About     Contact     Archives     Videos     Events     Hair Transplant

I have a non-hair transplant head scars and I was wondering if Acell would help this.

I realize the excitement level is pretty high for ACell right now, but it is not an answer to everything. It generated lots of interest and we are starting our clinical trials, but we aren’t looking at it for use in scar reduction at this time.

In your particular case, I do not even know where there scar is, how deep, wide, or even the shape. It may be that just a scar reduction surgery or a hair transplant may help. I do not know. Remember folks, at this stage ACell is being used for a study and there is no guarantee for success.

i have scar on my scalp. can i do hair transplant on my newly 1 month scar??

I don’t know what your scar is from, the placement of it, or even the size of it. You never know, you may have some hair grow back around the scar. Many people will show redness at the scar which fades over weeks and months. I generally advise patients to wait at least 6 months when the redness is also minimal. Sometimes up to a year.

I recieved a transplant of about 3,000 grafts from another doctor about 12 months ago. 720 are 1 hair and 2,140 are 2 and 3 hair grafts. I am 23 years old and I am not very satisfied with the results. Hair is not as thick as I would hope and the scar is wider than promised.

I was looking into doctors that could possible thicken up the front a little bit and try and reduce my scar as much as possible so I can keep my hair shorter. I was seeing what your thoughts would be on this. I am not able to make it into your office very soon but I can forward some pictures for now so you could give me some initial thoughts if possible before a consultation.

Before undergoing a hair transplant surgery, you must fully understand the limitations and have reasonable expectations. The scarring is also highly variable in each individual and there is no way anyone can predict how the scar will turn out with total accuracy. Everyone wants a great outcome and minimal scarring, but you must understand surgery is not an exact science and no matter how great your surgeon is there is always a variability.

You stated that the results are thinner than you expected. The 3000 grafts that you received was spread over your balding area, so if your balding area was large (Norwood Class 4,5 6, or 7) then I might expect thinner results than if your balding pattern was a Class 3 or less. Also, the thickness of the hair shafts (fine vs coarse hair) will reflect the fullness that you received. The growth of the transplants (100% or 50% growth) may play a role as well. If I was able to see you, I would have an appreciation of these factors and then give you an opinion.

You can always email us or call us at (800) NEW-HAIR to set up a phone consultation. We usually request photos in advance and you can arrange a time to speak to one of the physicians to facilitate the consultation.

I am 43. I had a scalp reduction at 24 along with 4 sessions of hair transplants. I was disappointed with results so I have been wearing a hairpiece the last 15 years. Now I wish to shave my head. Can the flaxel laser help with the scars on the back and top of my head? Or should I consider transplants in the scar areas or both options? I am a little leary to do transplants again. I appreciate any advice, don’t want to make any more mistakes.

In general, fixing a bad hair transplant or a bad scalp reduction surgery is very individualized and difficult. The results are often not perfect, so there must be a full understanding of expectations and what you are trying to achieve. There are always options for repairing your look, but you need to see a hair transplant doctor who specializes in these type of cases. It would be doing you a disservice to offer you specific advice for your case without seeing exactly what you’re talking about.

For the readers that aren’t familiar with a scalp reduction (see image at right), it was a procedure some doctors did that essentially just excised the bald spot. We’ve written before about how patients that underwent scalp reduction surgery often developed a “slot deformity”, where the hair from the sides grows away from the scar, causing an unnatural slot to appear.

Lasers will likely not achieve what you are looking for. Meet with a doctor in person that can advise you about what to expect the end result to look like. It might not be perfect, but I wouldn’t be able to outline your options until your repair area is examined.

I had a coronal brow lift in Feb. 2009. I had a wider than desired scar. I also had a spot the size of a quarter of permanent hair loss. The plastic surgeon who performed the brow lift has tried to do a scar revision by excising the scar. But I am 3 weeks post revision and I see where all along the new revision scar I have hair loss. The line where he cut is pencil thin, but I have hair loss in front of the scar.

Is this going to be permanent like before? I thought that maybe the staples I had in initial surgery were the problem. But he used sutures to do revision and I still had hair loss. Why is it that every time my scalp gets cut I have hair loss in front of the scar? And what can be done to fix this?

Thank you

This is a real problem. You must wait out the course (about 4-6 months) and then you will know if the surgery succeeded. I suspect that you will see that the scar is the same or worse and the hair loss may not go away. I see many female patients with this problem and end up transplanting most of them with good results.

Dr. Rassman,

I have a question about scars after one has healed from surgery. Mainly the recipient transplanted sites. I know a doctor will puncture holes to put the grafts in. And my guess is that these holes will eventually have some form of scarring. From your past experience how visible are these scars if one shaves his head, transplanted area not donor area. Will there be tiny white spots on the transplanted area with little holes from the punctures?

My second question relates to FUE mainly from thick coarse arm hair to a missing patch in my lip area. From your experience how is the scaring like on the arm? Since a doctor would removing the hairs on the arm out with FUE. Would the arm area scar less than using FUE hair from the scalp? Let me know, since I am considering using hair from this area. Thanks

Third question, I noticed scars from a hair transplant are usually white. How well does this blend in for asians, from your experience? I am asian with very pale skin.

Thanks!

The recipient sites are made with slits which heal very well and leave no visible scar in most people. The donor area does have whitish scars that can be seen on close inspection if the head was shaved, rarely with the hair long.

