Hair Transplant | I Have Scar Tissue In My Hairline, Can I Still Get a Hair Transplant?

I Have Scar Tissue In My Hairline, Can I Still Get a Hair Transplant?

I have had skin grafts on my head and have scar tissue. I have had some bald spots but generally had good hair growing up. As my head grew it didn’t look the same as when I was a kid. My hairline is now receding (the actual normal tissue) and I guess my question is, would I be able to get a hair transplant just where my normal hair was? Can they work around scar tissue without it being re-constructive surgery? I just want the hair transplanted where the tissue is normal again. Thank you, Jesse
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Thank you for providing photographs of your scalp. Although I do not know any of the specifics of your prior surgical procedures, it is clear that you have scarring present in what is considered the traditional zone for male pattern baldness. Your photos indicate that you do have a relatively early male pattern loss which is developing throughout the frontal, central and crown regions. The thinning appears to be worse in the frontal region, which happens to be the area affected by scar tissue.

First off, you have a relatively early pattern. By this I mean that you continue to have a significant amount of residual hair in the thinning zones. Based on this, you appear to be an excellent candidate for Propecia. This medication may help stabilize your hair loss so as to help preserve the remaining hair in the thinning regions. Stabilization of your hair loss would minimize the need for additional grafts later in life.

Surgical restoration certainly can be performed in the scarred frontal region. The creation of a new frontal hairline would provide two significant cosmetic advantages: 1) it would eliminate the balding appearance that has developed in your frontal scalp; and 2) the new hairline would help camouflage the scarring that is present in the thinning zones.

The key to surgical replacement in a scarred zone is conservation. Scarred tissue has a reduced blood supply. This means that there could be a higher risk of grafts not surviving the transplantation process. A lower density graft session is usually recommended in a scarred zone to increase the odds that all of the grafts will survive the transplantation process. Fewer graft openings in the scarred tissue will be less likely to disrupt the already compromised blood supply in the region. While a low density graft session will not provide a dramatic boost in new hair density, it will assure you a higher yield for the grafts that are placed. You would be able to undergo additional sessions later when the treated area has fully recovered from the initial transplant session. I usually recommend at least 8-12 months between sessions in scarred zones. This time interval allows adequate healing and full recovery of the residual blood circulation. The strategy of using several small sessions will eventually restore adequate density in the scarred tissue without taking the risk of grafts not growing because of poor blood circulation.

What can be done in terms of density during any given session is totally dependent on the conditions of the individual scalp being treated. All patients with scarring have to undergo a thorough examination by the operating physician to assess the nature of the scarring and the potential for circulatory compromise. Only then can a safe graft density and sound surgical plan be made.

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