Does an FUE Hair Transplant Leave Scars? Myths, Facts & What to Expect?

Does an FUE hair transplant leave scars? The short answer to this is yes. All current hair transplant surgical procedures do. However, a carefully planned hair transplant should ensure that no scar is visible to the naked eye. This depends on the skill and experience of the hair transplant surgeon.

In the following article, we discuss what these FUE scars might look like, the extent of them and how you can mitigate any visible scarring as a result of the surgery.

A well-executed FUE transplant surgery is determined by the competence and experience of your hair transplant surgeon, and their advice on what level of haircut would allow for the most natural results, and versatility when styling hair post-surgery. 

In this article, we will explore FUE hair transplant scars, their visibility, and solutions for managing them. 

What Is a FUE Hair Transplant?

FUE (Follicular Unit Excision) is a meticulous technique where individual hair follicles are harvested from a donor area (usually the back and sides of the scalp) and transplanted to a target area of balding/thinning, such as the frontal hairline, temples and crown.

The procedure is usually carried out under local anaesthesia and uses extraction devices less than 1mm in diameter to individually core out the follicles. These excised hair follicles are then reinserted into the scalp. 

While it may seem straightforward, highly artistic skills are required from hair transplant surgeons to produce natural-looking results. Deep consideration must be given to determining healthy and achievable hair densities, directions of hair growth, depth, and angulation.

Do FUE Hair Transplants Leave Scars?

All extensive surgical procedures produce scarring. In FUE, scars that resemble 0.7-0.9mm are left in the donor area once the hairs there are removed. 

A skilled surgeon determines the dimensions of the punch tool according to the sizes of the hair follicles to prevent tissue damage. 

The surgical result depends heavily on the surgeon’s skill level when it comes to minimising scar visibility, and post-operative care can determine the effectiveness of scar fading.

What Do FUE Scars Look Like?

FUE scars are tiny, dot-like scars sprinkled across the back and sides of the head in the donor area of the scalp. Each dot is approximately 0.7 to 0.9 mm in diameter. 

As long as hair is grown longer than a number 2 and above, these FUE scars are virtually invisible to the naked eye, as the hair has grown over to conceal them. 

In this picture, you can see the tiny, dot-like scars a day after surgery. The scars are significantly less visible by day 7 and continue to improve. 

Causes of Visible FUE Scars

Visible FUE scars can result from poor healing, the types of tools used for extraction, post-operative care and personal characteristics. Here are the leading causes:

I. Overharvesting: Scarring can become apparent when thousands and thousands of grafts are harvested from the donor area on the back and the sides of the scalp, leaving not enough hair to grow out and cover over where hair was taken from. Typically, even after one procedure, wearing hairstyles that are too short can expose scarring. Multiple procedures increase the risk of visible scarring as more and more dots accumulate. 

II. Poor spacing between extractions: When follicles are extracted too near each other, the small wounds can merge into larger, more visible scar tissue areas. 

III. Use of larger punch tools or unskilled technique: The size of the punch tool used to obtain hair follicles determines the size of each pinpoint dot, and a big punch can leave bigger scarring. 

IV. Skin necrosis due to improper technique: Skin necrosis following FUE hair transplant occurs when improper technique causes blood vessel damage that cuts off the scalp blood supply.

The loss of skin tissue through necrosis creates larger and irregular scars that differ from the more unnoticeable marks that appear during proper FUE execution.

The appearance and concealment of FUE scars become more difficult when necrosis occurs. Engaging with a safe and medically qualified clinic can help prevent serious complications like this. 

How to Minimise or Conceal FUE Scars

Minimising or concealing FUE scars requires care to be taken both before and after surgery: 

1. Choosing an experienced surgeon: A surgeon’s expertise determines the success rate of minimising FUE scars. It boils down to using quality, appropriately sized punches and knowing how to use them to prevent overharvesting and damaging the scalp. 

At Treatment Rooms London, we are dedicated to delivering high-quality surgical outcomes using the latest available technology and continually updating our skills to meet the expectations of our patients. Our attention to detail and commitment to safe, quality care set us apart as one of the UK’s finest clinics. 

2. Maintaining hair at Number 2+ for natural concealment: Longer hair strands more easily cover over FUE scars and provide a denser appearance of the donor area, better than shorter hair does. 

