Posts Tagged: Donor Scar

What are Options for Fixing Wide Donor Scars?

October 5th, 2009

Q: I would like to have the donor area from an old hair transplant repaired so it does not show the scar when I cut my hair shorter. What are my options?

A: Widened scars can be improved in two ways: they can be re-excised to make the scar finer, or hair can be placed into the scar to make it less visible.

Excising a scar works best when the original incision was closed with poor surgical techniques. In this case, using better closure methods can improve the scar. When the scar is the result of a person being a naturally “poor healer,” a wide scar will be the result – regardless of how the incision was closed.

I often approach the problem by excising a small area first, to see if I can decrease the width of the scar. If so, I would then proceed to excise the rest of the scar. If not, I would obtain hair using follicular unit extraction (FUE) — extracting hair in follicular units directly form the scalp — and place this hair into the scar. The hair placed in the scar can also be obtained from the edges of a partially excised scar.

If a wide scar that is thickened (called a hypertrophic scar) is also excised, it will usually reoccur and may result in an even worse scar. Because of this, thick scars should be flattened with injections of cortisone prior to removing. This will decrease the chance of a recurrence.

Flattening the scar is also important to permit the growth of newly transplanted follicular unit grafts.

For more on this topic, please see the Bernstein Medical – Center for Hair Restoration web page on fixing scars.

Topic: Repairs

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Posted by Robert M. Bernstein M.D. at 10:21 am

Is Hair Transplant Using Body Hair an Option?

January 15th, 2009

Q: I have heard of body hair transplants as an option being considered by some patients. Do you think that could be an option for me as my donor area isn’t able to provide the hair that I need?

A: With body hair transplants, the hair quality is poor and there can be a significant amount of scarring where the hair is harvested, so we are not recommending it at this time.

Topic: Hair Transplant

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Posted by Robert M. Bernstein M.D. at 4:26 am

Is it More Important to Do Scalp Exercises Before First Hair Transplant or Second Hair Transplant?

December 18th, 2008

Q: Is it more important to do scalp exercises before the first procedure or the second?

A: When the scalp is tight, it can be useful for either the first or the second hair transplant.

Keep in mind, however, that the scalp will naturally stretch between hair transplant procedures, so that if exercises were not needed for the first procedure, they will generally not be needed for the second.

In our practice, we generally wait one year between hair restoration sessions so that we can see the full cosmetic impact of the first procedure and give the scalp laxity a chance to return to normal on its own.

In addition, there is a risk that active massage after the first procedure may widen the donor scar. Therefore, before considering massage before a second hair transplant, make sure that enough time has elapsed between procedures so that stretching of the scar will not be a be a problem.

In general, since the scalp will normally continue to relax for up to a year after a procedure, it makes sense that when there is a tight scalp, one should wait at least a year before considering the next hair transplant session. If massage is contemplated, it should be started one year after the prior procedure. This will give the scalp a chance to loosen naturally and will ensure that the massage will not stretch the donor scar.

In my opinion, it is a mistake to plan hair restorations sessions too close together in patients where scalp laxity is a constraint.

Topic: Scalp Exercises

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Posted by Robert M. Bernstein M.D. at 7:07 am

Do You Perform Hair Transplant for Hispanic People with Wavy Hair?

January 28th, 2008

Q: I am Hispanic and I have thick, black coarse wavy hair. Do you transplant Hispanics and are there any difficulties in performing hair transplants in them?

A: Yes, we treat Hispanic patients. There are no specific issues unique to Hispanics when performing hair restoration procedures. However, things to consider are:

  1. Hispanics have a slightly greater incidence of forming a thickened donor scar than Caucasians (but not as great as African-Americans)
  2. Hispanics often have coarse hair, but a low donor density, so fewer absolute numbers of grafts may be available for the restoration. The coarse hair, however, will make the restoration appear fuller.

Topic: Hair Characteristics

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Posted by Robert M. Bernstein M.D. at 7:32 am

Will Second Hair Transplant Session be Different than First Session?

December 17th, 2007

Q: My first hair transplant was a breeze. Will a second procedure be any different than the first?

A: Generally in a second procedure, a patient can expect less swelling post-up although the reason for this is not known.

There will also generally be less shedding in the second hair transplant session since the weak miniaturized hair that will be shed is often lost in the first session and the previously transplanted hair is generally more resistant to shedding.

In a second session we generally, but not always, transplant fewer numbers of grafts.

If the old scar in incorporated into the new incision, then there will be slightly less hairs per graft since the density in and around the scar will be slightly altered.

For those who are bald, the second hair restoration is sometimes less dramatic than the first since the second is used for fine tuning rather than taking the person from completely bald to having hair.

Topic: Multiple Sessions

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Posted by Robert M. Bernstein M.D. at 5:46 am



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