Who is the Most Suitable Candidate for SCAR Transplantation?
Who is the Most Suitable Candidate for SCAR Transplantation?
SCAR Transplantation (Hair Transplantation onto Scar Tissue), one of the most complex and artistic applications in hair restoration surgery, offers a permanent solution to many aesthetic problems beyond baldness. However, this operation requires far more precision and expertise than a standard hair transplant. The main reason for this is that the “ground” being worked on, the scar tissue, is biologically completely different from a healthy scalp. Therefore, the success of a SCAR transplant is directly dependent on the selection of the right candidate. As the Görkem Kazan Hair Transplant clinic, we examine in detail who can achieve the best results from this special operation and the characteristics that an ideal SCAR transplant candidate must possess.
The goal of SCAR transplantation is not to surgically remove the scar, but to camouflage it by transplanting hair follicles onto it, making it aesthetically invisible. This challenging task can only be successfully completed in patients who meet certain criteria.
The 3 Main Factors That Determine the Ideal Candidate Profile
A candidate’s suitability for SCAR transplantation is evaluated based on three main criteria: the nature of the scar, the quality of the donor area, and the patient’s expectations.
1. The Condition and Nature of the Scar
Not every scar responds equally well to transplantation. An ideal scar should have the following characteristics:
- Must Be Stable and Healed: The scar must have been stable for at least 6-12 months, its color faded, and its healing process completed. Transplants are not performed on active, red, or newly formed scars.
- Tissue Type (Hypertrophic vs. Keloid): Transplants can be performed on thickened scars that have not grown beyond the original wound boundaries (hypertrophic). However, active keloid scars, which show a tendency to grow and rise continuously, are not suitable candidates for hair transplantation; the implantation process could trigger the keloid.
- Blood Circulation Level: The biggest problem with scar tissue is its poor blood circulation (avascular). The surgeon evaluates the scar’s blood supply level during the pre-operative examination. In scars with very poor circulation, the survival rate of the transplanted grafts may be low. In these cases, it becomes mandatory to increase the area’s blood supply with PRP or stem cell therapies before the operation.
2. The Strength and Sufficiency of the Donor Area
The golden rule of SCAR transplantation is this: to repair one area, you need healthy follicles from another. The ideal candidate:
- Must Have a Healthy and Dense Donor Area: The grafts needed to camouflage the scar (usually from the nape area) must be healthy and of sufficient density.
- Faulty FUE Victims (Special Case): If the scar was formed as a result of “overharvesting” the donor area in a previous FUE operation, this is the most challenging scenario. In this case, the remaining healthy parts of the donor area or alternative donor areas, such as the beard, are evaluated. If the donor source is completely depleted, SCAR transplantation cannot be performed.
3. The Patient’s Expectations and Psychological Suitability
SCAR transplantation is a “revision” (correction) surgery and requires realistic expectations:
- Understanding that the Goal is Camouflage: The ideal candidate must understand that the operation will not “magically erase” the scar, but will make it invisible by covering it with hair.
- Density Expectation: Due to the poor blood supply of scar tissue, the graft survival rate may be lower (around 70-80%) compared to a healthy scalp (95-100%). Therefore, expecting perfect density in a single session may not be realistic.
- Possibility of a Second Session: The ideal candidate should be aware that after 1 year, a second “touch-up” session may be needed to increase the density based on an evaluation of the result.
Who Are the Most Common Ideal Candidates for SCAR Transplantation?
- Those with a horizontal scar on their nape from an old FUT (strip) operation who want to cut their hair short.
- Those with permanent hair loss in the eyebrow, beard, or mustache area due to accidents, burns, or suture marks.
- Those with hairless scars resulting from neurosurgery or similar scalp surgeries.
- Those experiencing unaesthetic thinning in their donor area due to faulty FUE harvesting.
Scientific literature emphasizes that transplantation onto scar tissue presents special challenges and that success largely depends on the correct choice of technique. Studies published in the National Library of Medicine (NCBI) show that hair transplantation onto scar tissue (with FUE or DHI) provides high satisfaction rates in suitable patients. The International Society of Hair Restoration Surgery (ISHRS) also recommends that such advanced-level operations should only be performed by surgeons specialized in this field.
In conclusion, the most suitable candidate for SCAR transplantation is a person whose scar is stable, whose donor area is sufficient, and whose expectations are realistic. As Görkem Kazan Hair Transplant, we invite you for a detailed hair analysis and expert consultation to determine if you are a suitable candidate for this delicate operation. You can contact us for detailed information.
