Microvascular Injury and Regional Perfusion Vulnerability During Recipient Site Creation in Hair Transplantation
June 2026
in “
Journal of Cutaneous and Aesthetic Surgery
”
recipient site scalp necrosis hair transplantation microvascular injury regional vascular vulnerability frontal branch of the superficial temporal artery incision geometry instrument-related injuries ischemic complications frontal tuft scalp necrosis hair transplant blood vessel injury vascular vulnerability temporal artery incision shape tool-related injuries blood flow complications frontal hairline
TLDR Recipient site scalp necrosis in hair transplantation is linked to microvascular injury and regional vascular vulnerability, especially in the frontal and mid-scalp areas.
This narrative review addresses recipient site scalp necrosis (RSN) in hair transplantation, a rare complication leading to tissue loss and graft failure. The authors propose an anatomy-driven framework to explain RSN, focusing on regional vascular vulnerability and microvascular injury, particularly in the frontal and mid-scalp areas. They highlight the role of the frontal branch of the superficial temporal artery, which varies among individuals and creates high-risk zones. The review examines how incision geometry, instrument-related injuries, and cumulative incision burden, especially in the frontal tuft, may contribute to ischemic complications. The work synthesizes clinical observations and anatomical principles to generate hypotheses, aiming to improve recipient site design and aesthetic outcomes in hair transplantation.