3. Even the distribution of donor extraction: A proper distribution of extracted hairs throughout the area helps to avoid both unbalanced thinning and visible scars.

Studies have shown that the extraction of less than 40% donor density maintains the natural hair density(Mohmand & Ahmad, 2018). Essentially, once more than 40% of the donor area has been extracted, scarring becomes visible, and the area can start to look ‘moth-eaten’. 

4. Avoiding excessive harvesting: The removal of excessive follicles leads to a thinning donor region that increases both scarring and exposes the scalp. The number of follicles needed for surgery should match up with what the donor area can realistically provide. 

What If You Want to Shave Your Head?

As we discussed, the most natural result is achieved by keeping hair longer than a number 2 or above; anything shorter increases the risk of scar visibility. SMP (scalp micropigmentation) may help conceal scarring more effectively with a shaved head; however, this is not a guarantee. 

Scalp Micro-pigmentation (SMP) is a form of medical-grade tattooing where professionals create tiny pigment dots across the scalp to generate the appearance of hair follicles on the scalp surface.

SMP serves as a non-surgical approach to treat hair loss, baldness and scars on the scalp. The SMP technique replicates the natural appearance of hair follicles, allowing individuals to conceal hair loss and achieve a fuller head of hair. 

The longevity of scalp micro-pigmentation treatment can last up to six years or longer, depending on the procedure technique, the body’s response to the treatment, and the quality of post-treatment care.

The eligibility criteria for scar correction procedures: 

I. Scar Thickness: The restricted blood circulation in hypertrophic (thick) scars reduces the success rates of graft survival. The surgeon can assess whether the scar has sufficient strength to support follicle transplants.

Thin scar tissue often fails to provide sufficient stability to retain grafts properly, leading to irregular growth patterns.  

• Patients with a tendency toward keloid scarring or a family history of keloid scarring may be eligible for the FUE technique; however, this is determined on a case-by-case basis. 

II.  Scar Stability:  Only fully healed scars can be operated on, with no presence of inflammation or recent skin changes. The necessary waiting period for scars from burns and trauma should extend to 1–2 years according to medical recommendations.  

The treatment of inflammatory conditions requires at least 5 years of disease inactivity to prevent further inflammation.  

III. Blood Supply to the Scarred Area: The blood flow within scar tissue is usually insufficient for the survival of follicles. A surgeon will be able to assess the blood supply to the area and recommend treatment based on the findings. 

IV. Donor Hair Availability: The surgical process requires sufficient donor hair from the back and sides of the scalp, which must be healthy for transplantation. The patient may be disqualified if their donor area exhibits a low hair density.  

The donor site must not present diffuse unpatterned alopecia (DUPA),  as this condition weakens hair stability.  

• People who suffer from active autoimmune diseases and uncontrolled diabetes or scalp infections will need to wait for health stability and, in most cases, inactivity of their disease before proceeding with treatment. 

Can FUE Be Scar-Free?

Surgical operations always produce some form of scarring, regardless of any intervention to minimise it. FUE produces fewer scars than FUT, but the procedure nonetheless leaves some scarring behind. 

It’s essential to recognise that, with an experienced surgeon, the visibility of scars can be minimised if the proper techniques are employed.

Other Surgical Options for Scars:

Scar revision surgery is a medical procedure that helps limit scar tissue that can prevent movement or other bodily functions. 

The specific technique for scar revision surgery depends on the scar characteristics and location, and may include surgical excision and closure, skin grafts, flaps, Z-plasty, or laser treatment. 

A Quick Summary 

Surgeons who have advanced skills can minimise FUE scars to a degree that patients can easily manage them. Patients will achieve optimal results when surgeons use precise punch tools and benefit from effective post-operative care to enhance healing. 

Get in Touch

Curious about FUE hair transplant solutions? Secure your no-obligation call with our London hair transplant clinic, or head to our FUE hair transplant clinic in Bristol. We’re also proud to support clients in Oxford and Brighton.

References 

1. Mohmand, M. H., & Ahmad, M. (2018). Donor area complications in FUE hair transplant. Journal of Cutaneous and Aesthetic Surgery, 11(3), 145–148. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066700/