HT Scar advice, desperately needed please! (Photo)

Question

Hi,  Stupidly 2 years ago, I got a HT which left me with a scar, ear to ear and live with it every day, either by wearing hats or bandanas as the hair did not grow.  Moving on, I have thought about getting MHT, tattooing over the scar, but need to get rid of the pinky/brown areas around the scar and was wondering if there was anything anyone suggested to clear, soften this please? Picture attached.  I have seen reports on a new treatment called Recell, but some say a chemical peel perhaps. So many things, not knowing who to trust no more.  Would be good if someone could shed some light please.  Thank you  Riz

Jae Pak, MD · Answer

Redness on the scar will not go away with tattoo or MHT or SMP or surgery.  Chemical peels or Recell will likely not work.

Jeffrey B. Wise, MD, FACS · Answer

There is a guaranteed linear scar following an FUT-type hair transplant.  In some cases, it can become widened and unsightly, making in almost impossible for the patient to wear their hair short.  This is one of the many reasons for the increasingly popular FUE or NeoGraft procedures, and the reason that FUE is overwhelmingly favored in my practice.   We commonly improve upon these scars by performing FUE or NeoGrafting to the scars to fill in the bare scar tissue.   Recovery is generally short with minimal  post-procedure pain.

Renita (Lourdhurajan) Rajan, MD, DNB · Answer

You could consider doing an FUE on the scar. This works reasonably well, though the graft take may be less than optimal in the scarred area.Good luck!

Grant Stevens, MD · Answer

Sorry to hear about your scar problems. One of the main reasons that Neograft has become so popular for patients desiring hair transplantation procedures is the fact that there is no chance of an unsightly linear scar or a linear scar devoid of hair. Your options range from 1) doing nothing to the scar itself but growing the hair in such a manner that it will disguise it 2) tattooing of the scar area with individual tattooed 'hair follicles' or small bits of pigment that resemble hair 3) surgical scar revision 4) Neograft/FUE procedure to implant hair into the scarred area of hair loss (after evaluation to determine if it appears there is adequate circulation to support hair follicle growth).  It would be best to consult with a surgeon that can offer and address all of these options for you.  Good luck

Roy A. David, MD · Answer

The strip method of hair transplant does indeed leave a linear scar, unlike the FUE/ Neograft  method most used in our practice.  A scar revision with trichophytic closure may solve the issue for you. Consult with an experienced hair transplant surgeon.

Rashid M. Rashid, PhD, MD · Answer

As you have discovered,this is one of the differences between an FUE and an FUT strip surgery hair transplant. The scar treatment is not easy.  You may want to consider talking to a dermatologist that specializes in lasers and offers fractional type lasers.

William Rassman, MD (retired) · Answer

Scars like the one shown in the web reference below is best treated with Scalp Micropigmentation. Our results have been routinely spectacular as shown in the photo below

Amiya Prasad, MD - Account Suspended · Answer

Hair transplantation, whether
it’s the strip method or the follicular unit extraction method, will both
result in scars. As a hair transplant surgeon as well as a full body cosmetic
surgeon, discussions about scars is something I do all day long whether it’s
for tummy tuck, facelift or breast surgery.

Wound healing is a process that
happens in the course of six months to a year. Even with the best closure and with
the most advanced technology in terms of biomaterials, you could still get a
scar that’s undesirable. A scar that’s undesirable can be a widened scar,
thickened scar or an irregular scar. If you were not to have the best healing,
we can potentially revise the scar but it’s about how the body heals and that’s
something we can’t always predict.

For hair transplant scars, I
explain to our patients that we use not only cosmetic surgery techniques to
make the incisions as close as possible but we also use a material called
extracellular matrix and platelet-rich plasma. I use these biomaterials to
enhance healing and reduce scar formation, and also in treatment called Hair
Regeneration to thicken hair and stop further hair loss.

There are some options like
tattooing or a new technology that is being used for wound healing for burns. However,
I would caution you about medical tattooing. Although it can look good in
pictures, three dimensionally, it might not look right for you. The reality is
that the scar is at a deeper level and what’s responsible for the thickening is
more about the type of scars sometimes people refer to as a hypertrophic or
keloid scar.

In our practice, if someone has
a thickened scar like yours, we employ injections of material such as
5-fluorouracil (5-FU) and Kenolog. We’ve also had very nice results with injections
of platelet-rich plasma. Platelet-rich plasma is from the patient’s own blood
wherein the healing factors are taken and injected to the area. It has been
very successful for areas of hypertrophic scars or thickened scars to soften
them and ideally allowing some hair growth to occur through those scars.

Since you had your transplant,
you are somehow committed to have your hair length a little bit longer to make
sure the scars are covered. If you are aware that your scars are obvious when
your hair is wet or if someone is noticing it, then you may want to consider a
surgical scar revision or the treatment with injections, but I don’t think any
topical treatment will do that much. I think that you need to do some
consultations with cosmetic surgeons who have a lot of experience with scars
and understand what your options are. You can’t erase a scar, but you can make
a bad scar look better. I hope that was helpful, I wish you the best of luck,
and thank you for your question.

HT Scar advice, desperately needed please! (Photo)

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