Hair Transplant Scar - Always Big and Ugly?

i've read a bunch of hair transplant forums that talk about awful & ugly scars from hair replacement surgery. Is getting a bad scar a real risk or is it really depend on surgery method and the surgeon doing the work?

Doctor Answers (8)

Scars and Hair Transplant

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There are two types of transplant methods.  The original method is referred to as the strip method.  It will always create a linear scar at the back of the head.  The appearance of that scar does depend on the surgeon and what sutures/staples were used to close the scalp.  The newer technique is FUE (follicular unit extraction).  With this procedure, hair follicles are removed individually over a larger surface area, preventing large scars from forming.


Austin Plastic Surgeon
4.5 out of 5 stars 11 reviews

Risk of scarring after Hair Transplant

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The result of  the scar is totally dependent on the surgeon's skill.  If the donor hair site is closed properly with minimal tension, usually the scar is minimal.  Unfortunately, the rare unsatisfactory result gets all the press and the patients with excellent scars tend not to discuss it.

Jack Fisher, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 3 reviews

Hair Transplant Donor Site Scar

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Not true at all- as you can see if you go through some website photo galleries. However, there is always a risk of a widened scar, but on average, donor site scars typically heal up 1 to 2 mm wide. There is a second hair transplant technique, called follicular unit extraction (FUE) that avoids altogether a linear donor site scar.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

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Hair transplant donor scars are usually excellent

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Hair transplant donor site scars (where the grafts are harvested) are typically excellent.  By this I mean that they are usually thin, often difficult to find and can almost always be easily hidden completely by your hair unless you shave your head or do a buzz cut.

It is more likely to have a bit of a wider scar in repeat transplantation and it is always possible that a complication like infection can contribute to a wider scar, but even in those situations, existing hair can still easily camouflage things in most cases  unless your hair is cut very short.

If you are planning on shaving your head or having a "buzz cut" then you should certainly consider this risk more seriously and discuss with your doctor about either not doing the transplant or considering follicular unit extraction.

Daniel Berg, MD
Seattle Dermatologic Surgeon

Transplant scars

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hair transplant scars can be very thin and hard to find . Many patients have successful hair transplants and no visible donor sight scar. I personally have had 3500 transplants and it takes great effort for anyone to find a donor sight scar on my scalp. There are some individuals who have a tendency towards hypertrophic scarring and actual keloid formation. If you have a history of these problems you would best do an FUE proceedure and avoid a donor sight scar

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Thin scars after hair transplant

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The donor scar if placed appropriately and closed in the appropriate manner can produce a very fine scar. Technique is everything. Visit with several hair transplant specialist and discuss and review their results.

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Wide donor scars are not typical, but are a real risk

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Wide donor scars are more common with multiple procedures and certain scalp characteristics. A consultation with a hair transplant surgeon can reveal what risks pertain to you. I use a trichophytic closure on patients planning to undergo only one session, and the donor scar is usually undetectable.

Kevin Ende, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Donor Closure for Hair Transplant: Careful Closure Plus Trichophytic for Maximal Benefits

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It is 95% the surgeon's work and 5% the patient's healing that defines success. Let me refine that comment:

1. No matter if the surgeon is careful with donor harvest and closure, the patient may have some small widening like a mm or at most 2 mm.

2. If the patient has had multiple multiple procedures, especially following other surgeon's work, the blood supply may be worse and the scar may not be as perfect but very wide is doubtful.

3. can you shave your head? most likely not. the fine line may be visible with a shaved head or very closely cropped hair. hair an inch or more should cover the incision well.

4. if you are african, you have also a risk of a keloid. if you bar keloids and having had multiple harvests from not the best surgeons, you should heal well.

how do i minimize the chance of an unfavorable scar?:

1. i use very high tumescence so that i minimize transection or damage to the donor hair. i also use tumescence to push the hair follicles far away from the underlying blood supply.

2. i do a slow harvest so that i don't damage the blood supply below, which the tumescence helps tremendously.

3. i only remove just about 2 mm below the follicular bulb leaving fat down so that the wound closes well.

4. i clean the wound with loupes so that there are no hair fragments before closing.

5. i perform a trichophytic closure when indicated to let the hairs grow through the scar that makes the incision less visible in most cases.

6. i close with a non-reactive suture at mid-follicular depth so that hairs are not ensnared.

here is a video showing one of my closures. i have tons of these videos on my website plus videos and text explaining my approach more indepth at www.hairtx.com.

best,

sml

Samuel Lam, MD
Dallas Facial Plastic Surgeon
4.5 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.