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. 2022 Jul 1;48(7):726-729.
doi: 10.1097/DSS.0000000000003453. Epub 2022 Apr 12.

The Progressive Loss Risk Scale for Hair Restoration Surgery

Dow B Stough  1   2
Affiliations

The Progressive Loss Risk Scale for Hair Restoration Surgery

Dow B Stough. Dermatol Surg. .

Abstract

Background: Limited information exists on the long-term risks to individuals undergoing procedures in hair restoration surgery. The short-term risks are well known and similar to other procedures in dermatologic surgery. The long-term risks of hair restoration surgery are seldom discussed between the physician and patient.

Objective: The author sought to describe a classification system that can be used as a communication tool between physicians and patients to define the long-term risk involved with hair restoration surgery.

Methods: The Progressive Loss (PL) Scale is an attempt at assessing the cosmesis because of future hair loss following a hair transplant procedure. The PL Risk Scale has designated 5 levels, 1 to 5, with each ascending level representing a higher level of risk. The PL Risk Scale can be assigned to an individual at the time of the assessment for hair restoration surgery.

Results: Each patient can be assigned a risk level based on how future hair loss may affect the overall cosmetic result of their hair transplant. This risk is dependent on age, and specific for the area to be transplanted. The younger the age of the patient, the higher the risk. The larger the area to be transplanted, the higher the risk. It is not a static scale, because it will be affected by age, donor area, location of transplantation, and other mitigating factors.

Conclusion: Pattern baldness in men and women is progressive and unrelenting. The dichotomy of hair restoration surgery is that a satisfactory short-term outcome can evolve to disappointing results because of progressive hair loss. The PL Risk Scale can be assigned to every individual undergoing a hair restoration procedure. This scale assignment will convey to the patient their lifetime risk associated with any given surgical hair restoration procedure for that age and the specific area to be restored.

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References

    1. Marritt E. What if our assumptions and predictions were just simply wrong? HT Forum Int 1993;3:10.
    1. Knudsen RG. Balding aggressiveness and the balding aggressiveness index. HT Forum Int 2019;29:16–7.
    1. Hillmer A, Hanneken S, Ritzmann S, et al. Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia. Am J Hum Genet 2005;77:140–8.
    1. Liu F, Hamer Merel A, Heilmann S, Herold C, et al. Prediction of male-pattern baldness from genotypes. Eur J Hum Genet 2016;24:895–902.
    1. Pickrell Joseph K, Berisa T, Liu JZ, Segurel L, et al. Detection and interpretation of shared genetic influences on 42 human traits. Nat Genet 2016;48:709–17.

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