Hair transplant scars

Hair transplant surgery is one of the safest and most common procedures out there today and is a very effective way of reducing pattern baldness, thinning, and receding hairlines. However, if it is not performed correctly, hair transplant scars can present some major issues, most prominently uneven hair density and ugly scarring. 

Overview

You may have seen some terrible scar photos from online. Hair transplant scars vary depending on the surgery method and shaving method, these botched cases can happen both for FUT and FUE surgeries.

Types of Hair Transplant Scars

Is it possible to avoid scars? Unfortunately, there is no surgery method that completely removes traces of scars after extracting hair follicles. However, with the right know-how and expert technique, hair transplant scars can be significantly reduced.

There are two main types of scarring: donor area scarring, and recipient area scarring.

Depending on the methods used, FUT (incisional) or FUE (non-incisional), different types of scarring may occur.

1. FUT Hair Transplant Donor Area Scars

The donor area is where the hairs have been taken from to transplant elsewhere.

FUT donor area scars are linear scars resulting from the FUT method of hair transplantation, wherein a strip of skin is removed from the back of the head and stitched up. 

A good surgeon / clinic can do the FUT method without leaving much visible scarring. However, if done poorly, it runs the risk of leaving a garish linear scar across the back of one’s head. This type of scar can be hard to conceal, and, depending on the size of the strip removed, very large.

Although a little scarring is hard to avoid with the FUT method, a doctor with minimal or no experience can make it a lot worse.

After extracting hair follicles, the wounds are sutured back together as quickly as possible. This traditional suturing method includes medical staples. The advantage of this method is its time-effectiveness.

The biggest disadvantage to this method is that it is difficult to control the strength and spacing of the sutures. Therefore, we perform the double-suture method at Maxwell. This method uses medical sutures instead of medical staples, allowing the sutures to be present both on the inside and outside of the patient’s scalp. And this method allows us to adjust both the strength and spacing of the sutures, therefore minimizing scar tissue (too much or too little space between the sutures can mean more scar tissue).

Performing a clean surgery that minimizes scars is essential for any medical institutions involved in hair transplantation.

2. FUE Hair Transplant Donor Area Scars

These are the small circular scars resulting from the FUE method, where individual units of hair are removed using a punch tool. They are commonly known as ‘dot’ scars because they appear as small white circles in the donor area.

The area where hair follicles are harvested is filled with new flesh, which later turns into a white dot. Although it is a non-incisional hair transplant, this method does involve making a small incision around every hair follicle, one by one.

This non-incisional hair transplantation requires medical expertise and experience to correctly measure the spaces between hair follicles that are to be harvested. 

These are the small circular scars resulting from the FUE method, where individual units of hair are removed using a punch tool. They are commonly known as ‘dot’ scars because they appear as small dots on the donor area.

These dots can vary in size and intensity depending on the punch tool used, the density of punches, and the surgeon’s experience (or lack thereof). Unlike the FUT scars above, dot scars can be more dispersed either on the back of the scalp or on the sides. However, if the extracted area is concentrated too much in one area, or is connected in a long noticeable line, it may end up looking like a prominent scar.

If the hair extraction is done correctly and in moderation, you can expect amazing results. FUE hair transplantation methods have become very popular for this reason. However, as always, the surgeon’s expertise is critical for this type of surgery.

3. Donor Area Over-harvesting

It is also worth mentioning over-harvesting as a major cause for concern when receiving any kind of hair transplant.

Although not technically ‘scarring’, too many follicles removed in one sitting leaves the donor’s scalp exhausted, with significant scalp show and, in worst cases, necrosis (cell damage) and infections.

Harvesting a lot of follicles may seem like a good idea—”the more hair harvested, the more hair transplanted”—it can actually have the reverse effect of reducing overall hair density.

This way of thinking is a clear indication of inexperienced or underqualified surgeons, or of clinics that are wanting to compensate for their high-procedure rates. 

According to a 2022 study by the International Society of Hair Restoration Surgery (ISHRS), a not-for-profit medical association, the average number of grafts per session to achieve the desired results was 2,176 grafts (1 graft can be 2 hairs in general).

Transplants which harvest over 3-4,000 follicular units in one sitting can result in severe side-effects.

A good surgeon should know the safe excision limit of follicular units, as well as other factors such as residual hair density and the donor’s scalp type.

4. Recipient Area Scars

The recipient area is where the hair grafts are placed once they have been removed (for example, taken from the rear of the head and placed on the forehead/hairline).

