Help with Craniotomy Scar?

Hi there,

I’m hoping I can get some guidance on craniotomy scar issue I am having. I am a 27 year old male, and about 6 months ago I had a craniotomy for the removal of a benign tumor which was discovered shortly before the procedure. The surgery went well and all is good now health wise. However, I now have a 6″ long scar that is about 5/16″ wide in the back of my head.

I would now like to address how I can improve the aesthetics of the scar, as I prefer to keep my hair short. The good news is with longer hair (shown in the photo), I am able to cover the scar, but I’d really like to wear my hair shorter. I have visited 2 cranial plastic surgeons and one hair doc in the Bay Area, California. Here is summary of their recommendations on how to improve the scar:

– UCSF plastic suregon: Scar Revision and change scar to a zig zag shape.
– Stanford plastic surgeon: Standard Scar Revision. Advised against doing a zig zag as it would change hair growth directions and “make it look weird”.
– Hair Doc: Standard Scar revision and possibly hair transplant on scar if scar needs additional improvement.

Is it true that changing the scar to a zig zag shape would change the hair directional growth? If that is the case, why would the UCSF surgeon recommend that? Do any of you have any recommendations on the best way to improve aesthetics of the scar? My end goal is to not get rid of the scar completely, but to at least improve the aesthetics of it. I’d appreciate some feedback!

I really cannot give you good, personal medical advice via the internet, so I’d suggest if you’re interested you can see us at our office in San Jose or Los Angeles (the consultation is free). We have transplanted hair into craniotomy scars with very good success. Many of these patients have had scar revisions that failed to resolve the cosmetic issues. You may need more than one transplant depending on the case, the size of the scar, and the location of the scar. Dr. Pak recently performed a FUE/FOX transplant into a craniotomy scar where a zig zag attempt was made. Sometimes a zig zag revision can make the scar worse.

Ask your surgeons for examples with before and after photos. Maybe it will help disguise the scar, but it’s still a scar nevertheless. Hair transplants to the scar does not mean the scar will be removed, but at least there is hair growing “ON” the scar and if there is enough hair in the proper direction, the scar will not easily be seen.