Scars on the scalp have no hair and are easily visible even when narrow. Alopecia, mainly in the whorl of hair at the back of the parietal region is extremely difficult to cover up. 

New Treatment for Visible Linear Scars on the Scalp

November 21, 2021 by Dr. Sandeep Bhasin
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Scars on the scalp have no hair and are easily visible even when narrow. Alopecia, mainly in the whorl of hair at the back of the parietal region is extremely difficult to cover up. 

In order to deal with alopecia, a new technique has been used where multiple hair-bearing flaps are harvested near the area of alopecia using each flap that includes 10-15 hairs.  

Several patients suffering from alopecia are nowadays treated with multiple hair-bearing flaps. Depending upon the condition, the number of flaps per patient is used in order to complete the treatment. 

Once the treatment is done successfully, all wounds heal easily without any complications. Not only this but the scar is also hidden immediately with the help of hair after the operation. 

Patients who have visible scars need to undergo a secondary repair. One of the main benefits of using this technique is dense hair bundles in the flap are studded which assists in hiding the residual scar.

In this article, you will know which is the best technique to deal with visible linear scars on the scalp.

Hair Transplant Best Technique For Scalp Linear Scars

More than 70% of people consider hair as one of the most essential features of the overall personality. Hence, these days both surgical and non-surgical hair loss treatments have gained popularity. One of the best surgical options for you is to undergo hair restoration surgery

The issue of hair loss often affects the way you see yourself in several ways. It is true that hair is linked with beauty, youthfulness, and liveliness because the problem of hair loss leads to feelings of self-consciousness.

A hair transplant is basically a successful surgery in which hair is moved to bald or thinning areas of your scalp. If you have tried and tested several other hair loss treatments then a hair transplant is a one-stop solution. Hair transplant is usually conducted by dermatologists or plastic surgeons. 

In case, you are suffering from an alopecia problem that can have an impact on your scalp and even your entire body then hair transplant surgery can help you. Remember that hair transplant surgery can help you with permanent hair loss problems. 

During the surgery, grafts or small pieces of skin are taken from the areas of your body that contain healthy hair. This area is considered a donor site. You need to know this area is mainly found on your head or at the back of your scalp where the thickest hair is present. 

When it comes to performing hair transplant surgery, there are different ways:

  • Grafting 
  • Tissue expansion
  • Scalp reduction
  • Flap surgery

Do you need a hair transplant?

It is necessary for you to know that a hair transplant is permanent and the transplanted hair starts growing within four months after the transplantation is done. 

Depending upon the stage of hair loss you are at, it is decided whether you need to undergo hair transplant surgery or not. Before making a decision for a hair transplant, it is always better to consult an expert in hair transplantation because an expert can better determine whether you require a hair restoration or just a non-surgical hair restoration treatment.

What is the technique for performing this procedure?

In order to perform this procedure, the multiple hair-bearing flaps technique is used near the area of alopecia and each flap includes at least 10-15 hairs. Several patients suffering from alopecia with scar sizes ranging from 2cm to 17cm in length and 0.5cm to 2cm in width have been treated using this technique. 

Hair loss from the flap is rare but the scar can be hidden by the hair directly after the operation. In some patients, a visible scar remains or is created at the donor site. Such kinds of patients need to undergo a secondary repair. 

One of the major benefits of this technique is that the dense hair bundles present in the flap are studded here and there in the scar, the scar can be diminished and the remaining scar is easily hidden through the flap hair.

Such type of technique is often considered beneficial for the occipital and parietal areas, specifically near the whorl of hair. 

Operative Technique 

To conduct this technique, hair within about 2 cm of the scar is first cut to almost 5mm in length. Keep one thing in mind, long hair in a flap can cause interruption when passing the flap under the adjoining skin and even the direction of hair growth is not visible in case the hair is shaved off fully. 

