FUT hair transplant has left bald spots below the incision. What can I do? (Photo)

Question

After my 3rd Hair Transplant but my 1st FUT procedure I have been left with bald spots below the strip on both sides of my head. One of them is almost the size of my thumb. What can I do about this? Do I have to have another procedure just to fill them in or is there a trick to get the hair to grow back?

Jae Pak, MD · Answer

FUE or FUT strip surgery can sometimes cause temporary shock hair loss in the donor area.  It may take up to one year before the hair grows back.  Follow up with your doctor.

Hannah Vargas, MD · Answer

It depends on how long its been since surgery, sometimes hair can go into "shock" and fall out around the strip site.    This is usually temporary, however, if your more than 1 year post surgery than you will need to talk to your Dr. about options to revise the scar or transplant the area. Most FUT scars are very thin and the scar is not noticeable unless you shave your head. Good luck!

Levent Acar, MD · Answer

It depends on how long the surgery has taken place. Correction hairtransplant with FUE or SMP can solve your problem.

Greg Williams, FRCS (Plast) · Answer

Done by a skilled surgeon, Strip FUT donor wounds should heal with a narrow scar. Poor surgical technique can lead to delayed healing from a variety of causes including tissue necrosis. Occasionally shock loss (anagen effluvium) can occur is small or extensive areas. This usually starts to recover with hair growth after 3-4 months. If no hair growth occurs then scar revision or hair transplanted into the area are treatment options. Scalp micropigmentation tattooing is unlikely to give an acceptable aesthetic result given the hair colour. Wearing the hair longer will help to cover the defect.

Muhammad Jawad, MD · Answer

Shock loss is common in hair transplant specially over donor area...what we recommnd in our practice to also some gentle massage few times a day and apply 5% minoxidil twice a day for 3 to 4 months over the shock loss area.....Very good prognosis....
Unfortunately in few cases one might need scalp micropigmentation

Karl Hekimian, MD · Answer

You don't say how long ago your FUT procedure was done.  Hair loss around an FUT incision is often temporary.  If it's been only a few weeks or months best to wait and see how things go.  If it's been six months or more and no sign of regrowth, options include scar revision (removal of the hairless area), scalp micropigmentation or a small FUE procedure to put follicles into the scar.

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You describe this is your third transplant, but your first FUT. You’re concerned about bald spots in the donor area about the size of your thumb. You’re asking if there is a way to help this area by transplanting more hair, or if there is a trick to grow the hairs back.
I can share with you my perspective in a situation like yours. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a system we developed that was derived out of our experience with hair transplant. We can help patients from around the world, both men and women to non-surgically address hair thinning with technology that has become a category of regenerative medicine technology. I can share with you a perspective to give you an understanding of what you’re dealing with those bald areas. 
Just to step back to what we were trying to achieve with hair transplant that ultimately led to Hair Regeneration. We were doing mostly FUT or strip surgery, with the concerns of getting good donor area healing, trying to minimize the widening of the scar to expedite the healing, maximizing hair regrowth, and wanted grafts to heal better. Using Acellular matrix and platelet-rich plasma (PRP), we were able to achieve better healing of the donor area. 
In a situation like yours where you’ve had two prior hair transplants which were mostly likely FUE or follicular unit extraction transplants, your grafts had to be harvested very far and wide in the donor area. When you had a second FUE transplant, those dots become closer together, which means the density was diminished. I understand the strategic thinking which makes a lot of sense that if you had an additional surgery, then instead of trying to do another FUE, you’ve gotten an FUT or strip surgery because the density was limited.
For the question about growing the hair back, it is unlikely for any hair to grow back because the hairs have been transplanted. When you do hair transplant surgery, you’re taking the whole follicular unit: the hair follicle with its adjoining oil glands, sweat glands, fat, and everything that goes with the hair. In a lot of ways, I describe it as a skin graft with hair. You’re moving the whole hair unit, so the hair cannot grow back in the area. 
Often, when we see our patients who are not coming in for primarily Hair Regeneration, meaning men and women whose hair is thinning, we also see patients from around the world who have had hair transplant. What we have learned, and from our experience is we can expedite the healing process of the hair transplant so the grafts grow better, and grow sooner. This is empiric data that’s vulnerable to criticism, but from experience doing transplants for so many years, and seeing how people’s transplant do with our treatment, I think our data has validity in helping our patients heal better. Sometimes, the patient also asks us to do the injection into their donor area, and since they’re coming from all over the world, we don't get to necessarily follow-up with them, but I still think once a hair is gone, the hair is gone. 
You have to try to figure out, and you can certainly work with your doctor on this, is for that area to improve coverage, my opinion is if you’re going to transplant hair, where exactly are you going to transplant from, and how much hair can you really transplant? If you were to transplant that hair, would you not prefer to have it transplanted to an area that’s more visible, which is in the front? 
That said, I have discussed with my patients the opportunity to consider scalp micropigmentation. Although it’s not a perfect solution, it might help you in camouflaging. Often, just strategic hairstyling can help, but it is a trade-off, and it is unfortunately the reality of doing as much transplantation as one can. So I also advocate for even patients who have gotten several transplants to be proactive to slow down the progression of their hair thinning. I don’t see the top of your head, so I don't know the degree of hair loss you have. When we do our evaluations, we look at our patients who have transplants with a microscope, and very often not only do we see transplanted hairs, but we see miniaturized native hairs. 
We then employ a treatment plan, and we employ Hair Regeneration technology. This is a combination of Acellular matrix and platelet-rich plasma (PRP). We are able to stimulate the area to further enhance the coverage. Hair Regeneration is able to reactivate hairs that are currently not growing. That’s the nature or hair thinning is that a large percentage of hairs enter a prolonged resting stage. We’re able to thicken thinning hairs, and prolong the longevity of the hair growth cycle. We also observe that transplanted hairs can also have improvement in their quality. I think it’s consistent with the reality that multiple transplantations create a lot of scarring. Since we’re dealing with regenerative medical technology, it stands to reason that the environment of where the transplanted hairs are in, there’s scar tissue and vascular compromise, so this treatment results in improvement of the transplanted hair as well.
For your specific question about the back, there are very few options, but since you’ve been so committed to your management you should certainly explore those. I would ask you to strongly consider a strategy to help maximize the longevity of scalp coverage with whatever tools are currently available. I always explain to all of our patients, regardless of the number of transplants you do, hair loss is progressive, and the goal is to maximize coverage, and maintain a certain look for as long as possible. Learn about your options in pharmaceutical and regenerative technology, and see what you can do about the other options I discussed to camouflage the donor area. I hope that was helpful, I wish you the best of luck, and thank you for your question.

William Rassman, MD (retired) · Answer

Hair loss after a strip surgery does happen and it often reverses over the months of recovery. If it does not, the best treatment for it is either a scar revision or scalp micropigmentation

FUT hair transplant has left bald spots below the incision. What can I do? (Photo)

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