Concerned with large scars after FUE transplant 36 days post-op. Any ideas why this is happening? (Photo)

Question

FUE 36 days ago. Hair in donor area is growing back but there are circular areas ranging in sizes from dime to nickel that are not growing any hair back. There were major scabs in these areas after surgery that eventually fell off w/ time and washing. The reason I did FUE vs FUT was to avoid scarring. These scars are bigger than the FUT scars I've seen. I've never had keloid in my life so I'm not prone to that type of scarring. mixed race African American/White 44 yrs old Any ideas why this is happening?

David Deutsch, MD · Answer

It is difficult to make a diagnosis based on a photo only and without knowing the number of grafts harvested but it appears as if that area was overharvested.Alopecia areata and early keloid are other possibilities but unlikely.I would recommend having an evaluation by your surgeon and consider applying Minoxidil (Rogaine) to the affected area.

Levent Acar, MD · Answer

healing on the donor area takes sometimes more time (body support,the size of punches,the type of punch (sharp or not ) for extraxt the hair follicules,and of course the experience.

Dont worry it will looks much better after 2-3 month period.İts early to say if its over harvesting or not!Update your pictures.

Jae Pak, MD · Answer

FUE leaving no scar It is a misconception on the Internet.  FUE can leave massive depleted donor scar. It is best to follow your doctor if you are having issues after surgery.

Sean Behnam, MD · Answer

I would talk to your doctor. This could be shock loss, which would recover on its own within a few more months. Could also be overharvesting, which will not recover on its own but you could mitigate with scalp micropigmentation or other methods. It could also be something else entirely, its hard to make an accurate guess over the internet.

Parsa Mohebi, MD, FISHRS · Answer

The circular areas may represent patches of overharvesting. If a hair transplant surgeon extracts more grafts from the donor area than should be removed the donor areas may appear patchy. Secondly, the patchy appearance my represent shock loss. At times with over harvesting or even with regular harvesting in large areas of scalp, other hair in the area may get stressed and enter a telogen phase. This is called shock loss, fortunately after a period of 4-8 weeks the fallen hair will grow back.

I would give it more time to see if it fills in as well as follow up with your surgeon.

I would give it more time to see if it fills in as well as follow up with your surgeon.

Justin Misko, MD · Answer

An FUE does leave a scar.  The tools used are simply smaller and therefore leave pinpoint, tiny scars that aren't usually visible unless the head is shaved to skin.  I recommend you visit with the physician that performed your procedure.  Best case, You may simply be experiencing shock loss around the harvested grafts, in which case the hair should come back.  It will take some time.  However visiting with you MD in person will surely rule out other diagnosis.

Ilhan Serdaroglu, MD · Answer

That is not scarring or hypertrophic scar or keloid .. no need to worry about it. But what I  see that an over harvested donor area/transient alopecia ( we hope). İf the surgeon try to get more number of grafts than in  the first weeks of surgery you may notice that kind of alopecia areas on your donor site . But it will be resolves in 3 months and new hair regrow again in donor site . So it is better to wait 2 months more before make a judgement about scar on donor site !

Ryan Welter, MD · Answer

It is difficult to tell from the photos, but it looks like you may have been over harvested in the donor area which has resulted in excessive scarring.  If so, I would STRONGLY recommend fat grafting and cellular to stimulate healing right away.   I have seen great success with this process in other patients.  It is also possible that you have underlying alopecia areata or another form of alopecia.  It is impossible to tell from your photos, so see your doctor in follow up and find out.

Rae Lynne Kinler, MD · Answer

you should get the area evaluated by the surgeon who did your transplant procedure. It does appear that you have developed some areas of alopecia in the donor area, which can sometimes be seen after FUE procedures. Those areas grow back with time, obviously not where the individual hairs were taken, but the areas around that. You should try minoxidil 5% twice a day after you see your surgeon, it can help.

Anthony Bared, MD, FACS · Answer

It is best to return to your surgeon to have them evaluate and examine the area.  However, it appears you have developed areas of focal alopecia from your FUE procedure.  Visit with your surgeon but in the meantime you can try minoxidil to the area and massaging of the area twice a day.

Concerned with large scars after FUE transplant 36 days post-op. Any ideas why this is happening? (Photo)

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