Revising Old Hair Transplant Scars

Revising Old Hair Transplant Scars with FUE &; DHI Eyebrow/Scalp Grafts

By Dr. Mo Khairy Mosa | Luxor Hair Transplants & Cosmetic Surgery | March 7, 2026

If you underwent a traditional "strip method" (FUT) hair transplant years ago and are now left with a visible linear scar on the back of your head, you are not alone. At Luxor Clinic in Port Melbourne, we specialise in scar camouflage using Follicular Unit Extraction (FUE) combined with Direct Hair Implantation (DHI) for both scalp and eyebrow grafts. This advanced technique transforms unsightly scars into natural-looking hairlines and density, all without the need for additional strip surgery.

In this guide, I will explain the nature of FUT scars, our proprietary FUE + DHI revision protocol, and what you can expect from your initial consultation to the final 12-month results.

The Problem: Understanding FUT Scars

What is a FUT Scar?
FUT, or Follicular Unit Transplantation, was the standard procedure from the 1990s to the 2010s. It involves surgically removing a strip of scalp—typically 1-2cm wide and 20-30cm long—from the donor area, which is then dissected into individual grafts.

The resulting scar is characterised by:

·        Width: Can range from 2mm to over 8mm, often widening over time due to scalp tension, poor healing, or multiple procedures.Rouba Khairy

·        Location: A horizontal line across the back of the scalp (occipital region).

·        Visibility: Becomes exposed with short haircuts, ponytails, or when wearing hats.

·        Texture: Often appears shiny, hypopigmented (lighter than the surrounding skin), and can be stretched or hypertrophic.

Patients who have undergone multiple FUT procedures often present with overlapping scars and reduced donor density, making traditional scar excision risky and ineffective.

Why is this a Growing Concern?
Modern hairstyles favor shorter cuts, exposing scars that were once easily hidden. This, coupled with increased self-awareness amplified by social media, has led to a surge in demand for scar revision. At Luxor, we primarily see men aged 35-55 with significant hair loss and a history of multiple FUTs, as well as women with widened scars from ponytail tension.

The Luxor Solution: FUE Harvest + DHI Implantation

Why FUE + DHI?
Traditional scar excision often results in a new, sometimes wider, scar. Our FUE + DHI approach, however, camouflages the scar by harvesting individual healthy grafts from the donor zone and implanting them directly into the scar tissue. This allows hair to grow through the scar, effectively concealing it.

Luxor Advantages:

·        Sapphire FUE Blades (0.8-1.0mm): Provide a sharper, cleaner harvest with minimal trauma to the donor area.

·        DHI Choi Implanter: Enables precise depth and angle control when implanting grafts directly into dense scar tissue without the need for pre-made recipient slits.

·        Scar De-epithelialization: The scar surface is carefully thinned to create an optimal, vascular bed for the new grafts.

Our 5-Step FUE + DHI Scar Revision Protocol

Step 1: Donor Assessment & Planning

·        Trichoscopy: We measure scar width and donor density to determine graft availability.

·        Custom Design: We map out hair direction over the scar and plan any eyebrow restoration.

·        Graft Calculation: A typical case may require 1,500-3,000 FUE grafts for a crown scar, with an additional 200-500 for eyebrows.

Step 2: Tumescent Anaesthesia & Scar Preparation

·        Local anaesthetic is administered for complete comfort.

·        The scar surface is precisely de-epithelialized to prepare a healthy recipient site for the new grafts.

Step 3: FUE Harvest

·        Individual follicular units are carefully extracted from the safe donor zone using our motorised Sapphire FUE system, with a transection rate of less than 3%. The donor area heals as tiny, dot-sized scars that fade quickly.

Step 4: DHI Implantation Over Scar (The Key Innovation)

·        Using the DHI Choi Pen, grafts are implanted directly into the prepared scar tissue at a density of 35-45 FU/cm². The implanter creates the site and places the graft simultaneously, minimizing time out of the body and maximizing survival rates (95%+ in scar tissue). This technique allows us to control depth precisely and match the angle of your natural hair growth.

Step 5: Immediate Aftercare

·        A comprehensive post-operative pack and clear instructions are provided to ensure optimal healing and graft survival.

Eyebrow Restoration: DHI Precision Perfection

FUT over-harvesting can sometimes thin the temporal donor areas, leading to patchy eyebrows. At Luxor, we use DHI to restore eyebrows with elite, single-hair follicles for a natural, feathery density and perfect angulation. This dual-benefit approach not only restores facial harmony but also helps to camouflage the lateral ends of the scalp scar.

