Risk of pillar cysts after hair transplant?

This is a complex scenario and absolutely there is a possibility there will be new pilar cysts in the recipient area (and possibly donor area too). What we don’t know in your case is if there will be one cysts that develops 1 year after the procedure or 4 cysts that develop 6 years after the procedure or whether there will be 14 cysts that form within 8 months. Some degree of risk estimation will come from knowing more about your story (I don’t have enough information). But the key here is that absolutely this procedure comes with a risk. Hard to say if it’s a small risk or large risk but with 8 pilar cysts and a family history there is risk. I don’t know what treatments you have tried in the past .. but if you have not used treatments that have a good evidence base then you may want to discuss these options with your doctors. These include oral minoxidil, topical minoxidil, topical finasteride, spironolactone, other antiandrogens. and laser. I would be cautious about treatments like PRP and microneedling given their potential to worsen the pilar cysts in your case. But if you have had PRP or microneedling without any flare in pilar cyst count (ie new cysts) , then this would be helpful information. There is no right or wrong answer in this situation. What is needed is a full and complete understanding of the potential risks and benefits and then to avoid surgery if risks are too much greater than potential benefits for a given person and to proceed with plans for surgery if potential benefits are felt to outweigh all the potential risks. There is no right answer only calculated estimation of risk.