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All Scarring related posts

 

I (Dr. Rassman) have had a total of 2200 grafts in three strip surgeries over the past 20 years, the last one being 6 months ago. If you were to look at my single linear scar, most people (even with a comb in their hand looking for it) can’t locate it. My strip scar is certainly far less significant than the mottled scars from follicular unit extraction (FUE) in this patient below. To be fair, if the patient had let his hair grow slightly longer, the scars would be less visible.

This is not my FUE patient, but I was told that he had 2500 grafts extracted in one session four years ago (and saw extremely poor growth). FUE scars like these are very common, and as most people get FUE procedures because they want the option of cutting their hair very short without a linear scar, many of them can’t do so when these dot scars are so detectable. Click the photo to enlarge:

 

I grant that some patients will have visible scarring from a traditional strip procedure, but now with Scalp Micropigmentation (SMP) the linear scars can be made undetectable. The same treatment can make these ugly FUE scars undetectable.

My point for this post is that scarring occurs with all types of surgery. Scarring should not be the motivator for the choice of FUE over strip surgery. Considering the cost differential between strip and FUE surgery, this is just part of the calculation each person must do in making the decision between strip and FUE surgeries.

Tags: follicular unit extraction, photo, hair transplant, scarring

 

Can you stretch the donor scar 6 or 7 months after a FUT?

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Donor scars are considered stable after about 6 months following strip surgery. Like all rules, there are exceptions, but this is a general observation made from my experience.

Tags: hair transplant, surgery, scarring

 

My question is, can a hair transplant be successful on an scar that has no hair follicles? I got a 2 inch area on my head that was literally ripped from the top of my skull in a machinery accident. The top of my skull was literally exposed. Skin and tissue has grown back, but the problem is the hair follicles did not. So I now have about a 2 inch radius area on my head that is bald, and on me it looks really strange and dumb since I ain’t balding in any way. I have a full head of hair and it’s long hair even, except that one area that is just a bare bald spot now.

So can a hair transplant work on an area with no hair follicles?

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There are many types of solutions for this type of problem, but I would need to know more about your specific issue before suggesting a transplant as the solution. As a start, send me good quality pictures and I will try to assess what the problem is (please reference this post when sending). The photos alone may not be enough though, and possibly an examination would be critical.

Transplanted hairs can grow into scars, but I don’t know enough about your case — when the injury occurred, your age, if you have any genetic hair loss (or family history), etc. Until I make an assessment, I couldn’t say whether a hair transplant would be the best path for you to take.

Tags: scarring, accident, hair transplant

 

Hi.

I cut the back of my head quite badly a few weeks back. I had stitches put in and now they have been removed. The cut is healing well but the problem is that there are 2 cuts with a gap in between. Currently I have a large-ish bald patch covering the whole area.

My questions are:

A) Will the area between the 2 scars ever grow back the hair

B) Is there anything I can do to encourage the hair to regrow.

Thanks.

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Without seeing you, I can not tell you the answers to your question. The scalp frequently scars and the scar can widen. If that is the case, you may end up with a bald area where the scar forms.

Sometimes there is an area around the scar which has temporary hair loss. If that happens, it usually regrows in about 6 months. Best to see a doctor who knows about hair for an examination if you’re concerned.

Tags: scarring, scar, hairloss, hair loss

 

Hello, thank you Dr. Rassman and Dr. Pak, for maintaining this fantastic site.

You’ve explained that once transplant surgery has been performed, a patient cannot shave his head without scarring (either a FUT line or FUE dots) being visible.

My question is: If someone had a thin scar from FUT, would it really look so terrible if they shaved their head in the future (if Finasteride’s effectiveness waned and hair cloning treatments fail to emerge, and they become an advanced Norwood 6/7)?

Obviously, there are pictures of strip scars online, but it’s difficult to imagine what they would look like on a shaved head. Do you know of any patients who have done this?

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You can look at how bad strip scars may look on our ScalpMicropigment.com website (see some of the before photos of scalp scars). Unless you shave your head, even the wider scar is not visible with long hair. My scar, after three strip surgeries, can barely be seen; however, if I decided to shave my head, everyone would see the 1-2mm scar I have. Now unless you are wanting to completely shave your head, you should not have to worry about the strip scar.

In general, you can keep your hair cut as short with a number 2 to 3 guard on hair clippers without the scar being noticeable in most cases.

Tags: hairloss, hair loss, hair transplant, scarring, scar

 

Hi Dr. Rassman,
I am still waiting to do my first surgery with you in the LA office. An off-topic question today:

I have a 0.7cm scar in my forehead that resulted from a home accident by opening a door. Do you know of good doctors, laser surgery or other means, in the Los Angeles area who can remove such a scar?

