9 - Emergency preparedness in hair restoration surgery

Summary

One of the most comforting things about hair restoration surgery, to both the patient and the surgeon, is the very low risk of complications. Although there is no registry that tracks hair restoration surgery complication data, most surgeons describe their complication rates as being less than 1%. There is an even lower incidence of life-threatening emergencies during hair restoration surgery. In the last thirty-five years, the author has been informed through personal communications of five cardiac arrests, resulting in three deaths, one severe neurological deficit, a “lock-in” syndrome, and three myocardial infarctions occurring during hair restoration surgery procedures.

The International Society of Hair Restoration Surgery (ISHRS) membership survey indicated that approximately 225,800 procedures were done in 2006. If all six of these life-threatening complications had occurred in that year, the incidence would only be one in 37,633 procedures. Since these problems were reported over thirty-five years, the incidence of life-threatening complications is indeed extremely low. The fact remains, however, that if such an event should occur in one's office, the incidence suddenly becomes 100%. Therefore, we owe it to our patients and ourselves, to be prepared for these unlikely events.

It is the intent of this chapter to help the hair restoration surgeon to be prepared for such catastrophic events. The low incidence of life-threatening situations often creates a false sense of security on the part of the physician and staff. The only way to optimize the probability of a positive outcome after such an event is by being prepared.