Scarring in the recipient area is not common after a hair transplant, but it can happen due to overzealous packing of hairs, grafts not placed at skin level, or skin pigmentation changes.

Although most of these issues, if they do occur, will resolve themselves over time, some may require further treatment or revision.

It’s also worth noting that FUE hair transplants usually leave no visible scarring in the recipient area, unlike FUT where it is more common. This is just one more reason why people generally prefer FUE.

Scar Revision

Now that we know about the different types and causes of hair transplant scars, let’s take a look at some of the methods and treatments available to reduce and treat hair transplant scars.

There are many reasons why a person would want to or need to get  revision hair transplant surgery. These include:

1. The initial surgery was poorly performed due to lack of skill or experience
2. The methods used to do the hair transplantation was outdated
3. Patients might be happy with the first surgery but would like to increase density
4. Results of the initial surgery looked unnatural

1. FUE Hair Transplant Scar Removal

FUE donor area scar removal takes follicular units from other parts of the scalp and places them into the scar tissue itself—think hair transplant for scars. Although this might not entirely remove the scar (it is almost always impossible to do so), it may reduce the impact and visibility of the scar. There are a couple of drawbacks to this method, however. Most significantly, it runs the risk of inducing further scarring elsewhere on the scalp. Deficient donor hair and reduced blood flow in the scar tissue area can also be a hindrance to the efficacy of this method. Nevertheless, restoring follicle density uniformity to its original state, especially after an initial surgery was not performed properly, presents significant difficulties.

2. Laser Revision

Hair transplant laser scar revision is a non-surgical method of reducing the appearance of hair transplant scars, especially for FUE scars. 

It uses a laser device to target the damaged skin on the scar surface and stimulate the healing process. It may also be combined with other methods, such as hair transplant camouflage, for greater results.  

3. Scalp Micro Pigmentation

The next method for hair transplant scar reduction is scalp micropigmentation (SMP), also known as a medical hairline tattoo or scalp tattoo. 

A relatively recent technique (it has been in use since 2009), this permanent procedure involves injecting ink of the same or a similar color to your hair into the affected scar tissue area. The end result is the appearance of follicles and thicker hair, as well as disguising the scar entirely.

SMP has become a very popular technique thanks to its efficacy for hiding hair transplant scars. Many people even opt for SMP as a way of achieving a stubble-shaven look or even when treating other types of scars.

However, it is not as simple as going to any tattoo parlor and asking for SMP! It is a complex procedure that requires expert medical knowledge.  

Hair Transplant at Maxwell in Korea

At Maxwell Hair Clinic, we understand the importance of minimizing scarring following a hair transplant, and we’re dedicated to providing you with the best possible results. The visibility of scars post-surgery depends on the precision of the procedure and the level of care you receive. Our expert medical team excels in tailoring each surgery to your unique skin type, ensuring optimal outcomes.

Before and After Hair Transplant at Maxwell

The above is a design for an FUE treatment at Maxwell Hair Clinic that reduces the height and width of the forehead. For this treatment, we planned to transplant about 2,500 hairs.

After the successful hair transplant you will also receive special postoperative treatment unique to Maxwell, which significantly reduces pain and swelling, which can vary from person to person.

When the hair grows back following the transplantation, you will see a distinctly different forehead line.

The day after the treatment you can visit the hospital once more for further treatment, as the surgical site does not swell much and there is little blemishing. 

Around four to six weeks later you should be able to see some new growth. As you can see from the above picture, the forehead line is already beginning to take a natural and different shape. 

Three months later and the donor area is looking virtually back to normal, with no visible scarring, patchiness, or blemishing.

This is where expert punching tools and methods are so crucially important during FUE hair transplants. Irregular (non-linear) but regularly spaced punches result in natural-looking hair once it starts to grow back.

In the above picture you can see the difference between before receiving any treatment, Maxwell’s design, and the results four months later. The hair is actively growing in the recipient area, and the hairline in general is much more full. 

After 8-12 months, we can expect the full result of the surgery in general. A full eight months after the FUE transplant was undertaken, Maxwell’s design has come to full fruition. The hair is thicker, with a fuller (and most importantly natural) hairline.

Conclusion

If you’re considering a hair transplant, having a discussion about your goal and situation with our surgeons is very important. Maxwell Hair Clinic is a state-of-the-art hair restoration facility and international hair loss referral centre dedicated to the treatment of hair loss in men and women with over several decades of experience.

Rest assured, we’re here to guide you on the right post-operative care to help you achieve the most favorable results. Your journey to natural-looking hair begins with Maxwell. Please feel free to contact us for any questions via WhatApp button below!

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