Hair transplant surgical techniques have come a long way since the early days of hair plugs. Even so, scarring is still an inevitable byproduct of the procedure.
There are two types of surgical techniques that are widely used today. Each one produces a different type of scarring. Your surgeon’s skill and experience can in large part determine the amount of scarring you’re left with.
Whichever you choose, know that wound-closure techniques have improved, along with the procedures themselves.
The technique you choose will be determined by several factors, including:
- the type of scarring you can expect
- your hair loss pattern
- the amount and quality of your donor hair
- the size of the area where your hair has thinned out
Cost may also be a factor. You and your doctor can best determine which procedure will be most effective for you.
Transplant removal procedures
The two surgical procedures most often used for hair transplant are follicular unit extraction (FUE) and follicular unit transplantation (FUT).
Both surgeries begin to produce visible hair growth within three to six months.
FUE
This procedure uses hair follicles extracted from the back and sides of the scalp (the donor areas). Your surgeon will remove each hair follicle graft individually with a micro-punch tool. Each extraction leaves a tiny round scar, up to 1 millimeter in diameter.
Based on how many hair follicles are extracted, this can add up to many hundreds or even thousands of puncture mark scars. These scars may look like tiny white dots after healing. Each follicle contains one to four hairs.
The hairs are then grafted onto the recipient areas of the scalp, where small incisions have been made for each individual hair. Given the painstaking nature of this process, many hours — or even days — may be required for surgery.
The procedure may also be repeated several times over the course of two or three months to achieve the best result.
FUE is done on an outpatient basis, under local anesthesia. No stitches are needed and recovery time is typically short.
FUT
This procedure requires the surgical removal of a strip of scalp that contains hair from the donor area. This is typically located on the back of the scalp.
Once the hair strip has been removed, the area is sutured together.
This leaves a linear scar of varying lengths, based on the size of the strip extracted. In some instances, this scar might extend from ear to ear.
The hair follicle grafts are removed from the scalp strip and readied for grafting onto the recipient areas of the scalp, where small incisions have been placed for each individual hair.
This procedure also uses local anesthesia and is done on an outpatient basis. The stiches are removed approximately 10 days later.
The FUT procedure may produce more pain and swelling than the FUE procedure. Results vary from person to person.
Hair transplant scar removal
Several procedures may be used to lessen or reduce the size of the scar created through the FUT procedure. Their success isn’t always guaranteed, and some scarring is almost certain to remain.
Keep in mind that as you age, your scalp will start to naturally sag. This can make the scalp reduction scar wider or more visible.
Another option might be to graft hair follicles into the FUT scar using the FUE method. The effectiveness of this solution will be determined, in part, by the thickness of the scar.
Scar tissue can be thinned using medication, making this more viable in some cases.
Scarred skin does not, however, always hold onto the grafts as well as healthy skin. Your doctor will be able to tell you if this procedure might work for you.
How to handle Hair Transplant Scars
Thinking of hair transplant surgery but worried about the scarring? A lot of hair transplant clinics claim that their procedure leaves no scars, but that’s unlikely. Hair transplant surgery is still surgery, and scars are to be expected no matter how advanced the procedure. Getting hair transplant scars after the operation is part of the body’s natural healing process. It doesn’t mean you should get huge and obvious scars after the surgery, though!
There are a few things to consider when it comes to minimizing scars after hair transplant surgery.
First, a highly experienced surgeon can keep the hair transplant scars thin and easier to hide.
By strategically positioning the hair grafts, your surgeon can make the regrowth look a lot more natural. An experienced surgeon can also keep the scar from the extraction site a lot thinner and easier to hide.
Second, the right technology can make a difference in terms of scars after surgery.
There are two common technologies used to transplant hair today: Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE).
FUT cuts out a small strip of skin from the scalp containing the hair follicles for transplantation. This strip is cut into small grafts and planted into the areas losing hair.
The procedure leaves a thin, elongated scar but will fade after a few months. That is, if you make sure to follow proper hair transplant after care and pinch the scar area tight around 3 weeks after the surgery.
