Hair Transplant Scar Revision Using a Tissue Expander?

This below response from our Hair Loss Social Community and Discussion Forums was written by recommended hair restoration surgeon Dr. Ali Emre Karadeniz.

I’m about three weeks past a strip hair transplant. Due to tension issues, my hair restoration surgeon had to leave my donor site very open, and also had to loosen a suture a couple of days after the surgery. I’m looking at a 1.5 cm scar on my left temple, and about a 1 cm scar at the back, and a half cm scar on the right. Not quite the 2mm scar I was shown during consultation.

I know it’s early for me, as my scar has to mature, but I have been encouraged to see a plastic surgeon at some point. I’m worried about the lack of laxity at the time of a future scar revision surgery, so I’m also curious about the use of tissue expanders.

Here is my advice on approaching wide strip scars:

The first question to answer is, why is the scar wide? Bad surgical technique (transections along the incision, bad wound closure technique…), too wide strip excision or unlucky tissue character.

The second question is, is there any skin laxity left?

Now,

1. Bad surgical technique + skin laxity => Go for a scar excision and trichophytic closure.
2. Bad surgical technique + no skin laxity, or too wide strip excision with no laxity and unlucky tissue character probably doesn’t benefit from a scar revision.

All three situations could be improved by follicular unit extraction (FUE) on the scar and/or SMP. In the first two situations a tissue expander could be considered.

I have not used tissue expanders for the repair of a follicular unit hair transplant strip scar however I have used it on severe burn patients who had scars on close to half of the scalp. It is a very effective method. On the other hand the whole process of putting an expander under the scalp, inflating it twice a week by saline injections, having to camouflage a lump on the head which looks strange to other people, having to adjust sleeping position, this going on for many months and then having another procedure to remove the expander is not easy for the patient.

Dr. Ali Emre Karadeniz

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community.

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