Can I Have a Skin Graft After Scalp Cancer? (photo)

I had a large skin cancer on the top of my head that was removed and a skin graft was taken from my thigh. I also had to undergo 30 days of radiation. I have a crater on the top of my head due to this. Could it be possible to have hair replacement therapy or anything to help hair grown there?

Doctor Answers 6

Skini cancer removed with graft scar on crown

There are a number of options you have, of course, I would have to see you to make an actual recommendation. The three options could include (1) scalp micropigmentation (see below), (2) scalp expanders and (3) hair transplants

Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

It is possible to have hair transplant surgery over a skin graft.

It is possible to have hair transplant surgery over a skin graft.  It has been done.  You would need an exam first (as always).  It would be helpful if the doctor you choose has had experience with similar cases.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 101 reviews

Skin graft after cancer

I have successfully transplanted hair after radiation.  However, the take of the grafts can be unpredictable due to damage of the skin.  In some patients after radiation I've had excelllent results, others are not as successful. 

Jack Fisher, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 4 reviews

Hair grafts can be placed and grow on skin grafts/scar tissue, but effects of radiation on blood vessels must be checked first

It is possible to actually transplant hair to skin that has been grafted. In fact, we have been able to transplant hair on people who’ve had scars and burns with great success. However, when there is a history of radiation, there is always a concern about the blood vessels, vascular supply and whether it will be adequate to build the support for the hair follicles.

You mentioned that there is an indentation on your scalp with some fat atrophy or volume loss from the radiation. I would consider some different actions such as treating the indentation by something called Micro fat transfer. However, this is very dependent on the skin quality and whether or not there is a lot of scar tissue.

In our practice involving surgical hair transplant, we routinely use a material called extracellular matrix (ECM) that is made by ACell. This is a material that is derived from the bladder of pigs and it has a protein called a scaffold that has been used to help restore wounds, particularly open wounds, in the military or war injuries. I also have been using this material for the past 7 years for the treatment of hair loss and used the same material for several of my cosmetic and reconstructive surgeries. It works by regenerating tissues, so when used in hair transplants, it increases hair growth. When used in the body, it stimulates adult stem cells so that the wounds heal by duplication of the natural tissue that’s supposed to be there instead of healing by scarring

Before jumping right away to hair transplant, in my practice I would first do a physical examination and do a test session on the scalp. Here, I would transplant 100 or 200 hairs by microscopic surgical technique from the donor part of the scalp and inject extracellular matrix. After the surgery, we observe how those hairs grow. If they grow well, then the patient and I would have more confidence about going ahead with the procedure.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

Hair Transplantation Post Scalp Cancer

Yes, this is possible. Consult a hair transplant surgeon and have them work in conjunction with your oncologists.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

Large bald spot

I have treated 5 similar cases in the past 6 years with tissue expansion . In  all cases we got the effect of full coverage although sometimes it took 3 procedures. Transplants , in my opinion, may not be as good a choice for scalp reconstruction, especially after radiation.

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

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.