Hair Transplantation Workup
- Author: Jeffrey S Epstein, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA more...
When healing or bleeding characteristics are concerns, consider performing screening blood tests, including tests of following:
- CBC count with platelets
- Prothrombin time (PT)
- Activated partial thromboplastin time (aPTT)
Further testing (eg, chemical profile) is occasionally performed as the patient's medical condition dictates.
In female patients, extensive workup is indicated to rule out potentially treatable causes of the hair loss. Include tests of the following:
- CBC count
- Total iron and ferritin
- Thyroid function tests and thyroid-stimulating hormone
- Total and free testosterone
- Dehydroepiandrosterone (DHEA) sulfate, in cases of irregular menses
Further testing (eg, ECG) is occasionally performed as the patient's medical condition dictates. It also may be prudent to screen for antibodies to HIV hepatitis B and C.
Staging alopecia into both pattern and degree of severity can be accomplished through the Hamilton classification. Patients with Hamilton patterns I and II have very early limited alopecia requiring minimal treatment if accepted as candidates. Conversely, patients with patterns VI and VII may no longer be candidates for the surgery since their alopecia is so extensive. The very best candidates fall into patterns IV to V, which produce the best, most natural results. See the image below.
Wesley CK, Unger RH, Unger WP. Hair Transplantation. Thorne et al, eds. Grabb and Smith’s Plastic Surgery. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013. 549-64.
Bunagan MJ, Banka N, Shapiro J. Hair transplantation update: procedural techniques, innovations, and applications. Dermatol Clin. 2013 Jan. 31 (1):141-53. [Medline].
Williams KL Jr. Current practices and controversies in cosmetic hair restoration. Dermatol Surg. 2013 May. 39 (5):797-801. [Medline].
Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975 Nov. 68 (11):1359-65. [Medline].
Magro CM, Rossi A, Poe J, Manhas-Bhutani S, Sadick N. The role of inflammation and immunity in the pathogenesis of androgenetic alopecia. J Drugs Dermatol. 2011 Dec. 10 (12):1404-11. [Medline].
Redmond GP. Androgenic disorders of women: diagnostic and therapeutic decision making. Am J Med. 1995 Jan 16. 98 (1A):120S-129S. [Medline].
Rassman WR, Bernstein RM, McClellan R, Jones R, Worton E, Uyttendaele H. Follicular unit extraction: minimally invasive surgery for hair transplantation. Dermatol Surg. 2002 Aug. 28 (8):720-8. [Medline].
Harris JA. Powered blunt dissection with the SAFE System for FUE. Hair Transplant Forum International. Nov/Dec 2011. 20:188-89.
Salanitri S, Gonçalves AJ, Helene A Jr, Lopes FH. Surgical complications in hair transplantation: a series of 533 procedures. Aesthet Surg J. 2009 Jan-Feb. 29 (1):72-6. [Medline].
Knudsen RG, Unger M. Unger W, et al. Hair Transplantation. 5th ed. New York, NY: Marcel Dekker; 2011. 419-22.
Chiang YZ, Tosti A, Chaudhry IH, Lyne L, Farjo B, Farjo N, et al. Lichen planopilaris following hair transplantation and face-lift surgery. Br J Dermatol. 2012 Mar. 166 (3):666-370. [Medline].
Wesley CK. Enhanced Patient Selection: The Folliscope. Unger and Shapiro, eds. Hair Transplantation. 5th ed. New York, NY: Marcel Dekker; 2011. 82-3.
Jimenez JJ, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR, et al. Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study. Am J Clin Dermatol. 2014 Apr. 15 (2):115-27. [Medline].
Epstein JS. Hair transplantation in women: treating female pattern baldness and repairing distortion and scarring from prior cosmetic surgery. Arch Facial Plast Surg. 2003 Jan-Feb. 5 (1):121-6. [Medline].
Frechet P. Donor harvesting with invisible scars. Hair Transplant Forum Intl. 2005. 15(4):119-20.
Nordström RE, Greco M, Vitagliano T. Correction of sideburn defects after facelift operations. Aesthetic Plast Surg. 2000 Nov-Dec. 24 (6):429-32. [Medline].
Barrera A. The use of micrografts and minigrafts in the aesthetic reconstruction of the face and scalp. Plast Reconstr Surg. 2003 Sep. 112 (3):883-90. [Medline].
Harris JA. Follicular unit transplantation: dissecting and planting techniques. Facial Plast Surg Clin North Am. 2004 May. 12 (2):225-32. [Medline].
Lee SJ, Lee HJ, Hwang SJ, Kim DW, Jun JB, Chung SL, et al. Evaluation of survival rate after follicular unit transplantation using the KNU implanter. Dermatol Surg. 2001 Aug. 27 (8):716-20. [Medline].
Haber RS, Unger M, Unger W, et al. Hair Transplantation. 5th ed. New York, NY: Marcel Dekker; 2011. 279-80.
Rashid RM, Morgan Bicknell LT. Follicular unit extraction hair transplant automation: options in overcoming challenges of the latest technology in hair restoration with the goal of avoiding the line scar. Dermatol Online J. 2012 Sep 15. 18 (9):12. [Medline].
Seager DJ. Micrograft size and subsequent survival. Dermatol Surg. 1997 Sep. 23 (9):757-61; discussion 762. [Medline].
Limmer R. Micrograft survival. Stough D, Haber R, eds. Hair Replacement. St. Louis, Mo: Mosby; 1996. 147-49.
Kim JC. Unger W, Shapiro R, et al. Hair Transplantation. 5th ed. New York, NY: Marcel Dekker; 2011. 404-6.
Unger WP. Delineating the "safe" donor area for hair transplanting. Am J Cosmetic Surg. 1994. 239-43.
Wesley CK, Teo LH, Xu T, Unger RH, Unger WP. The influence of peri-incisional triamcinolone acetonide injection on wound edge apposition. J Dermatolog Treat. 2014 Aug. 25 (4):345-9. [Medline].