Is there a scar in eyebrow transplantation with FUT technique - Surgical Realities and Scarring of FUT Method
Do you want to get up from the operation table with a permanent surgical scar on your neck while looking for a clinic to eliminate eyebrow loss or to make the eyebrow form more aesthetic? Many of our patients anxiously ask Does eyebrow transplantation with FUT technique leave scars? There is only one medical and unalterable honest answer to the question: Yes, unfortunately, you will have a prominent scar on the back of your neck that will last a lifetime. FUT Eyebrow Transplant (Follicular Unit Transplantation) is the process of removing a whole layer of skin approximately 15-20 cm long and 1-2 cm wide from the nape of the neck, which is the donor area due to the structure of the operation, by cutting it with a scalpel.
As Istanbul Eyebrow Transplant, our team led by Dr. Handan Yavuz in our Nişantaşı clinic aims to maintain the quality of life and aesthetic satisfaction of our patients at the highest level after treatment. As a surgical golden rule, every area of skin on the body that is cut with a scalpel and then closed with sutures produces some fibrous scar tissue as it heals. Since these incisions in the natural structure of the skin permanently destroy the follicles where the hair follicles are located, no hair grows again on this horizontal line where the sutures were applied and a distinct line-shaped eyebrow transplant scar on the nape of the neck remains.
The quality of healing of the incision site, the individual's subcutaneous Collagen structure and vascular circulation. In FUT, when a large piece of donor skin is cut away, the remaining scalp is pulled up and down and pulled together. This excessive tension interrupts the capillary blood flow in the suture line, causing the wound edges to not receive enough oxygen. Deprived of oxygen, the wound lips heal by producing poor quality and inflexible hard connective tissue (scar) instead of natural collagen fibers, which increases the thickness of the scar.
Why Don't You Have to Carry This Mark?
In the past years, patients had to accept this permanent scar in advance because there was no other technical alternative in hair restoration surgery. Due to this scar after stitched eyebrow transplantation, patients could not cut their hair short and had to choose hairstyles that covered the nape of their neck. Today, with the modern advances in medicine Long FUE eyebrow transplant standards have completely eliminated these surgical traumas and the nightmare of permanent scarring. We can list the advantages that Long FUE offers to the patient as follows:
- Zero Cut, Zero Scalpel: In the modern Long FUE method, your skin is not cut with a scalpel, no skin strip is removed from the nape of the neck. Only single hair follicles are collected by loosening around them with special microscopic tips (punch). Tissue integrity is not disturbed.
- Seamless Application: After the procedure, only tiny micro-dots with a diameter of 0.7-0.8 millimeters remain in the donor area. These holes shrink and close spontaneously within 48 hours without the need for stitches and become invisible when healing is complete.
- Freedom of Hair Design: Since there is no horizontal, white and thick suture line at the nape of your neck, you can wear your hair as short as you wish and collect it freely after the operation.
- The Comfort of Painless Recovery: Since there are no suture threads that create tension on the skin, there is no restriction in your head movements or tension pain after the operation. You will not feel tension in your neck.
Risks of Keloid and Hypertrophic Scar Development
One of the greatest dangers posed by sutured eyebrow transplants in the donor area is pathological wound healing reactions. If the genetic structure of the individual is predisposed to excessive collagen production, abnormal scar tissues called “hypertrophic scar” or “keloid” may develop on the FUT incision line. A hypertrophic scar appears as a hard, reddish and itchy band that does not extend beyond the suture line but bulges upward from the skin surface.
Keloid ise çok daha agresif bir tablodur; dikiş sınırlarını da aşarak yengeç kıskacı gibi çevre dokulara doğru yayılır. Sürekli kaşınan, ağrıyan ve son derece çirkin görünen bu patolojik dokunun tedavisi çok zordur; cerrahi olarak kesilip çıkartılsa bile tekrarlama riski %80’in üzerindedir. Dr. Handan Yavuz, özellikle keloid eğilimi olan hastalarımızda FUT yöntemini kesinlikle yasaklamakta ve tamamen yarasız, dikişsiz modern Long FUE yöntemini önermektedir. Bu sayede patolojik iz geliştirme riski tamamen bertaraf edilir.
