Hair transplant scar revision is a delicate procedure of removing an old hair transplant
scar. Dr. Sean Behnam has spent years experimenting and researching newer techniques to revise the scar. Below are a series of FAQ pertaining to hair transplant scar revision.
It is important to note that there are two different methods of revising a scar. Either cutting it out or implanting grafts into it. In the latter option a technique called scar camouflage using the Follicular Unit Extraction
procedure to remove the grafts. The FUE method of extracting the grafts does not leave a linear scar. Scar camouflage depends on the number of grafts needed. During the consultation, Dr Sean will inform you on the number of grafts needed.
Hair transplant scar revision is a procedure that removes scars of hair transplant in the donor area. The end result is a minimal looking scar that can easily be concealed.
Many older hair transplant techniques may leave a linear scar in the back of the scalp that is wide or hard to conceal. If somebody does have a scar from a previous hair transplant, Dr. Sean can remove that scar and suture the area again in order to reduce the width of the scar.
There are four factors involved. Typically, when a strip of tissue is removed for hair restoration
, the width of the tissue is at least 1 cm. In scar revisions, the focus and goal is only to remove the scars. Dr. Sean uses a triple method technique to reduce scarring. The patient must do at least two weeks of scalp exercise prior to the procedure. Patients with wide scars may require longer. Scalp exercise increases the elasticity of the skin.
It will reduce the tension on the back of the scalp when the strip of tissue is removed. Tension between the upper and lower skin edges is what leads to stretched scars. Dr. Behnam uses a double layer closure during the procedure. This is when the inside of the incision is closed with dissolvable sutures and outside of the incision is closed with staples. The inner sutures reduce tension and the outside staples prevent stretching of the scar. Dr. Sean also uses the trichophytic closure technique. In this technique, a special cut is made such that when the incision is closed , there is a slight overlap. This allows hair to grow into the the scar. This makes the area much less noticeable and patients can cut their hair much shorter than they could before the scar was revised.
For approximately 2 weeks prior to the procedure, you will be doing special scalp exercise that increases the laxity of skin. Then on the day of the procedure, the area is numbed up and the scar is removed. The inside of the incision is then closed twice with a dissolvable suture on the inner layer and staples on the outer layer. The trichophytic technique used which causes hair to grow out, into the new reduced scar.
Dr. Sean performs a lot of scar revisions.
Since implementing the triple method technique in 2008, we have not had any patient that required scar revision.
ACELL is an extracellular matrix that promotes wound healing and decreases scarring. It is used for wound healing and provides a significant advantage in scar revision procedures.
Trichophytic closure refers to a specific closure method that causes hair to grow into the scar. During the actual procedure, special cut is made on the bottom edge. The two edges are then brought together with a slight overlap. When the wound has healed, the hair should grow at the level of the scar and camouflage it. Dr. Sean uses the trichophytic closure on every patient.
The 3 steps of the the trichytic closure. (top picture) Once the strip is removed, a special cut is made on the bottom edge. This way hair grow out, the hairs grow into the level of the scar ( middle and bottom picture)
This picture demonstrates how a trichophytic closure works. This gentleman’s hair was shaved to demonstrate that the hairs grow into the scar. This technique takes a lot of precision and this is why Dr. Behnam performs only one case per day. Dr. Behnam spends an hour closing the back of the scalp. The blue marks are markers.
Another example of the trichophytic technique. The slight redness represents the scar healing and the hair can be seen growing into it.
Double-layer closure refers to the special closure of the wound. When a strip is removed, the inner layer is sutured completely with dissolvable sutures, then the outer edges are also closed using staples. This double closure technique leads to minimal scarring.
No, there will still be very light scar visible, however it will be minimized, and easily camouflaged.
Yes, this is known as a scar camouflage with grafts. Follicular unit extraction (FUE)
is used to remove the individual grafts which are then placed into the level of the scar.
In scar revision, the actual scar is cut and removed and in scar camouflage, individual grafts are placed into level of the scar to camouflage it.
The cost of scar revision is $1995 per session. Patients with large/wide scars may need two sessions. The session price includes the use of ACELL.
Those hairs will be placed at no charge.