Controlled hypotension induced during rhinoplasty and risk for postoperative hair loss

There is evidence of the close association between controlled hypotension induced during rhinoplasty surgery to prevent bleeding and hair loss after surgery. We aimed to assess the effect of controlled hypotension on hair loss in patients undergoing rhinoplasty.

The current prospective cohort study was conducted on 170 patients scheduled for rhinoplasty that referred to Al-Zahra hospital in Isfahan, Iran in 2020. As the control group, a sex and age-matched group of women referred to the hospital for breast prostheses was selected. To determine the severity of hair loss after surgery, a score for determining the severity of hair loss called SALT was used and the patients were followed-up for six months.

In total, 85 patients undergoing rhinoplasty in a controlled hypotensive state and 85 patients scheduled for breast prosthesis as the control were included in our assessment. After one month of operation, the group undergoing rhinoplasty in the controlled hypotensive condition experienced a higher prevalence rate of hair loss as compared to the control group. However, after a 6-month follow-up, we showed no difference in the hair density in the vortex area between the case and control groups. According to multivariable logistic regression modeling, controlled hypotension remained the main determinant for postoperative hair loss (RR = 4.620, P = 0.014). Despite the beneficial effects of controlled hypotension during rhinoplasty on reducing the risk of bleeding, this condition may lead to temporary postoperative hair loss.