I am thinking to do it along with my first strip surgery on a trip to California. All the best doctor.

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There is no such product that exists that removes scars. Some scars can be modified in the hands of a good plastic surgeon. There may be ways to minimize the appearance of scars, but this is very specialized to the individual and the type of scar.

We will look at you when you come in and we’ll be able to give you an opinion then.

Tags: scarring, scar, scalp scar

 

I have a scar from a previous brain surgery. I went to hair transplant surgeon and he estimated that it would take about 300 to 400 grafts to adequately cover the scar.

However, I am 18, and I’m already experiencing balding. My dad (and most of my male relatives on his side) are diffuse NW6s, so I’ll probably be heading in that direction. Furthermore, I have straight black hair and brown skin, with a lower-than-average density.

Would it be smart to put off the filling in of the scar?

Basically, I don’t want to unnecessarily deplete my donor supply.

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At NHI, we have good experience in addressing brain surgery / craniotomy scars with hair transplants. In general, patients usually need more than one surgery to be adequately satisfied, so be prepared.

If you are balding to a Norwood class 5 or 6 it may not be advisable to fill in the scar unless you plan on having a full hair transplant surgery and have adequate supplies of donor hair.

Tags: scarring, brain surgery, hair transplant, hairloss, hair loss

 

Is it possible to smooth out just a small area where old hairline used to be that was damaged from surgically removing old plugs? I am a 45 year old male who had a hair transplant in 1984. I had one session (47 plugs, about 8-10 hairs each plug) around the frontal-hairline part. I did not like it as the result was not what I had expected so did not go back for another one.

In 1988 I had all of the plugs surgically removed. For the most part it looks ok except for the right side above the right temple but close to the forehead. In certain lighting you can see the scarring and tell that it was where the old transplant hairline was as they fall in or pitted is the word used to describe it (where 5 plugs were removed on this side). So instead of having cobblestones I now have the opposite.

I would be interested in seeing if just this area can be improved by either laser therapy to smooth it out or to do a surgical scar repair and pull the skin tighter on these 5 only or any other recommendation? If it improved just 50% it would be a great improvement. I would not be interested in another hair transplant. I keep my hair long enough so the donor area is ok as is.

Also, would massaging this area help smooth it out or make it worse? Thank you and your site is amazing and very much appreciated.

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In general, scalp scars (or any scars really) are very difficult to treat. If there is something that can be done, it would involve understanding that the outcome will not be perfect.

You are asking a very specific question for a case that is likely quite unique. You would need to visit a doctor one-on-one and have him/her examine you for their assessment and recommendations. Since you indicated that you’re in New York, you could check with Dr. Robert Bernstein.

Tags: scarring, hair plugs, repair, hairloss, hair loss, hair transplant

 

Hi,

I had 3050 grafts taken from my donor hair to create a hairline and add density to frontal area. so far so good, but 5 weeks after surgery and my first hair cut ( just blending in etc ) i have noticed that the donor hair area does not match up and its very obvious that i have had a procedure! now im worried that too many grafts were taken from certain areas at the back and It looks like Im going to have a constant “horse-shoe” shape on the back of my head! please tell me this is normal and it will grow and blend in to the rest of my hair

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Your doctor should have described what your scar will look like and how wide it may be. Many doctors and patients forget to address the potential scarring from hair transplant surgery. Some believe that only a strip procedure can leave a visible scar, but even a 3000 FUE surgery will leave a significant series of scars (3000+ dots).

It’s also possible that perhaps you just got your hair cut too short, and that is why your scar is visible.

Tags: hair transplant, scarring, scar

 

Dear Dr Rassman, please excuse my question if it is stupid. I’m not medically trained!

What is normally discussed is the movement of hair follicles *from* the donor site *to* the recipient site. And this inevitably leaves some form of scarring in the donor area. But is it technically possible (in FUE) to also implant skin *from* the recipient area *to* the donor area, in such a manner to “eliminate” scarring? i.e. for every follicle the surgeon would swap tissues A and B, where A would be the tissue originally at the recipient site, and B the tissue originally at the donor site.

I’m sure this would be more costly for the patient, buy I’m wondering: has this ever been tested? And would it eliminate scarring?

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A number of years ago, a well-known doctor preached that small punch extractions of scars would produce “mini-scalp reductions”. It never worked. This sounds like what you are asking about, and if one removes scar from a scarred area, you just get scar to replace it. Not such a good idea.

By the way, there are no stupid questions. Your question reflects an inquiring mind.

Tags: fue, scarring, surgery, hair transplant

 

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