Hair Loss After Rhytidectomy

The document reports a case of a 52-year-old woman experiencing hair loss after undergoing a rhytidectomy (facelift). She presented with a 6-week history of bitemporal shedding and thinning, which began 9 weeks post-surgery. The patient had a history of hypothyroidism and depression and was taking Synthroid and Prozac. Physical examination showed bilateral symmetric thinning at the temples, but the pull test was negative. Two punch biopsies were performed, and histopathologic analysis revealed an increased number of hair follicles in the catagen and telogen phases, with no peribulbar inflammation, scarring, or hair shaft abnormality, leading to a diagnosis of telogen effluvium. Additionally, there was evidence of androgenetic alopecia. No treatment was suggested, and the patient experienced gradual resolution of shedding and regrowth of hair, returning to baseline density one year after the rhytidectomy. The study concludes that one mechanism for temporal hair loss after rhytidectomy is an acute localized telogen effluvium, which is usually transient. Permanent hair loss can occur in up to 2.8% of patients, with those having thinning hair at greater risk. This case represents the first histopathologic evaluation of hair loss post-rhytidectomy to the authors' knowledge.