Scarring varies significantly from patient to patient and is largely influenced by genetic and biological factors, even when the same surgical technique and meticulous standards are used. Individual healing response, collagen production, skin characteristics, scalp laxity, and adherence to post-operative care all play important roles in how scars form and mature.
Skin type and genetic background are also important considerations. In general, patients with darker skin types—including many individuals of African American or Latino descent—have a higher tendency toward wider scars, hypertrophic (raised) scars, or keloid formation compared to patients of Caucasian or European descent. This does not mean that good healing cannot occur, but it does mean that scar behavior can be less predictable in certain individuals.
The type of hair transplant procedure also affects scarring. FUT (strip) procedures result in a linear donor-area scar, while FUE procedures create multiple small, circular scars. These factors, along with a patient’s genetic healing tendencies, are carefully evaluated when determining whether FUT or FUE is the most appropriate option for a given individual.
In FUT procedures, surgical closure technique plays a critical role in the final appearance of the scar. Dr. Armani utilizes an exceptionally refined closure method, placing precise, small, tension-controlled sutures that often result in a scar resembling a finely sewn seam. This meticulous closure typically takes approximately 15–20 minutes to perform. In contrast, closures that rely on metal staples or large, widely spaced suture bites—sometimes used for speed and convenience—can take less than two minutes to complete and may result in increased post-operative discomfort and a more noticeable “railroad track” type of scarring, particularly when the hair is worn short.
It is important to understand that variations in scarring are expected and normal, and do not necessarily represent a complication or surgical error. While the surgeon can significantly influence scar quality through technique and planning, the body’s healing response ultimately determines the final result.
In cases where a scar heals less favorably than expected, several treatment options may be available. These can include scar revision surgery, steroid injections to help flatten hypertrophic or keloid scars, camouflage techniques such as scalp micropigmentation, and in selected cases, placement of hair follicles directly into the scar using an FUE procedure to help conceal the area and improve its appearance. At Armani Medical, we have been fortunate to treat patients from across the United States seeking scar revision and hair follicle placement into scars, including scars from prior hair transplant procedures as well as scars from other surgeries such as facelifts, brow lifts, or neurosurgical procedures, when appropriate based on individual circumstances.
