Hair Loss After Brow and Face and Neck Lift

Any incision in the scalp can cause the hair follicle to go into a hibernation phase and the hair can fall out. This is temporary and will regrow. Hair-loss can also be from injury to the follicle from heat from cautery or the loss of blood flow to the temporal hair area because of too small of an area left there. It is more common in a hairline brow-lift. I would wait at least 3 months to see if there is hair re-growth in the areas you are concerned with, though is after a year the areas of balding can be safely removed and hair-bearing scalp closed to hair-bearing scalp.

I hope this helps.

Dr. Trussler

Hair loss after brow and/or facelifts is possible. This can occur as a result of how the incision is made or closed, but can also occur randomly due to stress to the hair follicles in that area. In most cases, the hair will regrow, but this can often be a challenging time for patients. If the hair does not regrow after 3-6 months, then excision of the bald areas and closure using trichophytic techniques is an option. Hair transplantation into the areas of hair loss would be another excellent option.Patients should always be sure to discuss any postoperative concerns with their surgeon.All the best,

Hair loss is not uncommon following
facial rejuvenation surgery.  In
the vast majority of cases hair loss is a transient phenomena and resolves with time. Occasionally, it can be permanent and requires
secondary treatment.

Hair loss with scarring can occur
for a variety of reasons including tension on the wound closure, use of the
cautery and thinning of the skin flaps.

A variety of options exist for
treating permanent hair loss following facial rejuvenation surgery.  These include surgical scar revision,
hair transplantation and the use of Rogaine.

The majority of patients are happy
with their surgical result even when hair loss occurs.  In most cases, scars and hair loss can
be easily hidden.   When hair
loss is visible secondary procedures may be necessary and in most cases solves
the problem.

I tell my patients hair loss can occur after face/brow/neck lifts for two reasons.  First, incisions and tension can sometimes lead to hair loss do to their affect on blood flow.  Second some people believe that general anesthesia and/or the "stress" of surgery can lead to generalized hair loss.  In both cases the hair loss can stop and hair can regrow.  I often recommend to my Facelift patients that they regularly use Nioxin shampoo before and after their procedure and rogaine as well to potentially reduce the potential for hair loss.  Do not take this as medical advice/Consult your plastic surgeon - I can not state that this would apply to you I am simply stating what I do routinely in my practice.

The good news is that hair can regrow.  Often the surgery simply caused root shock.  However, it can take 6 months for the hair to return.  If it does not grow back in this period, it was permanently damaged by your procedures.  If this is the case, an very experienced hair grafter can place micrografts into these areas to help restore the hairline.

There are different types of hair loss that can occur after facial plastic surgery.  Around the incisions, there can be temporary hair loss that many times will resolve with time.  Distortion of the hairline, including it getting pulled back, can occur due to the tightening of the skin backwards especially of the sideburns but also along the frontal hairline.  Lastly, there can be some overall thinning of the hair especially in the upper temporal regions due to the pulling of the skin.  Most of these conditions can be nicely treated with hair transplantation, but it is always best to try treating these areas with Rogaine and time.

With an open brow lift, it can occur at times. Especially if a subcutaneous plane is used. A scar revision can be done to remove some non hair bearing skin in the area. A hair transplant can usually be done by your surgeon if hair hasn't returned in 4 months.

Most hair loss after procedures that involve incisions within the hair are temporary. Sometimes the hair follicles go into a phase called telogen, where the hair falls out and the hair bulb or follicle goes into a non-regrowth period for up to four months. There can however be permanent hair loss if the incisions made did not parallel the follicles and they were damaged or if too much tension was placed on the closure of the incision. Other hair loss can occur if there was improper placement of incisions, causing such problems as loss of the hair tuft in front of the ears. If the hair fails to regrow, micro-follicular hair grafting can successfully be done, but I'd wait about 5 months to allow the follicle to regrow on their own first.

I do a lot of the procedures you mention. In my experience, hair loss is uncommon. The causes are too thin a flap, cautery of the hair follicles and tension at the suture line. Most likey your hair will come back.

 Hair loss can occur whenever the scalp is dissected beneath the follicles.  This is increased, IMHO, by using staples and other forms of closures that are less gentle on the hair-bearing scalp than smaller gauge nylon sutures. 

 There's a method of placing the two edges of cut scalp at the proper orientation to ensure increased viability of the follicles.  I have found, after performing Face Lifts, Neck Lifts and Brow Lifts for over 20 years that closing the scalp with 3-0 or 4-0 nylon (no staples) and using Rogaine along the incision line beginning at 1 month post op for a full year dramatically improves the amount of hair in and around the scalp incisions.