Can scar revision with artas or neograft conceal a hair transplant donor strip scar?

Question

I would like to able to shave my head and the donor scar be undetectable. If not are there any other options? Please help!!

Amir Yazdan, MD · Answer

There are a few options to repair a donor strip scar.  Sometimes the scars can be revised depending on how bad your scar is.  Grafts can also be transplanted into the scar to minimize it's appearance.  We also do micro pigmentation (tattooing) into the scar to help hide it.  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.

Sanusi Umar, MD · Answer

These types of technologies help make the FUE hair transplant extraction process easier for the surgeon. Yes they can be used. But they are not necessary for the goal of concealing linear strip scars. It is important that the grafts are well harvested, chosen carefully and unharmed to produce successful growth. They are inserted into the strip scar tissue so that it is no longer visible. The follicles need to be carefully selected and free from surgical injuries and other forces that can damage the graft such as air drying. However, if a patient’s head donor supply has been depleted for further surgery, Artas and Neograft cannot be used to extract body hair follicles. Here is an example of a patient here at the Dr. U Hair Clinic who required beard hair grafts to conceal multiple strip scars and restore his overall coverage.

Anil R. Shah, MD · Answer

One of the  criticisms of the strip method is it leaves a permanent scar.  All scars are permanent and can be attempted to be lessened in appearance.  Some techniques to decrease appearance of scars from the strip method:
Steroid injection- can thin a scar and make it more likely to accept hair grafts
Direct excision- best for thick scars and unsightly scars
Tissue expansion and direct excision- Used for rare cases with multiple harvest and especially poor scars
FUE placement- Here only the best of the best grafts will survive and ARTAS for patients with donor hairs still available as well as body hair can be options
Scalp Micropigmentation-  An increasingly valuable tool in hair transplantation to help hide scars and improve hair results

Matthew Richardson, MD · Answer

A strip harvest scar can definitely be improved by implanting grafts into the scar after FUE extraction. A widened scar can also sometimes be improved by re-excision, depending on the surrounding hair and scalp characteristics.
Unfortunately, it is probably impossible to make the scar go away completely to the point where it would not be visible with a shaved head. Scalp micropigmentation could be helpful to disguise the scar as well. Neograft vs ARTAS really doesn't impact the improvement of the scar itself as both are likely to give good results.
All the best,

Gregory Turowski, MD, PhD, FACS · Answer

FUE is the best option to option to obtain the grafts to hide a strip donor scar. It definitely will help and possibly erase the stigmata. You need an experienced FUE surgeon to deal with that properly

Jae Pak, MD · Answer

FUE to strip scar will help disguise your scar. But it will NEVER allow you to shave your head so your scar is undetectable.  Actually it will make it look WORSE.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.

Louis M. Iorio, MD · Answer

There are some options available to you to minimize the appearance of the scar if the head is shaved, but please be advised that none will eliminate it completely. 
  
A scar revision can be performed to excise the scar and re-align the follicles on either side of it. Alternatively, an FUE procedure may be the best option for camouflaging a wide strip donor scar. Transplanting hair into the scar will help to disguise its appearance when you wear your hair shorter, but again, it may still be detectable with a shaved head. Another option would be tattooing the scar using scalp micro pigmentation, which would help to camouflage its appearance. 
  
My recommendation is to consult with a board certified plastic surgeon in your area that has the necessary skills and experience in hair transplant surgery that can discuss with you all your options and the best course of action.

Mark Bishara, MD, FISHRS · Answer

Most young male patients can scar well. Too well sometimes bc the body's ability to lay down scar is robust at an early age. If the scar has a blood supply it can be transplanted. WE simple poke it with a needle and if it bleeds it will succeed. You must make sure the angle is acute enough to help hide the scar- common problem. Sometimes the best results come from scalp micropigmention especially if you wish to shave the head or wear the hair short.

Dr Mark A Bishara, MD, FISHRS
Paragon Hair Clinics, DFW, Texas

Dr Mark A Bishara, MD, FISHRS
Paragon Hair Clinics, DFW, Texas

Justin Rome, MD · Answer

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.

Ken Williams, DO, FISHRS · Answer

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.

Can scar revision with artas or neograft conceal a hair transplant donor strip scar?

Answers (20)

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