  • The very first step is to multiply small ellipses almost 8-10mm long and 3-5mm wide, which are removed from the scar. When the scare becomes narrow, the ellipses are excised in a proper line. 
  • When the scar is extensive, a dual line of alternating ellipses might be excised. 5-10mm from the scar margin, small flaps are designed on the scalp. The alignment of the flap depends on the direction of hair growth which must be capable of covering the scar. However, it is vital that the size and shape of the flap must match the defect which is created in the scar.         
  • The long axis of the flap must be designed slanting to the direction of the scar. When the scar is extremely long and spreads beyond the area of the whorl of hair then the area of the whorl of hair is treated only by using this technique. The size and shape of the flap must match the imperfection which is created in the scar. 
  • When the scar is long and spreads beyond the area of the whorl of hair then only the area of the whorl of hair can be treated using multiple hair-bearing flap techniques which further helps in maintaining the supply of blood to the flap.

The skin present between the flap and the defect is destabilized just above the galea. After this, the flap is moved to the defect in the scar using the tunnel. The margin of each flap is sealed at two or four points. On the other hand, the donor site is firmly sewn using dermal joints. Later, after 7-10 days of postoperatively, all the joints are removed. 

Know its effect with case studies

Case 1

A 24-year-old male was diagnosed with Alopecia along with the removal of a skin tumor. Due to the removal of the tumor, in the parietal area, a 4cm x 1 cm scar was created. 

The way of hair growth made the mark prominent and even the right side of the mark lay along the hair whorl. After this, the men decided to undergo multiple hair-bearing flap techniques where nine flaps from both sides of the scar were used with the help of local anesthesia. 

Although, after the operation, there was a slight hair loss from the flaps after a month the hair began to regrow. By combing his hair, the patient was successful in biding the mark and also creating a normal whorl.

Case 2

An 18-year-old female was suffering from burn-scar alopecia in her parietal area. She went through the elimination of the scar with direct closure in two preceding cases. But a 3.5 cm*0.8 cm still persisted. 

The scar was prominent as the hair follicles released away from it. Not only this but even the center of the scar was present in the area of the hair whorl. Later, by giving local anesthesia, eight small flaps were used. Right after the operation, fine hair started to grow and the scar was no longer present when she combed the hair properly.

Case 3

A 9-year-old boy diagnosed with alopecia following trauma went through an examination where it was revealed that a 13cm *0.6-1.2cm scar was present from the parietal region to the right temporal scalp which resulted in traumatic laceration of the skin. 

But the patient did not experience any substantial enhancement even after undergoing scar excision and relaxation suturing twice. The hair only parted on either side of the scar. Later, the flap technique was used through local anesthesia. After the operation, the flap hair started growing well and even quickly. 

Just after six months of operation, the scar was not visible anymore when the hair was combed properly.

What are its results?

Several patients suffering from scalp alopecia are treated using the multiple hair-bearing flaps technique and the operation is performed using local anesthesia. The number of flaps used ranges from three to twelve which means 8:6. After this, there was a follow-up of almost one year. 

Without any kind of complications, all wounds healed well and satisfactory results were attained in more than 50% of patients. In these cases, the flap hair started growing right after the operation immediately and even preserved its preoperative thickness. 

Reviews

Several men and women suffering from the problem of alopecia went through this multiple hair-bearing flaps technique and are really happy with their results of hair growth. The multiple hair-bearing flaps technique is not only easy to manage but also looks aesthetically pleasing at the same time. 

References

New treatment of a visible linear scar in the scalp: multiple hair-bearing flap technique

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Dr. Sandeep Bhasin

Dr. Sandeep Bhasin is a highly skilled cosmetic surgeon and the owner of Care Well Medical Centre in Delhi. With extensive expertise in cosmetic and plastic surgery, he is dedicated to providing exceptional care and transformative results to his patients. Dr. Sandeep Bhasin obtained his MBBS and MS in General Surgery from Aligarh Muslim University (AMU) and served as a consultant at Bhaktshreshtha Kamalakarpant Laxman Walawalkar Hospital, Diagnostic & Research Centre. Specializing in various procedures such as face-lifts, rhinoplasty, liposuction, breast augmentation, hair transplant and many others, Dr. Sandeep Bhasin is committed to enhancing his patients' natural beauty and self-confidence.

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