Scalp Scar Revision

The excitement of having a full head of hair following a hair restoration procedure was often offset by the appearance of hair transplant scars from older techniques of hair restoration. These older techniques of hair transplant or other scalp procedures did not have proper methods to deal with the appearance of scars after surgery and patients often had to wear their hair long on the back of their head in order to hide any scars from the original procedures. The way a scalp scar revision is performed is primarily determined by the shape, size and location of the scar.

Why Are Scalp Scars Visible?

The size of the scar is the most obvious factor that makes them visible especially if there is little hair surrounding the scar. The contrast of the area where the scar is located is also important as the lack of hair in a scar surrounded by a good amount of hair density can cause the scar to greatly stand out.

Scar Revision Options

The scalp scar can be revised through a variety of methods.  At times, a hair transplant surgeon may combine more than one technique for the best results. Of course, using cosmetics always has a place in revising the scars.  Here are the most common methods used in revising a scalp scar:

  • Simple scar revision
  • Scar revision with trichophytic closure
  • FUE hair transplants into the scars
  • Scalp micropigmentation
  • Cosmetics

Scar Revision and Trichophytic Closure

The procedure known as trichophytic closure minimizes the visibility of the scar and can often be accomplished in a simple scar revision. Depending on how much stretching is involved with the existing scar, the scar will be removed and closure is performed. Trichophytic closure is done on just one edge of the scar or both sides of the scar. This procedure is helpful in bringing hair into the scarred area as well as making it blend in naturally with the area surrounding the scar. At times, a partial trichophytic closure is sufficient to bring adequate number of hair into the scar to make it look less visible. 

FUE Hair Transplant into the Scar

Hair Transplant Scar

Left: Scar After a Strip FUT Hair Transplant, Right: Immediately After Repair

Follicular Unit Extraction (FUE) can often be utilized in scalp scar revision in order to bring a greater amount of hair into the scar or to remove or minimize the density of hair that surrounds the scar location or both. No matter which method is chosen by the surgeon, FUE minimizes the contrast between the scar area and surrounding scalp and can effectively improve the appearance of the scar.

SMP and Cosmetics

SMP is a method in which dermal pigments are inserted into the scalp or scar to darken the color of the area.  This helps minimize the contrast of the scar with the surrounding areas. Using cosmetics can do the same for improving the visibility of the scars. Cosmetics used to cover up scars are often referred to as cosmetic camouflage products and they must be used with great care. Toppik and other microfibers can conceal the scar by minimizing the contrast between the colors of scalp scar and surrounding hair.

Consulting with a good hair transplant surgeon is the first step in revising the scalp scar. An experienced hair transplant surgeon can review the various options with a patient as well as help the patient decide which revision option will best help them achieve their scar revision goals.

Video: Hair transplant scar revision with FUE implantation into the scar

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