Scar Grafting

As we noted in the section on strip harvesting for hair transplant surgery, scars across the back and sides of the head may widen, sometimes to disfiguring proportions. These scars may be concealed by hair, or they may be obvious to anyone and cause great embarrassment and emotional pain to the hair loss patient. For a long time, the only option was a scar revision; this is simply another surgery designed to remove the existing scar with a scalpel, and close the wound again with sutures or staples. It sounds like a simple, straight-forward method; however, the problem is that more often than not, the resulting scar is about as big as the original one, or even bigger!
There are other methods that are more consistent. It is possible to transplant hair, from scalp or body, or both, into scars in order to camouflage them. It is not necessary to achieve a density the same as that found in the area around the scar, only to add enough hair to break up the appearance of the straight, shiny-white scar.
We recommend you utilize scalp hair taken by CIT over body hair to treat scars as the result will be better with scalp hair and more consistent.  Sometimes there is inadequate scalp hair so the only option becomes body hair.  Strip hair transplant surgery sometimes leaves a pink or red scar.  CIT hair transplants into these pink scars has been shown to modify the color of the scars more similar to the surrounding donor area. 
It is important to understand that scar tissue may not grow hair as well as virgin scalp. In other words, the growth yield may be lower than with regular hair transplants. Very often, it takes more than one “pass” (procedure) to get the kind of density needed to help hide the scar. It requires patience and diligence to get the desired final result in some patients. Also, lower densities are necessary to get any kind of reasonable growth.

Camoflaging Strip Scars

Scars in the donor area from strip harvests may be problematic for many men. They may be short or run from ear to ear. Sometimes they widen over time, occasionally to more than two centimeters, which is deforming. This is usually due to an overly tight scalp, too low a placement, or poor surgical technique. They also change the direction of hair growth below the scar, relative to above the scar, which may cause a “shadow” of the linear scar to be evident even with the hair grown out somewhat.

IN order to minimize the appearance of scars, several strategies are available. There are cosmetics such as Dermatch, which may help disguise the scar. The hair may also be grown out fairly long to attempt coverage. This, of course, may not be an option for those with an over harvested donor region.

Surgical scar revision may be attempted, often without success. This consists of excising the scar and them suturing up the wound, hoping that the resultant scar will look better than the original one. This can work in some instances; however, if the condition that led to the scarring is not remedied, then even the best revision may fail.

Grafting into the scar is another option. Because yields tend to be lower in scars, this may take more than one surgical procedure over many months to have a significant cosmetic effect. Either body or scalp hair may be used; scalp hair is generally a better choice if it is available.