Scar Revision Help/Advice (Please)

This is really a great forum. It's very informative. I wish it would have been around before I got my first HT.

I am hoping to get some help from someone about what direction to go with a scar from a HT I received in 1990. I currently have a punch type scar (60 punches at 3.5mm to 4.5mm each) on the left side of my head that reaches to the middle of the back of my head. It is approximately 10 cm long by 2 cm wide. I am a NH6 and would like to be able to shave my head without having evidence of a huge hair transplant scar. I don't mind having some type of scar, but to have a bunch of big white holes is not very appealing to me. It would be nice to end up with a much smaller scar if possible and without a huge dent in my head. I have seen some crazy looking scars on the internet and honestly I would rather do nothing than end up with something worse.

What I am looking for is guidance and direction. I am a 48 year old male and heal fairly well. The old plugs on the top of my head no longer grow hair and are not very visible. I was thinking of having fraxel to smooth out the small dents.

These are the things I am NOT concerned with regarding the scar: cost, number of surgeries or location of doctor(s). The problem is, if I speak to a FUT doctor (which I have in Los Angeles), he suggests cutting out the scar. If I speak to an SMP doctor he suggests SMP. If I speak to an FUE doctor he suggests FUE and so on. I have also spoken to the staff a very well known acell transplant doctor (not in L.A.) and received a bunch of conflicting information.

It just seems every doctor wants to sell their own services and not just tell me the best way to accomplish my goal. Again, if a small scar is not realistic, then what is? It might be a combination of different techniques. I have been waiting for 20+ years, because the “cure for baldness” is just 5 years away. I really do not want to wait any longer and just want to be able to move forward. I have no idea what to do. The truth is, maybe my expectations are not realistic and I will not be able to shave my head, but rather just cut my hair short. I would just appreciate some straight talk and some type of a realistic game plan, which I am willing to pay for as well. If you need photos, I can email them to you. Thank you, Jeff

You are in a very difficult position because you have multiple scars that are spead out over a very large area. It is almost impossible to condense these scars. If at some point we can create unlimited donor hair we would be able to place hairs into the scarred areas to help camoflage them. Unfortunetely, we do not have that technology yet. Hopefully, some big breakthrough is right around the corner.

It's my pleasure Jeff, to help you out.

Personally, I don't perform just one or two different procedures, for given my extensive experience in surgical hair transplants with particular expertise in repairs, I don't feel that one technique works in every case.

In your situation, it may be helpful to first attempt to excise the majority if not the entire scar, depending on a variety of factors, some of which I can assess through photos. Then, for months later, FUE hair grafts could then be placed into the residual scar, reducing its visibility by as much as 60%. Alternatively, FUE grafts placed into the punch graft scars may be your best approach.