Treatment of Postsurgical Scalp Scar Deformity Using Follicular Unit Hair Transplantation

Background. Although stable cicatricial alopecia (SCA) secondary to surgical events of the scalp can affect patients’ psychosocial status, hair transplantation onto postsurgical scar tissue on the scalp is challenging because of tissue stiffness and poor blood circulation. Objective. In contrast to traditional surgical treatments, such as excision, local flap, and tissue expansion, follicular unit (FU) hair transplantation offers aesthetically pleasing results in the treatment of postsurgically induced SCA. Materials and Methods. This study included 15 patients with SCA of the scalp due to postsurgical scarring. The patients underwent a single session of hair transplantation of approximately 35 units/cm2 density. The graft survival rate was evaluated 12 months after the procedure. The Patient and Observer Scar Assessment Scale (POSAS) was used to analyze the preoperative and postoperative satisfaction. Results. The FUE hair transplantation had a mean survival rate of 80.67% (range 70-90%). The patient and observer satisfaction significantly improved after the procedure; the POSAS scores were 24.47 (range 16-38) preoperatively and 11.60 (range 7-18) postoperatively. Conclusion. FU hair transplantation could be an effective method for managing scar tissue on the scalp and offers several advantages, including a high transplantation survival rate and satisfactory postoperative results