I Have Concerns About My Hair Transplant Experience, Is This Normal?

Written by Raymond J. Konior, MD on March 23, 2008

I’m a police officer who had a hair transplant three years ago. I was told that I would have no problem wearing a military cut on the job but now I have a very noticeable scar from the surgery straight across the back of my head. I specifically asked the person I signed up with if this would be an issue and he said absolutely not. That’s the only reason I decided on going through with the hair transplant. Now I’m always being asked about it. I am wondering if it could be fixed. Also is it unusual not to have the opportunity speak with the doctor until the day of the hair transplant? This was my experience.

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I am sorry to hear your story. It is my firm position as a professional that you have had your patient rights violated in a number of ways. It is beyond my comprehension why a physician was not involved with your initial consultation for a surgical procedure. Unfortunately, there are various surgical hair restoration offices that utilize so-called “expert consultants”, often to the detriment of proper patient education. These individuals often wear a white coat, like a doctor, so as to generate a sense of professionalism and competence. Unfortunately, these individuals are often nothing more than a sales-person for the clinic they represent.

Patients need to realize that it is their right to have a physician present for their consultation. The physician you speak to should be the same person who will be operating on you. The patient should be properly prepared with as many questions as they can think for the treating physician. Questions that should be asked include: 1) what treatment plan is proposed; 2) what are the physician’s qualifications; 3) what specific technique will be used; 4) what non-surgical options are available; 5) what will the treatment zone and the rest of the scalp look like with advancing age; 6) what will the donor scar look like; 7) what additional surgery might be required in the future; 8 ) how many people will be assisting the physician and how long have they be performing hair restoration; 9) will the physician be present for the entire procedure; and 10) are high-quality photos available that demonstrate the quality of work from the treating physician.

Scars vary from person to person, and despite the most meticulous technique possible, some patients will heal with a wider-than-average scar. An ethical physician has the responsibility to provide you with all of the risks associated with the surgical procedure, including the possibility of a problematic scar in the donor area. The guarantee of anything to the contrary is without question a violation of your right to be informed about the actual risks associated with this procedure.

It is possible that the visible scar can be improved upon, especially if the procedure was carried out with poor surgical technique. It is a fact that some people are simply predisposed to adverse healing, but there are several surgical mistakes which could have caused a wide scar. Excessive wound edge tension, indiscriminate use of cautery, follicular transection along the wound edge, and suture strangulation of the circulation along the incision line are a few of the technical mishaps which could lead to a wide incision line. Repair options include scar revision, whereby the old scar is removed and a new, more meticulous closure is performed. This approach is favored when there is good residual elasticity and density in the area around the scar. Grafts can be inserted into the scar utilizing follicular unit extraction (FUE) for tight scalps with relative inelasticity.

Raymond J. Konior, MD
Member, International Alliance of Hair Restoration Surgeons

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