Recipient Site Scarring after Follicular Unit Extraction (FUE) Hair Transplant?

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

I was wondering if someone had follicular unit extraction (FUE) hair transplantation, would the recipient area be left with scars like pitting in the skin? After the healing process and everything, if I wanted to shave my head will there be any pitting in the skin in the recipient area?

Also, if I am considering FUE what kind of questions should I ask the hair transplant surgeon regarding the tool the use? Which is better, a manual or automatic tool? What size of tool is better if I want the extraction to be from my beard? Some docs use 0.6 mm diameter while some use 0.8 and others 1 mm.

Recipient site scarring is really rare. I see lots of unhappy patients coming for second opinions and maybe 1 a year has scarring in the recipient area that I can see without magnifiers.

Donor scars from FUE always occur. You simply can’t make a cut in the skin, remove something, and not get scar formation. Now you can minimize it with smaller punches. But the smaller the punch used, the smaller the cylinder of scalp removed and the higher the transection rate in multi-hair grafts. So, with a 0.6mm punch I suspect the number of 2s and 3s harvested would be less than if a 2mm punch were used. But a 2mm punch leaves a large depigmented (white) scar. So there is a happy medium that each doctor has to figure out so that scars are smaller and less noticeable yet you still harvest more than just a bunch of singles.

The problem that I’m seeing now and have blogged about, is that one or 2 patients a month are coming in with virtually no results from an FUE performed by someone new to hair, and instead of having “no scar” as they say they were assured, they instead have 1000 white splotches in their donor area.

Bottom line, discuss all of this with your potential hair restoration physician before you sign up and thoroughly understand the pros and cons of FUE or follicular unit strip surgery (FUSS).

Lastly, decide if you really want a hair transplant. I spent a while the other day with a lawyer who needs 2000+ grafts, and as we got done with the discussion, he then says he might want to shave his head so he wants FUE. IF you might shave your head then don’t get a hair transplant, strip or FUE, as either one will likely leave scars in the donor region that will be noticeable with a clean shave.

There is never a rush to have a hair transplant. Take all the time you need to make a decision.

Dr. William Lindsey – McLean VA
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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.
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