Hair Transplantation on Free Flap in a Patient with Malignant Scalp Neoplasms: A Case Report

This case report presents a novel approach to treating severe alopecia in a 41-year-old female following free flap reconstruction for malignant scalp tumor resection. The patient, who experienced significant psychological distress due to baldness, underwent staged autologous hair transplantation using follicular unit extraction (FUE) directly onto the flap. The procedure involved two sessions, with 2,289 grafts in the first and 2,571 in the second, achieving complete coverage with ~35 FU/cm² and no complications. The patient was highly satisfied with the natural aesthetic outcome. This case, the first reported in China and the third globally, demonstrates that staged FUE transplantation on free flaps is a viable, minimally invasive solution for post-oncologic alopecia, expanding reconstructive options for patients.