Sewing Thread Reactions and Foreign Body Reaction
Surgical suture materials (needles and threads) used to close the nape of the neck after FUT operation are perceived as “foreign bodies” by the body. During surgical intervention, absorbable or non-absorbable threads may be preferred. If the patient's body overreacts to these sutures, small, hard, inflamed micro cysts called “suture granulomas” can form along the suture line.
These granulomas not only prevent the wound lips from joining properly, but also cause an irregular, pitted or rough scar tissue to remain in that area even after the stitches are removed. In addition, the longer the sutures remain in the skin, the more transverse small white scars resembling railroad tracks are added at the entry points of the sutures. The modern unshaven Long FUE technique, on the other hand, does not use any suture thread or foreign material, so the body does not develop such foreign body reactions.
FUT Scar Treatment and Camouflage Solutions
In our clinic, we offer various scalp scar treatment solutions for our patients who have undergone an operation with the stitched FUT method in a different center in the past and have permanent scars on their neck. The most common camouflage and treatment methods we use are as follows:
1. FUE Transplantation on Scar Tissue: New healthy hair follicles taken one by one with the FUE technique are transplanted on the old FUT scar on the neck. Since the blood circulation in the scar tissue is limited, this procedure requires special solutions and high precision. As the transplanted hairs grow, the scar is hidden naturally.
2. Hair Micropigmentation (Hair Simulation): The scar area is treated with micro dots that mimic hair follicles using special medical pigments. In this way, the white, balding line image created by the scar is visually camouflaged.
3. Fractional Laser and PRP Combination: Fractional laser sessions are applied to soften the hardened scar tissue and reorganize the collagen structure of the skin. This process, supported by PRP treatment, significantly reduces the prominence of the scar.
FUT Scar Related Surgery Comparison
You can examine the effects of the old generation FUT method and the modern, scarless, seamless FUE and Long FUE techniques on the donor area in the comparison table below:
| Evaluation Criteria | FUT Scar Status | Modern FUE / Long FUE Status |
|---|---|---|
| Scar Size | Permanent white line 15-20 cm long on the back of the neck | No visible trace remains (Millimeter dots close) |
| Graft Reception Area Damage | As the skin strip is removed, the hair in that area disappears | Dilution is not evident as the roots are taken with homogeneous distribution |
| Numbness and numbness | Nerve damage due to large incisions and numbness for months | Zero nerve damage (Superficial micro punch process) |
| Tissue Tension and Pain | High tension, stinging and pain at the sutures | Only a slight tenderness on the first day, comfortable |
| Need for Suture Removal | Removal of stitches is mandatory after 10-14 days | Seamless, there's no need to get stitches. |
Frequently Asked Questions
No, the scar tissue formed in the areas of skin that are cut with a scalpel and stitched does not disappear completely. Although the color of the scar fades over time and becomes less prominent, it remains on your neck for life as a white line on which no hair grows.
Yes, hair can grow in transplants performed after the thickness of the scar tissue and blood circulation are examined by the physician. However, since the skin in this area is hard and poorly circulated, the rate of graft adhesion is slightly lower than normal skin. It must be performed by an experienced surgeon.
No. Although the millimetric openings where the roots are taken form small crusts in the form of dots in the first days, these crusts completely fall off within 7 to 10 days with special washes. The skin underneath heals completely and becomes smooth, leaving no permanent scars.
The FUT scar itself does not trigger general hair loss. However, since the hair follicles on the suture line are permanently destroyed, natural hair will never grow from that strip area again. This area has to be camouflaged by growing the surrounding hair.
If the scalp is sutured too tightly after the skin strip is removed from the nape of the neck, the suture line may stretch with head movements and the scar may widen over time into a thicker, more prominent white strip. This is especially common in patients who start sports activities early.
The lifespan of organic and biodegradable medical pigments used in hair simulation is between 3 and 5 years on average depending on the skin structure. At the end of this period, a touch-up session is recommended to refresh the color.
Yes, the absolute amount of hair in the donor area is reduced as thousands of hair follicles in that area are permanently removed from the body along with the skin strip. However, when the hair is left long, this reduction is not visually apparent.
