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QUESTION OF THE WEEK


Scarring Alopecia after Face Lift Surgery

Facelift surgeries have a good safety record but it is important to be aware of the rare complications that can occur as they relate to hair loss. Telogen effluvium (abnormal shedding) and scarring alopecia can occur. This photo shows a patient who developed scarring alopecia (lichen planopilaris) in the area around her face-lift scar.

Chiang and colleagues presented data in 2012 to support that scarring alopecia (in this case frontal fibrosing alopecia) might be associated with face-lift surgery. They reported patients who developed FFA after their facelift. None of these patients had scarring alopecia before surgery. It is not a common occurrence, of course, but not likely to be a coincidence. The critics would say these women had undiagnosed FFA before surgery and surgery simply made it worse. But I don't think so. Countless cases of my own support that trauma can induce scarring alopecia.

In my opinion, it does seem that trauma to the scalp can trigger scarring alopecia in rare situations. In the same year as the Chiang study, I reported a study in the journal Dermatologic Surgery of patients who developed scarring alopecia following hair transplant surgery. These patients had no known scarring alopecia before the surgery. The critics would say (and have said) that these patients had undiagnosed scarring alopecia before surgery and surgery simply made it worse. However I do not believe so, countless cases of my own support that trauma can induce scarring alopecia.

Reference
Chiang et al. Lichen planopilaris following hair transplantation and face-lift surgery. Br J Dermatol. 2012.

Donovan J. Lichen planopilaris following hair transplant surgery: report of 17 cases. Dermatologic Surgery 2012; 38:1998-2004


This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.



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