Strip (FUT) donor scars
The linear scar left by an earlier strip procedure, at the back of the head. The most common scar we treat, and usually the most rewarding – the surrounding scalp is healthy and the scar is narrow.
Hair transplant into scars
In short
Hair can be transplanted directly into scar tissue to camouflage it, and it works – but it works differently from a normal transplant. Scar tissue carries less blood supply, so grafts go in at a lower density and fewer of them survive than in untouched scalp. The aim is a scar hidden at ordinary hair length, not a scar removed.
Grafting into scars is effective and we do a lot of it. It is also the area of hair surgery where expectations most often outrun what tissue can deliver, and where the difference between a good and a bad outcome is decided before anyone picks up a punch.
Scar grafting at a glance
Procedure time2–5 hours
AnaesthesiaLocal
GraftsSet by scar area, not by a standard figure
Graft survivalLower than in untouched scalp
SessionsOne, sometimes two
Test sessionAdvised for some scars
Full result12 months
Scars we treat
They behave differently, and the differences matter more than the label. Blood supply is what decides every one of these cases.
Scars from earlier transplants
Punch scarring, pluggy grafts and irregular donor depletion from work done elsewhere. Usually part of a wider corrective plan rather than a scar procedure on its own.
Burns
Blood supply in burn scarring is the limiting factor and varies enormously between cases. Some support grafts well; some do not support them at all. A test session establishes which.
Surgical and trauma scars
Scars from neurosurgery, facelift incisions, accidents and cleft repair. Often small, well-vascularised and among the more predictable cases.
Traction alopecia
Loss along the hairline from years of tension. Where scarring is established the follicles will not return on their own, and grafting is the only route – but the tension has to stop first or the new hair goes the same way.
Blood supply sets the ceiling
What scar tissue can and cannot do
A follicle transplanted into healthy scalp is plumbed into a dense capillary network within days. Scar tissue is fibrous and comparatively poorly vascularised, so the same graft in the same hands has less to work with. Two things follow by design: grafts go in at a lower density than we would use on normal scalp, and a second session is planned to build on what the first proves will grow.
Where the supply is doubtful – burns especially – the procedure begins with a test session. Donor hair is finite. Spending several hundred grafts to discover that tissue will not hold them is a cost you carry for the rest of your life, not a setback you can repeat.
Scar grafting questions
Can hair be transplanted into scar tissue?
Yes, and it is routine work here. Grafts are placed directly into and around the scar to break up the line and blend it into surrounding hair. What differs from a normal transplant is the blood supply: scar tissue carries less of it, so grafts are placed at a lower density than in healthy scalp and survival is lower.
What survival rate can I expect in a scar?
Lower than in untouched scalp, and how much lower depends on the scar. The range across burn scars, strip scars and surgical scars is wide enough that a single figure for "scars" would be meaningless. The surgeon assesses the tissue and tells you what is realistic for your scar specifically.
What is a test session?
A small number of grafts placed into the scar and left to grow for a year before committing to a full procedure. It is advised where blood supply is doubtful – most often burn scars. It costs you twelve months, and it saves you from spending a large part of a finite donor supply on tissue that was never going to hold it.
Will the scar disappear?
No. The aim is camouflage, not removal: hair growing through and around the scar so it is not visible at ordinary hair length. The scar tissue is still there underneath and will still show if you shave the area. Anyone promising you a scar that vanishes is describing something the procedure does not do.
Will it take two sessions?
Sometimes. Because density has to be built conservatively in compromised tissue, a second pass twelve months later can add more once the first has proven it will grow. That is planned as a possibility from the start rather than presented afterwards as a complication.
Can a scar be cut out instead?
For some strip scars, surgical revision is an option – excising the scar and closing it more finely – and it can be combined with grafting afterwards. Whether it is worth doing depends on the width of the scar and the laxity of the scalp around it. It is assessed case by case.