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Thuangtong R, Suthakorn J. Design, proof-of-concept of single robotic hair transplant mechanisms for both harvest and implant of hair grafts. Comput Struct Biotechnol J 2024; 24:31-45. [PMID: 38162956 PMCID: PMC10755542 DOI: 10.1016/j.csbj.2023.11.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
The design and development of a prototype for a singular robotic hair transplant system capable of harvesting and implanting hair grafts were executed in this study. To establish a proof-of-concept for hair transplant procedures involving harvesting and implantation, a test system using a spherical phantom of the scalp was selected. The developed prototype of the robotic hair transplant system demonstrates the potential to reduce the duration that grafts remain without a blood supply, thereby minimizing hair graft damage. Additionally, the overall operation time for follicular unit extraction is comparatively shorter than that of conventional systems. Results from the robot vision tests indicate an 89.6% accuracy for hair graft detection with a 4 mm hair length phantom and 97.4% for a 2 mm hair length phantom. In the robot position control test, the root mean square error was found to be 1.268°, with a standard error of the mean of 0.203°. These outcomes suggest that the proposed system performs effectively under the conditions of a spherical phantom with a 2 mm hair length and a 5 mm distance between harvests.
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Affiliation(s)
- Rattapon Thuangtong
- Department of Biomedical Engineering, Center for Biomedical and Robotics Technology, Faculty of Engineering, Mahidol University, Salaya, Thailand
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
| | - Jackrit Suthakorn
- Department of Biomedical Engineering, Center for Biomedical and Robotics Technology, Faculty of Engineering, Mahidol University, Salaya, Thailand
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Liu RH, Xu LJ, McCarty JC, Xiao R, Chen JX, Lee LN. A Scoping Review on Complications in Modern Hair Transplantation: More than Just Splitting Hairs. Aesthetic Plast Surg 2024:10.1007/s00266-024-04316-3. [PMID: 39179656 DOI: 10.1007/s00266-024-04316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 08/01/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Hair restoration surgery (HRS) is a commonly performed elective procedure but to date lacks a review of the full scope of complications. OBJECTIVES To provide a comprehensive overview of observed complications associated with follicular unit extraction (FUE) and follicular unit transplantation (FUT). ELIGIBILITY CRITERIA Randomized control trials, cohort studies, case series, and case reports published in 1985 or later on adults (age>18). Nontraumatic or autoimmune etiologies of alopecia were excluded as procedure indications. SOURCES OF EVIDENCE PubMed, EMBASE, Cochrane databases (last search December 31, 2022). CHARTING METHODS Data-charting and extraction were independently performed with two reviewers using Covidence. RESULTS Forty-three publications were included. Two large series reported the overall complication rate to be 1.2 and 4.7%. Common complications included bleeding requiring intervention (up to 8%), persistent numbness (up to 11%), infection (up to 11% with two reports of Kaposi varicelliform eruptions and one of mucormycosis), effluvium at donor and recipient sites (up to 4.1% and 6.5%, respectively). The most common donor-site complication was hypertrophic scarring/keloid formation after FUT (up to 15.1%). Complications at the recipient site, including crusting (up to 54.8%), frontal edema (up to 50%), and sterile folliculitis (up to 53.3%), tended to be poorly defined with a broad range of incidences. CONCLUSION Serious complications associated with HRS are rare in the hands of experienced providers. However, comprehensive discussions of risk must be had with prospective patients as any complication in the context of an elective procedure may be significant and psychologically devastating for the individual patient. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Rui Han Liu
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
| | - Lucy J Xu
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
| | - Justin C McCarty
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Harvard Medical School, Boston, MA, USA
| | - Roy Xiao
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
| | - Jenny X Chen
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Linda N Lee