Real Luxor Transformations

·        Mark, 42: After three FUT procedures, Mark had a 6mm scar that prevented him from getting a #2 haircut. We implanted 2,200 grafts over the scar and 300 in his eyebrows. At 12 months, he enjoys a #1 clipper cut with 95% scar coverage.

·        Sarah, 38: Sarah had a widened ponytail scar and thinning brows. A single session of 1,800 crown grafts and 450 eyebrow grafts restored her confidence, allowing her to wear her hair up without worry.

·        Multiple Scar Overlap (5x FUT): A patient with three overlapping scars and depleted donor density received 2,800 conservative FUE grafts. The result at 12 months is a seamless, natural look with a #1.5 cut.

The Science & What to Expect

DHI excels in scar tissue because it allows us to precisely penetrate dense collagen and place the graft at the exact depth needed to reach the vascular dermis, achieving a 92-97% survival rate.

Recovery Timeline:

·        Days 1-10: Rest and careful post-op care, with scabs healing by day 10.

·        Month 1: Initial shedding of transplanted hair is normal.

·        Month 3: New growth begins to appear.

·        Month 6: Approximately 50% of final density is visible.

·        Month 12: Full, mature results are achieved.

Is FUE + DHI Scar Camouflage Right for You?

Ideal candidates have stable hair loss, visible FUT scars, a goal of wearing short hair, and adequate donor density. The procedure is not suitable for those with active hair loss or healing conditions like uncontrolled diabetes or heavy smoking.

Frequently Asked Questions

Q: Can the scar be completely eliminated?
A: The scar tissue itself remains, but it is rendered over 95% invisible as healthy hair grows directly through it, allowing for short haircuts.

Q: Is the DHI method worth it for scars?
A: Absolutely. For scar tissue, the precision and higher survival rate of DHI are superior to traditional forceps implantation.

Q: Will I need more than one session?
A: Most patients achieve their goal in a single session. More complex cases with extensive scarring may benefit from a second session 12 months later.

Q: Is the procedure painful?
A: The procedure itself is pain-free due to the local anaesthetic. Patients typically experience only mild soreness for a few days afterward.

References for "FUE + DHI Scar Camouflage Blog Post"

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Clinical Studies & Peer-Reviewed Papers

1. Jiménez, F. et al. (2023). "Anagen hair follicles transplanted into mature human scars remodel fibrotic tissue." npj Regenerative Medicine. Demonstrates hair grafts actively remodel scar architecture toward a healthy skin profile (epidermal thickness ↑, collagen reorganization).nature+1
2. Abstract: Camouflage of Scarring Alopecia (2017). Follicular unit transplantation into scars (n=27 patients) – 85-90% coverage success. PMC5636414[pmc.ncbi.nlm.nih]
3. Camouflage of Postburn Scarring Alopecia (2023). Nanofat + FUHT for burn scars – high patient satisfaction. PubMed 37253046[pubmed.ncbi.nlm.nih]

DHI/FUE Technique & Graft Survival

4. Estenove Clinic (2025). DHI graft survival 90-97% vs FUE 85-95% due to Choi pen precision.[estenove]
5. HairMD India (2026). DHT/DHI >95% survival – minimal out-of-body time key for scar tissue.[hairmdindia]
6. Raadina Health (2023). DHI success >95% – ideal for precise scar implantation.[raadinahealth]

Scar Camouflage Techniques

7. Imperial College London (2023). Hair follicle transplants remodel scars (2-6 month biopsies).[imperial.ac]
8. RegMedNet (2023). Transplanted follicles rejuvenate scar tissue morphology/genetics.[regmednet]
9. HairMedico (2024). FUE/DHI micro-scars are invisible even shaved; superior to FUT.[emrahcinik]

Clinical Practice & Reviews

10. Grace Touch Clinic (2025). Modern FUE/DHI innovations minimise FUT scar visibility.[gracetouchclinic]
11. Folisim Melbourne (2025). SMP + FUE camouflage for Australian patients.[folisim.com]
12. Emrah Cinik Clinic. DHI reduces scarring to near-invisibility on shaved heads.[emrahcinik]

ISHRS Guidelines

13. ISHRS FUE Clinical Practice Guidelines (2019). Sapphire FUE + DHI recommended for scar revision.[ishrs]