I would use scalp hair though, not arm hair for your lip area (I assume you mean moustache). On the arm, I imagine the scarring would be more evident with less hair to cover it.

Dear Dr. Rassman:

If someone has their donor scar from ear to ear but only one side (left, let’s say) is very tight, probably due to a thicker strip being taken from that side. If that person is considering one additional strip procedure with the best close possible, is it best for the entire previous strip to be excised, including the already very tight side? If so, can the excision on the tight side be very thin while being substantially wider on the less tight side?

Alternatively, can only part of the previous donor scar (on the right side in this case) be excised, such as the final 1/3 of the strip on the right side? What would be most desirable option and what would be an appropriate time to wait before doing the second procedure? The patient in the case intends to have the second strip procedure be the last one, using only FUE or FUE squared after that as needed if additional hair loss/thinning occurs with aging and needs to be taken care of.

Thank you in advance for your advice.

Best regards

If the excision area is at least 6 months old, the laxity can be assessed. If the excision area is less than 6 months old, the laxity of the excision area will change the further in time you are away from the strip harvest. I never make an assessment of the donor area until at least 6 months have passed. As most second procedures are usually more than 8 months following the first one, this has rarely been a problem.

A second strip procedure puts a good burden on the surgeon to make judgments. If there is a large demand for more hair grafts at the second procedure, the degree of tightness will dictate what can be removed. I generally remove any scar along with hair if there is enough laxity and the width of the strip may vary depending upon the tightness of the scalp. Sometimes one side is tighter than the other so the strip width will be narrower on the tighter side.

The laxity issue seems to also vary with the individual. Most people will find that their scalp will return to its original laxity, but a small number of people will find that the scalp will become tighter with each successive procedure. In this later situation, the amount of scalp that can be removed will decrease with time. As the density also drops with each successive strip harvest, the combination does not bode well when both a tight scalp and a reduced donor density occurs in the same patient as measured 8 months following the first procedure. For those people with tight scalps, the FUE approach may be preferable to another strip harvest.

Hello Doctors!

I have a question about FUE and scarring. It seems that you use the same instruments to make both the donor excision as well as the recipient sites. Yet the recipient sites show no scarring. Where the small donor area punch marks are simply left open (and a scar forms from the skin healing over the small hole) I am guessing the fatty tissue keeps any perceptable marks from forming on the transplanted ares.

So, if you wanted to take it a step further, couldn’t you perform a body hair transplant on someone to fill in the FUE scars? Even if the body hair is not as cosmetically effective wouldn’t the “fatty tissue” from the BHT leave the donor area with no small white holes? Is my logic twisted?

A crazy hair question for the only people capable of answering it. Thanks for your time!

The recipient sites are not made with punches like those used for follicular unit extraction (FUE). They’re two different tools. We generally create slits for recipient sites with needles or tiny scalpel blades.

The white dot scar is the result of skin being removed along with the graft in the FUE technique, and it really would not be reasonable to fill these tiny holes with body hair to eliminate all scalp scarring. The ‘bulk’ of a body hair may be finer than the ‘bulk’ of your head hair. Body hair usually grows in single-hair follicular units while scalp hair usually has more than one hair in a follicular unit, making for even less ‘total bulk’ of the transplanted grafts. That is why it is important to be assessed for these many variables and their meaning to you.

Thirty years ago I had 4 or 5 sessions hair transplant sessions done using the old punch graph method. For most of those years I was fairly satisfied. Lately that has not been the case. The appearance of corn rows is starting to show in the front and it is getting harder to cover up the donor area in the back. Twenty years ago I spoke to a specialist in Philadelphia who disappointed in the methods used in my procedures and he implied that I was not a good candidate for future transplants. If this is the case I would prefer to shave my head instead of continuing trying to cover up, which can only become more problematic in future years.

The scarring at the donor site is a concern. Are there any procedures to reduce this scarring? Thank you in advance for any information and/or advice you can give me based on this limited description.

We have routinely performed surgeries for men who are in your situation. You can read about one patient’s journey here and see some of my repair patients here.

As you undoubtedly know, everyone is different and unique so I really cannot comment on your particular case without examining you. Many patients who had 4-5 sessions of the old hair plugs have heavily depleted donor areas, and a skilled surgeon with experience in this field can often soften the plugs by harvesting the recipient plugs as well as redistribute some of the remaining donor area. If you want to explore options, please send me photos and set up at the least a phone consultation with me.

There is no simple answer to your problems, and each person must be evaluated one on one before recommendations can be made. This goes for both repairing/removing the “corn rows” and seeing what can be done about fixing the donor scars.

Hi Doctor, thanks for your site

I am keen on getting a hair transplant, but i am a little bit worried about the scaring that will occur.

I was just wondering, say i only want a small amount of grafts done, is it possible to get a procedure which will only produce a small scar in length, say one 5cm long on the back of the head rather than one from ear to ear?

Thanks in advance for your reply.

You need to talk with your surgeon, and ask these specific questions and convey your wishes. You do NOT have to have an ear to ear scar. There are options for hair transplantation, such as the FUE procedure, which produces no linear scar.

A shorter length linear scar (5cm long) is possible though, and would obviously yield less grafts than a longer strip. It all depends on how many grafts you are expecting or require. A 5cm length strip might yield anywhere from 300 to 600 grafts (depending upon height of the strip and the density of your donor hair), but this is a VERY general estimate and will vary with each individual.