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
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Zhang J, Zhao Y, Zhang J, Zhou Y, Yi Y, Lei R, Qu Q, Hu Z, Gao Z, Li Y, Tang Q, Miao Y. Risk Factors and Hazards of Recipient-Area Perifollicular Erythema After Hair Transplantation: A Multicenter Retrospective Cohort Study. Aesthetic Plast Surg 2024; 48:2771-2777. [PMID: 38849551 DOI: 10.1007/s00266-024-04166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/24/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Recipient-area perifollicular erythema (RPE) may delay graft growth after hair transplantation. However, there is currently a lack of observational clinical studies of RPE. OBJECTIVE To study the clinical features and risk factors associated with RPE while analyzing its correlation with graft growth. METHODS We conducted a multicenter retrospective cohort study between June 2020 and January 2023. RESULTS A total of 1090 participants were included, 178 (16.33%) showed mild RPE, 56 (5.14%) showed moderate RPE, and 10 (0.92%) showed severe RPE. Patients with RPE had severe hair shaft shedding (P < 0.001) and a lower survival rate (P < 0.001) of grafts. Logistic regression analysis showed that folliculitis is a significant risk factor for mild RPE (OR 6.061, 95% CI 3.343-10.991, P < 0.001) and moderate RPE (OR 3.397, 95% CI 1.299-8.882, P = 0.013). Besides, untimely first postoperative hair washing was associated with the development of moderate RPE (OR 0.724, 95% CI 0.553-0.947, P = 0.018) and severe RPE (OR 1.553, 95% CI 1.156-2.086, P = 0.003). CONCLUSION RPE is a postoperative complication closely related to high hair shaft shedding proportion and low graft survival rate. Both postoperative folliculitis and untimely first postoperative hair washing may induce the occurrence of RPE. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jiaxian Zhang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yingjie Zhao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jiarui Zhang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yi Zhou
- Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 314408, China
| | - Yanhua Yi
- Department of Burn, Would Repair Surgery and Plastic Surgery, Department of Aesthetic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China
| | - Rui Lei
- Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zhiyong Gao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yufei Li
- Department of Plastic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China.
| | - Qiang Tang
- Surgery Department of Burn Plastics and Wound Repair, Affiliated Hospital of Youjang Medical University for Nationalities, Baise City, 533000, Guangxi, China.
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Jean-Pierre P, Pulumati A, Kasheri E, Hirsch M, Nouri K. Lasers in the management of alopecia: a review of established therapies and advances in treatment. Lasers Med Sci 2024; 39:102. [PMID: 38630348 PMCID: PMC11023987 DOI: 10.1007/s10103-024-04054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
Alopecia, also known as hair loss, is a highly prevalent condition affecting millions of men and women in the United States and worldwide, making it one of the most common complaints by patients presenting to a dermatologist. The symptomology on the presentation of alopecia can be highly variable, ranging from diffuse thinning of hair, discrete and localized patches completely absent of hair, or noticing significant shedding when brushing and showering. Although alopecia does not have a direct negative health impact on patients, it is nonetheless a debilitating disease as it can profoundly impact an individual's self-image and psychosocial well-being. There are multiple treatment options available to patients with alopecia, and they are typically tailored to the patient's needs and preferences. The most common of these is the Food and Drug Administration-approved drugs for alopecia, minoxidil, and finasteride. However, both of these are known to be partially efficacious for all patients, so clinicians often use different modalities in conjunction with them, in particular laser-based therapies. This review article will provide a comprehensive assessment of lasers and other light therapies that may be used to manage the two most common types of alopecia: androgenetic alopecia and alopecia areata.
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Affiliation(s)
- Philippe Jean-Pierre
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA.
| | - Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Eli Kasheri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA
| | - Melanie Hirsch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA
| | - Keyvan Nouri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA
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Williams KL, El-Maghraby S. Complications with Follicular Unit Excision. Facial Plast Surg 2024; 40:234-244. [PMID: 37907286 DOI: 10.1055/a-2201-8302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Hair restoration surgery (HRS) is typically a safe outpatient or office-based procedure when physicians follow high ethical standards and uphold community practice standards. Patients' clinical outcomes are mostly operator dependent, and temporary and permanent complications rarely occur. Follicular unit excision (FUE) donor harvesting, in particular, is a challenging harvesting technique requiring a long learning curve, physical stamina, higher than average hand-eye coordination and manual dexterity. The types of complications associated with FUE are comparable to linear strip excision (LSE). Similar to LSE donor harvesting, FUE complications may occur irrespective if standard precautions are followed by the physician. As in any skin and scalp procedure, injuries and poor cosmetic outcomes occur despite appropriate preoperative precautions and intraoperative technique. In increasing and greater instances, however, FUE complications are observed when the physician fails to follow hair restoration practice standards and routine surgical precautions. Physician induced, or iatrogenic complications occur more often when untrained licensed surgeons perform HRS, and who fail to meet practice standards and best practices. In the last decade, physician-influenced FUE complications, or iatrogenic cause of FUE injuries are increasingly observed which results in poor aesthetic outcomes. Higher than average FUE complication rates occur in cases involving inadequately trained physicians, as well as in cases where improper delegation of the FUE hair transplant procedure is performed by unlicensed and untrained individuals. In this chapter, we described commonly encountered HRS complications, as well as physician influenced, or iatrogenic causes of FUE complications.
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Okochi H, Onda M, Momosawa A, Okochi M. An Analysis of Risk Factors of Recipient Site Temporary Effluvium After Follicular Unit Excision: A Single-Center Retrospective Study. Aesthetic Plast Surg 2024; 48:1258-1263. [PMID: 37816944 DOI: 10.1007/s00266-023-03699-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Temporary hair loss at the recipient site after hair restoration surgery is called shock loss (SL). This study analyzed the risk factors for SL among patients who received follicular unit excision. MATERIALS AND METHODS This study included 621 patients (554 males and 67 females). Twenty-three patients had SL (9 males and 14 females with a mean age of 40.8 years). The prevalence of SL was analyzed in relation to sex, age, graft follicular units, cause of alopecia, diabetes mellitus, smoking, drinking alcohol, and local anesthesia agent. RESULTS Sex was identified as a risk factor for SL (odds ratio [OR]: 30.18; 95% confidence interval [CI] 9.43-96.55; p<0.001). Among female patients, age was identified as a risk factor for SL (OR:1.07; 95% CI 1.00-1.15; p=0.039). Over 40 years, the female pattern hair loss group had a significantly higher risk for SL than a female cosmetic group younger than 39 years. CONCLUSION Sex was the only risk factor found for SL in this study. In addition, age was identified as a risk factor for SL among female patients. We believe our results provide information and risk factors for SL, not only for hair transplant surgeons, but also patients who will receive follicular unit excision. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Hiromi Okochi
- Department of Plastic and Reconstructive Surgery, Yamanashi University, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | | | - Akira Momosawa
- Department of Plastic and Reconstructive Surgery, Yamanashi University, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Masayuki Okochi
- Department of Plastic and Reconstructive Surgery, Teikyo University, 2-11-1 Kaga, Itabashi, Tokyo, Japan.
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Mir-Bonafé JM, Mir-Bonafé J, Rubio-Lombraña M, Gómez-Zubiaur A, Hermosa-Gelbard A, Pigem R, Mir-Bonafé M, Santos-Briz A. 'Vasculitis-like' damage due to micropunch in follicular unit excision hair transplantation surgery: Ten cases. J Eur Acad Dermatol Venereol 2024. [PMID: 38534163 DOI: 10.1111/jdv.19993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Affiliation(s)
- J M Mir-Bonafé
- TricologiaMir - Hair Transplantation and Trichology Unit, Palma de Mallorca, Spain
| | - J Mir-Bonafé
- TricologiaMir - Hair Transplantation and Trichology Unit, Palma de Mallorca, Spain
| | | | - A Gómez-Zubiaur
- Trichology Unit of Ricart Medical Institute, Madrid and Valencia, Spain
| | - A Hermosa-Gelbard
- Trichology Units of Hospital Ramón y Cajal and Grupo Pedro Jaén, Madrid, Spain
| | - R Pigem
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - M Mir-Bonafé
- TricologiaMir - Hair Transplantation and Trichology Unit, Palma de Mallorca, Spain
| | - A Santos-Briz
- Department of Pathology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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