Bald patch/hair loss due to ponytail facelift. What are my solution options? PRP, hair implants, cosmetic tattooing? (photos)

Question

Since getting surgery, I've lost hair around the incisions in hair line. It's been a year and the hair has not grown back. What are my options ?

Michael Zacharia, MBBS, FRACS, FAAFPS · Answer

Localised hair loss around the incisions in the hair line can be caused by hair shock or damage to the hair follicles. In women, this area can be visible especially when the hair is tied up. Non-surgical techniques such as injections with growth factors (e.g. PRP, factor 4, stem cells, exosomes) can encourage hair growth. Although often effective, results can sometimes be unpredictable and suboptimal. In these cases, hair transplant (FUE) to the affected areas can be considered to address this concern.

Giray Genc, MD · Answer

Hello, there may occur after the surgeries have incisions inside of hair bearing skin. There are two ways to solve this problem. You can conceal the hairless area covering with close hair. Or ypu can get hair transfer

Ajaya Kashyap, MD · Answer

Thank you for query. It is not unusual to have some temporary hair loss after a ponytail face lift because of the surgical “shock”. However you have had this for a full year and that is not common. At this stage I would recommend some local steroid injections with PRP. Hair transplants can be done later if this does not resolve the situation in a few months. Please discuss your concerns with your surgeon who should be able to help. All the best!

Ronald J. Edelson, MD · Answer

It could be that your scar widened over time. A scar revision should be able to narrow the scar so it doesn’t look
Like a bald patch

Zoran Potparic, MD · Answer

In your case scar revision with a zig-zag scar or heart transplantation should be considered. You should discuss this issue with your surgeon. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

The first thing to do is to assess how the incision was made. When doing this type of surgery, it’s important that the surgeon cuts the skin/scalp exactly parallel with hair follicles in order to not create hair loss. Sometimes the tension put on the incision can cause hair loss but from excessive tension the hair loss is usually more diffuse. For most patients hair loss can be avoided. If the incision was not made parallel with hair follicles, then hair follicles will be damaged and your type of hair loss will happen. One option is to do a scar revision, cutting out the scar perfectly parallel to hair follicles, and see if you can restore or remove the areas of hair loss. 
The chance of success with this depends on how well the first operation was done. If your first surgeon did the surgery with technical expertise, cutting skin edges parallel then revision may not make that much difference. If the surgeon didn’t pay attention to the direction of the hair, follicles than simply as scar revision might be all you need. Hair grafts are also an option, but it would be nice to avoid grafting if not necessary.
I suggest having multiple in person, consultations with senior plastic surgeons in your community. See what each of them has to say, and what type of experience they’ve had with these cases in the past.
I suggest you get a copy of your previous medical records, including all before, and after pictures, and a copy of your operative report. Those should all be available from your previous provider upon request.
Bring those with you for any in person second opinion consultation.
Best,
Mats Hagstrom, MD.

Jared Blau, MD - Account Suspended · Answer

For this, I would recommend follicular unit extraction and have fresh hair follicles transferred to the patch

Bald patch/hair loss due to ponytail facelift. What are my solution options? PRP, hair implants, cosmetic tattooing? (photos)

Answers (7)

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