Looking For Hair Transplant Scar Repair In Miami

Written by Jeffrey S. Epstein, MD on September 18, 2009

I had a hair transplant when I was 20 and would prefer now to just have a buzz cut. I have a straight scar in the back of my head that is very thin but if I buzz my head it will definitely be visible. My doctor did not take the extra step of stitching or cutting the skin so hair would grow through the scar. Is there anywhere in the Miami area, where I currently live that I can go to get the scar fixed to become hard to see? - Patrick
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First of all Patrick, you bring up a very good case in point as to why young men (those under the age of 25 or so) should not be readily treated for their hair loss with a transplant procedure. Certainly, anyone at that age, I am going to recommend the most conservative approach, most likely Propecia, possible laser light therapy, and conservative follow up. For those men under the age of 26 or so, FUE is essentially the only procedure I would consider, for it does not leave the problem of a visible donor site scar.

With your donor site scar, I have found that the first step should usually be the excision of the scar with plastic surgery closure. While there is no guarantee that this will improve the appearance of the scar, it makes sense to try this first, for it does have a reasonable chance of scar narrowing, and perhaps if there is enough laxity, for the allowance of hair growth through the scar using the HITS (trichophytic) technique. A variety of techniques can be used for scar revision- most commonly it involves the use of deep sutures to help hold the tissue together, with superficially placed skin sutures as well. While results of this scar repair depend upon the scalp elasticity (sometimes very elastic scalps can actually have greater scar widening than non-elastic scalps), the location of the scar (the lower down in the back of the head the more likely to result in widening), and the technique used by the surgeon. With this scar excision, some donor hairs will be removed with the strip, which can be dissected out then planted into any part of the scar that is not excised.

The next approach to the scar is to plant into it. I will wait a minimum of 4 months- 6 to 8 months is preferable- before transplanting into the scar. The donor grafts can be obtained by the FUE technique, but for some patients it is preferable to make another donor site incision (obviously not in someone who plans to cut his hair very short) from which the grafts can be obtained. These grafts are transplanted into the donor site incision, using careful techniques to maximize the percentage of take, making deeper incisions typically that generate blood flow to assure graft survivability.

With these scar repair techniques, success as defined by meeting patients’ expectations is assured by two steps- using the very best techniques, and providing realistic goals of the procedure. Do not minimize the challenge in obtaining good results with these procedures- there are sometimes variables that result in less than ideal healing. However, by doing your homework and seeking out the most experienced and confident surgeon, the patient can help himself get the best results.

Jeffrey S. Epstein, M.D. FACS
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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