Healing and scarring after follicular unit hair transplants

Question: Hi Dr. Kabaker – I’m leaning toward doing this procedure. Before I do, I have some more questions.

I’d like to understand better how much hair (1/4 inch? 1/2 inch?) is removed from the back of my head. I guess what I don’t fully appreciate is that this hair will grow back and hide the scar. Does that happen in every case?

Will I feel physical sensation at the surgery site for months, years after the procedure?

Is there a chance that the site would not heal properly, or that it could reopen?

I’d appreciate 3 references I could contact by telephone or email.

Answer: We remove a certain amount of hair from an area of the scalp that does grow bald in the patient’s lifetime. We do not create more hair, we simply move existing non-balding fringe hair to balding recipient areas. We have to leave enough hair so that the donor area looks normal with usual hair styles such as the one you wear. The transplanted hair grows in the recipient area and does not grow back where it was taken from. This is the basic concept of hair transplantation.

If I were to do 2500 grafts I would need to take about 25-30 square centimeters of donor scalp. Therefore the strip of donor scalp could be 1.3cm in height and about 20cm in length. That would leave a suture line and eventual scar that would measure about 20 cm from side to side that is immediately covered by the surrounding hair. This becomes a scar which is similarly hidden forever. Alternatively one could have 1500 small drill holes (FUE) of a shaved area of the scalp that eventually gives tiny white scars that , like the linear scar, only shows if you shave your head. I do not use this second harvesting technique as I feel the quality of the grafts and the subsequent result of good growing hair is lessened. Also the total cost is more. There is a $400,000 robot machine made by Artas which can do this FUE (follicular unit extraction) harvesting work. I am not buying one. I feel that the artistry in this work is in the creation of the recipient sites , the proper selection and sizing of the best quality grafts, and the placing of them in the recipient sites. There is no robot that does this yet, however some marketing schemes seem to imply that there are such devices. I sure wish there was such a machine .

You should feel no more residual discomfort, early and late, than a dental procedure .

I leave sutures in for two weeks to prevent an accidental opening of the donor area. At times I have removed them in one week. A strong blow to the back of the head could open up the donor incision. The donor area, like any repaired body incision, is not strong for about 6 weeks.

I no longer will ask prior patients to be called by prospective patients. I have exhausted my favorite and most vocally articulate patients’ respect for privacy. I do not do discounted hair transplant surgery in exchange for such impositions. Maybe I should.

Four months is plenty of time to heal and there might be about a half inch of growth from the transplants. The sooner you start the sooner your result.

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