This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY. Dr. Beehner is one of our recommended hair restoration physicians. His professional answer is below.
My doctor told me that I will end up with a 1mm wide donor scar. But now, 70 days after my hair transplant surgery, my donor scar is at least 2mm wide. Will it take much longer to shrink or do I have to live with this 2mm scar?
A hair transplant scar doesn’t ordinarily get slimmer over time although, at 70 days post-op, I think it almost certainly is as wide as it’s going to be. What does happen over that first year is that the color of the donor scar goes from a pinkish hue to a white one similar to the surrounding scalp so that it is much less noticeable.
Because of the huge variance from one patient to the next as to the elasticity of the scalp, I would say your doctor went out on a limb promising you a 1mm or less wide donor scar. In my own practice, first time hair transplant patients end up with a 1mm or less scar probably 80% of the time. But, some of the others end up with 1.5, 2.0, or rarely 3mm. This latter happens in those with “hyper-elasticity” of the scalp. When we inject the tumescent fluid into the donor area prior to making the cut, we can often tell who is hyper-elastic and then plan the excision and post-op care to try and help the donor scar end up as narrow as possible. Ways to do this are the following:
- Leave the sutures in longer (14-18 days instead of 8-10)
- Take a narrower strip
- Keep a small section of scalp intact just behind the ear so that the donor strip doesn’t go all the way through this area but rather is divided into a straight strip from the back wall and two (if needed) strips from the sides.
- In the first couple of months post-hair transplant, have the patient avoid doing activities that accentuate flexion of the neck down onto the chest such as sit-ups or laying in bed reading at night with the head propped up on 2-3 pillows.
I am also one of those hair restoration physicians who believe trichophytic closures are only indicated for those who are having their final hair transplant procedure. I will make an exception if I think a patient has a lot of laxity and doesn’t intend to have another surgery for quite a few years in order to maximize the cosmetic appearance of the donor scar in the ensuing years.
In general, hair transplant patients have to be told that they should expect to wear their hair at least 1/2 inch in length to cover the typical donor scar of 2-3 sessions. If they are not willing to do that or still want to preserve the possibility of shaving their head, then they should look into a non-surgical hair replacement system or possibly follicular unit extraction (FUE). If they are heading toward a typical Norwood VI degree of balding later in life, then I am quite sure that the cosmetic deformity of that many FU’s using FUE will give a “moth-eaten” appearance just as unsightly with close shaving as the worst donor scar.
So, in summary, my prediction for you is that, in around 10 months, your scar will look just fine but won’t be any slimmer and shouldn’t be wider.
Mike Beehner, M.D.
David – aka TakingThePlunge
Assistant Publisher 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 and Social Community
Follow our community on Twitter
Watch hair transplant videos on YouTube