I read that some doctors have suggested that Botox can help in the reduction of scar widening following a hair transplant. If this is true, why don’t doctors use this routinely?
Botox (Botulinum Toxin Type A) works by paralyzing muscles. If the widened scar was the result of muscle pull, then the idea would make sense. Let’s take a look at the anatomy:
In the area below where the donor area is taken out lies a muscle that is called the occipitalis muscle. It has the unique character of not attaching to any tendons or bones, and is a vestigial muscle that has no real function in humans. It does not connect to the scar, so paralyzing this muscle will have no benefit. The only other muscle in the vicinity of the donor area is the occipital head of the trapezius muscle, which inserts on the occipital bone on the skull and its purpose is to allow you to lift your head and hold it upright. Paralyzing this muscle might just give you a head drop, which would not be a good idea. I am not sure what else might be paralyzed to help heal the donor wounds.
In conclusion, it does not makes sense to use Botox for scar stretching prevention.