Our patient had four strip surgeries at another clinic for a total of 4000 grafts. Every subsequent strip surgery increases the probability of ending up with a widened scar. A short time after his fourth strip, his scar stretched to measure 21cm wide by 2cm high. On 07/23/2012 Dr. Cole injected his scar with 5cc of ACell and placed 443 scalp hair grafts into his scar. As you can see there is quite an improvement for only 443 grafts. We hear from our patients that there are many hair transplant doctors advising against grafting into scar tissue. Their advice is based upon their mistaken notion that hair cannot grow in scar tissue. When a repair patient accepts this advice, the only repair alternative is a scar revision. Sometimes scar revisions work but often times the scar stretches back to where it was. Dr. Cole has found that graft survival is improved when ACell and PRP are administered during surgery. Also low density placement, the first pass increases the graft survival rate and improves the blood supply, creating a more supportive environment for grafts placed at a later date. Additional density will provide a better appearance when the hair is cut shorter in the back.