/14764172.2022.2088795
Kumar AR, Ishii LE. Hair Transplantation for Scarring Alopecia. Facial Plast Surg Clin North Am. 2020;28(2):177-9. doi: https://doi.org/10.1016/j.fsc.2020.01.001
Sand JP. Follicular Unit Transplantation. Facial Plast Surg Clin North Am. 2020;28(2):161-7. doi: https://doi.org/10.1016/j.fsc.2020.01.005
Evin N, Guray Evin S. Camouflage of Postburn Scarring Alopecia Using Nanofat Grafting and Follicular Unit Hair Transplantation. Plast Reconstr Surg. 2024;154(1):207-15. doi: https://doi.org/10.1097/PRS.0000000000010759
Dai JJ, Wang L, Qiu HY, Huang XY, Tian YX, Peng Q, et al. [Clinical effects of autologous follicular unit extraction transplantation in the treatment of small area secondary cicatricial alopecia after burns]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022;38(6):532-537. Chinese. doi: https://doi.org/10.3760/cma.j.cn501120-20210224-00064
Gupta AK, Love RP, Harris JA. Old Friend or New Ally: A Comparison of Follicular Unit Transplantation and Follicular Unit Excision Methods in Hair Transplantation. Dermatol Surg. 2020;46(8):1078-83. doi: https://doi.org/10.1097/DSS.0000000000002373
Huang YL, Lee MC, Chang SL, Hu S, Chang CS, Lin YF, et al. Harvested vs estimated follicular units in hair transplantation. J Cosmet Dermatol. 2019;18(3):902-7. doi: https://doi.org/10.1111/jocd.12740
Park JH, You SH, Kim NR. Nonshaven Follicular Unit Extraction: Personal Experience. Ann Plast Surg. 2019;82(3):262-8. doi: https://doi.org/10.1097/SAP.0000000000001679
Akdag O, Evin N, Karamese M, Tosun Z. Camouflaging Cleft Lip Scar Using Follicular Unit Extraction Hair Transplantation Combined with Autologous Fat Grafting. Plast Reconstr Surg. 2018;141(1):148-51. doi: https://doi.org/10.1097/PRS.0000000000003956
Jiang W, Wang M, Wang B. Clinical outcomes and technical tips for eyebrow restoration using single-follicular-unit hair transplantation: A case series review. J Cosmet Dermatol. 2020;19(8):2057-60. doi: https://doi.org/10.1111/jocd.13242
Lizardi JJ, Treger D, Braud SC, Boghosian T, Abd RE, Jabori SK, et al. The Most Influential Publications Regarding Hair Transplantation: A Bibliometric Review. Aesthetic Plast Surg. 2024;48(23):5189-99. doi: https://doi.org/10.1007/s00266-024-04049-3
Nuri T, Abe N, Sakamoto A, Tsushima A, Kasai Y, Narui Y, et al. Treatment of scarring alopecia from trauma and surgical procedures in young patients using follicular unit hair transplantation. Pediatr Dermatol. 2021;38(3):721-3. doi: https://doi.org/10.1111/pde.14553
Epstein GK, Epstein J, Nikolic J. Follicular Unit Excision: Current Practice and Future Developments. Facial Plast Surg Clin North Am. 2020;28(2):169-76. doi: https://doi.org/10.1016/j.fsc.2020.01.006
Mylytsya KM, Sorokina IV, Myroshnychenko MS, Pliten OM. [Morphological features of adipose tissue of epiploon and subcutaneous fat cellular tissue of people with normal body mass index]. Pathologia. 2015;(3):90-4. Ukrainian. doi: https://doi.org/https://doi.org/10.14739/2310-1237.2015.3.55612
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 O. A. Hyndych, I. M. Savytska

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

