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Donor scarring is a consequence of removal of the strip of donor hair that occurs during the hair transplant process. What determines the extent of donor scarring that occurs in a particular individual? The single most important factors in donor scarring is the ability of the surgeon to excise the strip and close the wound from the donor site correctly. Hasson & Wong employ the Trichophytic Closure Technique to minimize donor scarring.

The ability of the individual to heal well is much less important except for a very small percentage of individuals who either heal with keloid formation or have an abnormality of collagen formation.

The tension in the donor scalp should be accurately assessed before and during surgery. The elastic limit of the scalp should never be exceeded. This principle applies to both the first and subsequent surgeries. Scar formation after multiple surgeries will still be minimal if the elastic limit of the scalp is not exceeded. It is however after multiple surgeries that surgeons most frequently exceed the scalps elastic limit with resultant wide scars.

The method of closure (staples vs. sutures), is relatively insignificant and dependent on the surgeons capability. We however prefer the use of staple in the scalp as they are nonirritant and have superior mechanics over sutures. Staples are however more painful to have and remove, but ten days of mild discomfort is a small price for a virtually undetectable scar.

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