One of the goals of a good hair transplant is to incur as fine a scar as possible.  The finer the scar, the shorter a patient may cut his hair without a scar being detectable.  Over the years, we have developed a number of techniques to ensure that we create fine donor scars.  These techniques include using massage strategies to make the scalp less tight for double layer closures and trichophytic closures.  They have all been discussed elsewhere on the site. 

One of the most critical factors in determining whether a scar remains fine or not is the tension on the wound at closure.  If the closure is tight, there is a chance that the scar will stretch.  It the closure is loose, the chance of the scar stretching is reduced.  This is one reason we recommend stretching exercises in patients with tight scalps.

A new product called Vitrase (hyaluronidase) is being used by some hair transplant physicians to help ensure that donor closure is not tight.  Vitrase breaks down a substance in the skin called hyaluronic acid.  This substance controls the amount of water in the skin.  When Vitrase is injected, some of the excess water in the skin is allowed to leave.  This increases the laxity of the skin and enables more donor to be taken out, under less tension.  This reduces the appearance of a scar.  We recommend Vitrase if we believe it will be helpful to a particular patient, and we discuss the option before surgery begins.