Can scar revision with artas or neograft conceal a hair transplant donor strip scar?
Doctor Answers 14
Can a linear donor scar from a hair transplant be concealed with FUE?
For scar camouflage, options are:
1) scar removal and revision by an highly experienced scalp surgeon if indicated, with or without tissue expansion
2) FUE into the scar; typically 2 or more small sessions will be required
3) following FUE the scar to provide some texture, the skin of the scar, which is typically lighter than the surrounding skin of the scalp, can be tattooed with a specialized scalp micropigmentation procedure (SMP), which are temporary tattoos that will need to be revised about once every 2 years or so.
However, as you mentioned that you'd like to "shave my head" following a linear strip procedure and have the donor scar be "undetectable", this is not likely ever to happen. This is definitely something your hair restoration surgeon should have disclosed to you prior to you signing up for surgery. These techniques can help to decrease the visibility of the scar, allowing for shorter hair styles, but following a linear procedure, is it typically not possible to shave your head without the scar being at least a little bit noticeable, despite the techniques mentioned above. All scars are, by definition, permanent, as your physician should have mentioned to you as well.
Options for Scar Revision
All of these options will help minimize the scar. It is unrealistic to think it will become "undetectable" with any repair procedure if the head is shaved.
Yes it can make it much better
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Transplanting into Scars
1. Follicular units can be put into the scar to try to camouflage the appearance of the scar. This is essentially a small hair transplant done by FUE into the scar.
2. The scar can be tattooed using scalp micro pigmentation (SMP).
FUT Scar Options
While it is possible to improve a FUT scar with FUE grafts, there are some special considerations to keep in mind:
- Grafting into a scar can lead to uncertain results. Some dense scars lack blood supply and will not support a graft to grow. The circulation can be tested by your hair restoration surgeon by numbing up a small area of the scar and seeing if sterile pin pricks will cause bleeding. I also like to inject scars I treat with a steroid solution to soften them up to help them support the new hairs.
- Is it worth using FUE grafts? Until cloning techniques become available and we no longer are limited to our current supply/demand considerations and restrictions of hair restoration procedures, each graft you use to fill a scar is a graft that you cannot use elsewhere. Some FUT scars are quite large and some guys have multiple scars, so to place hairs into all the scars can easily eat up quite a few grafts. While this may be a good option if the scarring is your main concern, however if you have thinning elsewhere, you may want to use the limited donor hairs you have left to address that. There is no right or wrong answer here.
- FUE placing is not the only option. As some of my colleagues have correctly pointed out, SMP is often a good option for FUT scar masking. It's important you go to a an experienced SMP artist who uses proper SMP pigment. SMP is much less expensive than FUE revision and does not limit an FUE revision later if still desired.
Scar Revision Surgery
Follicular Unit Extraction (FUE) is an excellent technique to reduce the visibility of and conceal a donor linear strip scar. FUE devices like ARTAS and NeoGraft do not contribute to cosmetic outcome of any hair surgery. Many patients are unaware that a FUE device does not make a hair restoration procedure better than another device. There are other great FUE harvesting devices that may be better then the two mentioned. It is always the physician’s aesthetic eye, skill, and experience; and not a FUE device that ultimately determines the patient’s cosmetic outcome.
Performing hair restoration surgery requires proper training and knowledge. Many surgeons perform hair surgery without proper training, or they don’t perform the surgery and illegally delegate the procedure to hair technicians. This is a felony. A board certified hair restoration surgeon is the ideal and ethical choice to perform hair transplant surgery and they abide by high ethical standards and best practices. Board certified physicians from the American Board of Hair Restoration Surgery have passed a written and oral exam demonstrating their knowledge and expertise in performing hair surgery.
I use a punch grafting technique to excise as much scar as I can. I also combine this with Scalp Micropiogmentation (SMP). A hand held motorized FUE device and a 0.8 mm circular round sharp punch are used to punch into the scar and remove scar tissue. The scar tissue is removed and FUE grafts are then placed into the created punch wounds. This technique provides a natural appearance and better coverage may be achieved. The procedure may need to be retreated depending upon graft survival.
Hiding the FUT scar with FUE
You can definite minimize the scar by adding grafts into the scar. With that said, you should not expect 100% of the graft to grow in the scar as the blood supply is limited in scar tissue. You may want to consider SMP to minimize or disguise the scar. Many of my patient are happy with the result!
Considerations in Fixing Scars Using FUE
Not completely You will Always See the Scar
Think about it. You are having a hair transplant to the scar. Then you are SHAVING it. This is not going to hide your scar. You will still have the scar and the transplanted hair may even make your scar look worse as the transplanted hair will not completely match your surrounding hairs in texture and hair direction. Furthermore, your FUE scar will now be an issue with tiny white dots (when you shave your head).
FUE to the transplanted scar can work if you keep your hair long, but it will not work if you shave your head.
Even Scalp MicroPigmentation (SMP) which I perform at my clinic will have limitations. You can see all my before after photos on this site and my website but YOU WILL STILL SEE THE SCAR in certain lighting and angles. No treatment will make the scar undetectable. The goal is to make the scar less detectable and not noticeable to the general public at a casual glance.
This is why you need to see a doctor for a realistic assessment.
Scaring after FUE
So it is very important to chose an experienced doctor and discuss the options in detail to make sure it meets your concerns and expectations.
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.