Is Scarring Common at the Recipient Sites?

Thank you for the time and effort you put into answering all of our questions. My question regards scarring. I have heard some people say that scar tissue forms where the hairs are implanted during a transplant, and that this can result in bumps or raised spots on the hairline. Is this true? If so, is it common? If not, why don’t scars form where the hairs are implanted? After all, a wound of sorts must be made to implant the hair, so how would do you prevent hundreds or thousands of scars from forming after a hair transplant?

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With the technique we pioneered, we do two things that minimize recipient site scarring —

  1. We make very small wounds in the skin, essentially slits that approximate the size of the grafts. These heal very fast.
  2. When preparing the grafts for implantation, we cut off the skin disk at the skin level. To minimize the skin disk, we remove the top layer of the graft skin from the surface of the graft. This prevents the skin from surviving the transplant which could, in some individuals, produce the bump seen in recipient areas. The same process is done with grafts taken from strip surgery.

When doctors use grafts that have a larger surface area than what I described above, the bumps you referenced get more prominent. We have seen from the old days when plugs were done and the graft sizes ranged from 3-5 mm across, the skin always was deformed. Clearly the more skin that survives at the top of the graft, the more detectable will be the existence of the transplanted graft.

Tags: hairloss, hair loss, hair transplant, scarring

3 thoughts on “Is Scarring Common at the Recipient Sites?

  1. Dr. Rassman, does this mean you actually trim off the top of the graft before implanting? Would that mean, then, that there is no visible hair sticking up after transplanting? I haven’t heard this before.

  2. To my knowledge, few doctors trim off the skin for FUE or regular FUT. Back in the early 90s, the Mosher Clinic in Austria amputated the entire skin and hair for a depth of about 1mm at the top. They knew what was up and what was down because of the existence of the bulbs at the bottom. Even though they were not doing traditional Follicular Unit Transplants as we know them today, the used small grafts did successfully addressed the skin deformities that traditionally appeared under the hands of most surgeons. They, like NHI, were doing megasessions at about the same time (early 1990s) so we had commonality in what we did with the skin of the grafts. Keeping the skin at the top of the graft served no value then nor today. Ask your doctor what they do!

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