Extensive Traction Alopecia Attributable to Ponytail Hairstyle and Its Treatment with Hair Transplantation

In 2005, a case was reported of a 23-year-old woman who developed extensive traction alopecia in the temporal areas due to the tensile forces from her tight ponytail hairstyle, which she had worn for 5 years. The alopecic areas measured 10 × 7 cm on the right side and 9 × 8 cm on the left side. Hair transplantation was chosen as the treatment method, and a single session was conducted where 1,600 grafts, including micrografts and minigrafts, were transplanted. The procedure took 4 hours under local anesthesia and resulted in a 90% to 95% survival rate of the transplanted hair at the 1-year follow-up, with the patient being satisfied with the outcome and declining a second session. The case highlighted the effectiveness of hair transplantation using micrografts and minigrafts for the aesthetic reconstruction of irreversible traction alopecia, emphasizing the importance of angling grafts naturally, proper selection, and creating a natural appearance and density. The document also discussed the need for realistic patient expectations and the potential for more than one session to achieve a cosmetically acceptable result.