Hiding an FUT scar is easy as long as you won’t keep your hair extremely short.
The other option is Follicular Unit Extraction (FUE), which extracts the actual hair follicles and transplants them into sparse or bald areas of the scalp. It’s a lot less invasive, but does require precision work.
The scars left by FUE are circular and are easier to hide. However, the number of hair transplant scars can vary depending on the number of follicles to extract.
Finally, the body’s natural healing process also plays a significant factor.
Scars usually fade faster on young skin, but this is typical of most wounds and post-surgery scars.
One catch: some people are genetically predisposed to over-produce scar tissue during the wound healing process, resulting in keloids. Patients with this problem are normally not advised to undergo hair transplant surgery.
There are several options available in handling scars left behind after hair transplant surgery.
One option is to hide the scars using FUE.
The extracted hair follicles are transplanted straight over the scars to cover them up. Take note, though: the FUE procedure will fail if there is no blood supply to the area, as no hair will grow from the transplanted follicles.
Trichophytic Closure is another option, especially if you underwent FUT.
After the strip of skin is extracted from the donor area of the scalp, the surgeon will trim the edges of the wound as closely as possible. This is to achieve a much thinner and cleaner hair transplant scar that won’t be very visible once it heals.
Finally, there is Scalp Micropigmentation (SMP) to cover up scars.
SMP is a procedure wherein small, very fine dots are strategically tattooed over the scar to make it less obvious.
Hair transplant scars are unavoidable. Choosing FUE makes for less visible scars, but it’s a good idea to talk to your doctor first. The right surgeon can make the difference, and give you optimal results with less scarring to worry about.
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How to conceal scars
Concealing the scarred area cosmetically is another option. This may be possible by growing your hair over the donor area.
Certain types of scars, such as keloid scars, may be harder to conceal than others. Keloids are raised scars, which grow larger than the original surgical scar.
Keloid scars may continue to grow over months, or even years. Some people are prone to keloid scarring.
Let your doctor know if you’ve already had a keloid scar before you undergo any type of hair transplant procedure.
There are also procedures that can help to disguise your scar:
Scalp micropigmentation (SMP)
Also called medical hairline tattoo or scalp hair tattooing, this permanent procedure introduces injected pigment directly into the scalp, giving the appearance of thicker hair. Some people opt to use SMP instead of surgical hair transplant procedures.
This procedure can also be used to color in the scarred areas left behind by FUE or FUT.
It may take several sessions to complete, depending on the size of the area being injected. The ink color is chosen to match your current hair color. Keep in mind that your hair may go gray or lighten, but the ink will probably not lighten at the same rate.
Some discomfort may be felt during this procedure.
Tricopigmentation (TMP)
TMP is a temporary form of SMP. This procedure provides semi-permanent inking, because it inserts the ink into the top layer of the dermis.
The length of time that inking from TMP lasts can vary from clinic to clinic, anywhere from six months to three years.
This procedure may also be physically uncomfortable for some people.
Laser treatment
This treatment may help reduce the appearance of scars and is sometimes used in conjunction with SMP or TMP. The laser targets and removes the damaged skin on the surface of the scar.
It also helps stimulate collagen production in the skin’s dermis layer, rejuvenating the elasticity and overall appearance of the skin.
This procedure was not designed specifically for hair transplant scar removal, and results may vary from person to person.
The takeaway
For many people, hair transplant surgery can be a safe and effective way to restore the look of a rich head of hair. This can go a long way toward restoring confidence and self-esteem.
However, scarring is an inevitable result of both the FUE and FUT procedures. The FUE procedure may provide a less noticeable type of scarring and may be a better fit for some people.
Choosing a knowledgeable, experienced surgeon prior to undergoing either type of procedure is paramount.
Some scar removal may also be possible. Covering the scarred area cosmetically or with permanent or temporary tattooing may also be an option.
If scarring makes this procedure a nonstarter for you, talk to your doctor to learn about a body hair transplant (BHT) procedure.
