Scar revision by hair transplantation
Scar revision through hair transplantation is unquestionably the most complex aspect of hair transplantation surgery.
It should only be undertaken by those who have sufficient experience in this intricate area.
Fortunately, when carried out successfully, it is one of the most rewarding areas of plastic surgery as it can transform people’s lives; where once patients experienced anxiety and low self-esteem, they can move to a place of peace of mind and confidence.
As a consultant plastic surgeon - with a major interest in scarring and facial disfigurement - understanding the importance of both prevention and successful treatment in this area has been an integral part of my everyday professional career for more than 25yrs.
Hair transplantation is but one technique in the arsenal of reconstructive methods which can be deployed in minimising the appearance scarring.
Hair transplantation is, in itself, not necessarily a universal panacea. Nor it is the one ‘perfect’ technique for all hair bearing skin scar correction. Other conventional plastic surgery techniques may be used instead of, or in conjunction with, hair transplantation. The ability to combine the right surgical techniques for the particular problems of scarring are crucial.
In addition to technique, selecting the correct sequencing of operative procedures is important to make sure subsequent reconstructive procedures (such as other procedures of the face) are not jeopardised. It is vital not to ‘burn one’s reconstructive boats’.
Why is scar revision more complex than routine hair transplantation?
There are a number of reasons why direct hair transplantation into scar tissue is significantly more complex than routine hair transplantation. Scarring has both a differing blood supply and substantial variation in elasticity when compared with normal skin. There is an increased risk of skin necrosis (death) especially if carried out by unskilled hands. In addition, it is important to remember that scarring treatment must not jeopardise subsequent scar treatments or compromise future hair loss appearance when undertaken for aesthetic purposes.
Scarring treatment can be executed by a number of surgical methods, not just hair transplantation. Choosing the best method is paramount. This requires experience and knowledge for the reason that scarring involves complex facial structures. The ability to manage the face - and all of its associated anatomical structures - is important so that, amongst other things, we can prevent facial paralysis.
Which scars can benefit from hair transplantation?
Scarring within hair-bearing skin is potentially treatable by hair transplantation. Areas such as the scalp, the eyebrow and the beard are all treatable through hair transplantation.
Mr Fogarty may also use non-transplantation techniques, depending on the intrinsic nature of the scarring. Outpatient consultation and assessment will be able to inform the patient about the variety of potential treatment options available.
What are the principles of hair transplantation scar-revision?
Hair can be taken form a donor-site. This may be the scalp or the beard area, when working with male patients. Using the FUE method of extraction, we can harvest the required type of hair grafts from the donor site, implanting them into the scarred area as required.
After a period of approximately 6 months, the transplanted follicles will be growing. This means that the underlying scarring area can be disguised. Indeed, of all the potential scars in the body which are situated in hair-bearing areas can not only be improved - but almost effectively eliminated.
What complications may occur with scar revision hair transplantation?
No surgical procedure is completely predictable as it is a biological process and therefore beyond absolute human control. That said, we can plan and execute procedures to ‘roll the ground’ and optimise surgical outcomes. Thankfully, with our experience of scar management, the risk of complications is minimal. Importantly, in the unlikely event of complications occurring, mitigating the consequences is vital through skilled and timely patient management.
The type of complications are the same as those found in conventional hair transplantation for hair-loss. However, the risks are slightly higher in scar tissue transplantation. These are;
Skin/scar necrosis:
Surgery can compromise the blood supply of the skin/scar and in such an event, insufficient blood supply will cause the skin/scar to die (necrosis). Thankfully this is unlikely to occur in our hands owing to Paradigm’s knowledge of, and skill in, performing the procedure. This has to be done in a judicious fashion to ensure that appearance is optimised and risk minimised. Should necrosis occur, we have a number techniques available in order to address any complications. This means the patient will experience the best possible outcome.
Other complications:
As mentioned above, scar transplantation must be staged and coordinated with all other forms of treatment. We need to think about potential future hair loss and integrate our approach with other scar revision procedures. It is important to any avoid surgical errors in planning. This form of treatment should only be carried out by those with expertise in both reconstructive plastic surgery of the face AND scar management. It also needs to be undertaken in conjunction with expertise in hair transplantation for aesthetic purposes.