What Options are Available for Hair Transplant Scar Revision?

This question comes from a member of our hair loss social community and discussion forums: 

Several years ago, I underwent Follicular Unit Transplantation (FUT), and the post-operative scar did not heal well. I’m now left with a very large hair transplant scar, and I’m wondering what options I have for strip scar revision? What are the advantages and disadvantages associated with each option?

In my opinion, there are three options available for those seeking Follicular Unit Transplantation (FUT) scar revision:

Option 1: Undergo traditional scar revision with a second strip excision and a better closure.

During this procedure, the scar will be excised like a strip in a traditional FUT procedure, and a second closure (likely a two layered, trichophytic closure) will hopefully heal “better” and create an improved post-operative scar. The advantages of this procedure include: the possibility of extracting extra tissue and performing a second hair transplant procedure; the disadvantages include: the possibility of a second unacceptable post-operative scar (if the patient truly scars poorly).

Option 2: Follicular Unit Extraction (FUE) into the strip scar.

During this procedure, follicular unit grafts are extracted from the donor tissue surrounding the scar and implanted into the inappropriate scar tissue. The advantages of this type of scar revision include: lack of a second linear scar and minimal trauma in donor tissue; disadvantages include: the possibility of poor growth in the scar because of the nature of the thick, avascular scar tissue, and the potential for FUE scarring in the donor region (though this should be minimal).

Option 3: Scalp Micropigmentation (SMP) into the strip scar.

During this option, permanent or temporary SMP ink will be applied FUT scar, and help camouflage the scar tissue with the surrounding hair. The advantages of this procedure include: a very minimally invasive nature, the possibility to use temporary ink (in case the end result is not ideal), and highly effective camouflage (if performed correctly); disadvantages include: the possibility of permanent ink turning “green” or “blue” over time, and the scar tissue not responding well to the inking process.

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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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