Does an FUE Hair Transplant Leave Scars?

An FUE hair transplant leaves small pin-point scars across the back and sides of the scalp. These scars are typically concealed when the hair is kept at a grade 1 or 2. The scars can be more visible in certain patients depending on their skin tone, hair type and size of surgery. There is no method of scarless surgery. However, a carefully planned hair transplant should ensure that any scarring is disguised. The ability to disguise scarring is highly dependent 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.

What Is An 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 cut 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 for a patient to have a natural looking outcome.

Do FUE Hair Transplants Leave Scars?

All surgical procedures produce scarring. In FUE surgery, patients will have small circular scars that resemble 0.7-0.9mm left in the donor area where the hairs have been removed. These are disguised at short hair lengths.

A skilled surgeon determines the dimensions of the punch tool according to the sizes of the hair follicles to prevent tissue damage. The size of the punch tool can influence how large the scars will be in the donor area.

The aim of a hair transplant is to provide a natural looking outcome but to minimise the visibility of the small scars left behind in the donor area.

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 normally 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, poor post-operative care and personal hair 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. This can leave large deep scars after a hair transplant.

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. Below you will see evidence of necrosis in a patient who underwent surgery in a London clinic and signs of overharvestation on the right where has had too many hairs taken out in the donor area.

How to Minimise or Conceal FUE Scars

Minimising or concealing FUE scars is important and there are ways patient can increase their chances of ensuring they have well disguised FUE scars.

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 our clinic, 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. 

Dr roshan vara, co-founder and Surgeon at the treatment rooms london

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. Feathering the distribution of donor extraction: Feathering the extraction in the margins of the donor area helps avoid the “window-effect” of too many hairs being taken out adjacent to areas that haven’t been harvested.

4. Avoiding excessive harvesting: The removal of excessive follicles leads to overly thinning the 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. 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’. 

Factors that increase the risk of visible scars

Some patients have a higher risk of visible scars compared to others. These are due to hair types, hair thickness, hair and skin colours.

1. Hair curl- If you hair is curly, you can disguise the scars easier as the hair curls and covers the scars even at a shorter hair length
2. Hair thickness- if you hair is thick, it blocks out more of the scalp and scar than finer hair types
3. If you hair is dark and your skin colour is light, the contrast between light skin and dark hair is higher where you have a scar, ultimately making the scarring more visible

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 FUE scars becoming visible. If you want to shave your head after having an FUE hair transplant, you will tend to expose the small pin-point scars. You may want to then concern having SMP (scalp micropigmentation) which can 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. This technique can be applied to conceal the FUE dot-like scars in the donor area.

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.

Can you treat FUE scars?

There are options for treating FUE scars that are hypertrophied. The first line treatment option is SMP. However, some patients may wish to have hair re-implanted into the FUE scars. This is a procedure called donor area restocking. Patients can have their hair transplant removed and replaced back into their donor area. This is a complex procedure that we provide here at The Treatment Rooms London. Below you will see an example of a patient who had their hairline corrected by removing the hair there are replacing it back into their donor zone.

Does FUE produce less scars than FUT hair transplant surgery?

Surgical operations always produce some form of scarring, regardless of any intervention to minimise it. FUE produces fewer visible scars when hair is kept a shorter hair length than FUT hair transplant surgery. FUT hair transplant surgery leaves a linear scar at the back rather than the small pin-point scars of FUE hair transplant surgery.

Technically, a large FUE hair transplant will leave a patient with a larger surface area of scarring when compared to FUT hair transplants. However, FUE scars are better disguised as they are spread over a wider area in the donor area.

Get in Touch

Book a consultation today to learn more about our options. From FUE to FUT hair transplants, we’re leading industry experts. As the winner of Hair Restoration Clinic of the Year 2023, we know you won’t see better results anywhere else.

Want to understand how a hair transplant can help you? Secure your no-obligation consultation with our London hair transplant clinic. Our award-winning team, including leading London hair transplant surgeons Dr Fernando and Dr Vara, are here to support you every step of the way.

At The Treatment Rooms London, we specialise in FUE, FUT and DHI hair transplants. Feel free to get in touch to find out more.

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/