Postoperative alopecia in a woman after a lengthy plastic surgical procedure

Pressure-induced alopecia was reported in the past. We observed postoperative alopecia (presumably pressure-induced) after a plastic surgical procedure of a long duration. Shortly after the operation, the patient noted swelling and exudation of the scalp near the vertex. The symptoms abated in the course of a week. The hair loss occurred quite rapidly (within 48 hours) in the area of the previous symptoms on the sixth postoperative day. Irregular regrowth of short hairs was first noted after 6 weeks. The patient's last examination 10 weeks after the operation revealed a 4 x 4 cm area of baldness with few scattered hairs 5 to 6 mm in length. The cause is considered to be pressure-induced ischemia based on the following: preceding period of deep unconsciousness (the operation) and natural history of the disease.