Hair Transplant on Scar:
Scar on fore head and scalp most commonly cause from previous surgery. Like forehead lift,face lift. Or even from previous hair transplant and produce scar in the back of scalp( doner site). Uncommonly from trauma, accident. Some scar from previous inflammatory disease of scalp like SLE, Lichen Plano Pilaris, Pseudo Palade of Broque etc. Very uncommon is cause from birth called Triangular Alopecia, Aplasia cutis congenita.
Scar can be correct or camouflage by transplant hair on the scar. Scar have less blood supply than normal skin. Patchy scar with wide diameter have less blood in the center and inner circle.So narrow linear scar is better than big patchy scar for hair transplant. Soft elastic scar is better than hard scar.
Never try hair transplant on Hypertrophic scar or Keloid. Because will make the scar worst instead of improving it.
To transplant hair on the scar.General rule is slow and less density. Dr. TRUE(USA) and Dr. Martinic(AUSTRALiA) advocate
Punch graft if the scar is hard to avoid pressure necrosis of graft in the tight space of hard scar tissue.
Test graft during operation and test graft for a session is a very good idea in transplant into scar.
Test few graft when start transplant. To see viability of graft check for colour and capillary filling of graft and recipient skin.Check and palpate the skin for tension build up very carefully.Check for stability of graft because occasionally graft is very slippery in scar tissue. Wait for 15 minute if very thing s ok then go for the amount of graft according to plan.
Test session for scar or any questionable area.Whever indoubt do some test .Why ?If a scar look very quiet but doubt if it need about 500 FU. May be can try with 100 FU.for that session and wait 1 year for final evaluation before do another 400 FU. To see the viability of the 100 FU. To see the reactivate process of the disease process( to make sure the scar is free of disease).To improve quality of the scar.
Follicular unit have plenty of stem cell after hair transplant. Graft put into the new host. Stem cell from graft will move to the scar tissue and start repair ,replace, .Will improve quality of scar make it more suitable for next Hair Transplant and also look better in colour ,consistency,softness .
1 Day Post Surgery
6 Months Post Surgery