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Dear Dr. Cole, I have a scar on the top of my head from a traumatic injury. I reside in Bangkok. I desire to fill this area in with grafts obtained by FUE. I am of Asian decent. Is it possible to graft this scar on the top of my head, and where I should have the procedure done.
Yes, it is possible to graft scars due to trauma. We recently had a patient return to our office following a procedure to help conceal the scar. He had an excellent yield and result. Asian patients are ideally suited for FUE procedures to treat both balding areas and scars.
This patient of Korean ancestry returned following treatment for an area of alopecia secondary to a traumatic delivery. He developed this large area of hair loss following forceps trauma during his delivery. The trauma damaged the follicles and the area healed by secondary intention. The results from the initial surgery are 10 months subsequent to hair transplant surgery using the CIT method of FUE. Because the grafted area was scar tissue, we did not attempt maximal density with the transplant procedure. Scar tissue has excellent circulation, but high densities might affect the yield so we generally begin with a lower density of 30 to 40 grafts per square cm. The patient returned to our office in an effort to add additional density. In the initial procedure we placed 203 grafts. In the follow up procedure we added an additional 243 grafts.
We have two affiliate clinics in Asia that can provide FUE. One is in Singapore and is staffed by Dr. Tyng Tan. The other is in South Korea and is a Dr. Cole Forhair clinic.
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What are the ways to camouflage strip hair restoration scars?
Camouflaging 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.