Commentary on Hair Transplantation in Burn Scar Alopecia After Combined Non-Ablative Fractional Laser and Microfat Graft Treatment

The paper discusses the challenges and solutions for hair transplantation in burn patients with scarred tissues on the face and scalp. The authors highlight that the mechanical properties of the scar tissue can compromise hair transplantation due to reduced graft survival. They also note that the thickness and vascularity of the normal scalp, which are crucial for successful hair transplantation, are often lacking in burned scalps. The authors suggest that fat grafting can improve the mechanical structure of the scar tissue and enhance its blood supply, making it more conducive for hair transplantation. They employed a protocol of multiple sessions of fat grafting, usually at 3-month intervals, until the scar tissue became soft and pliable. The authors also used non-ablative fractional lasers to improve the scar tissue recipient areas before transplantation. They reported an 85% hair growth survival rate on average, which is considered excellent given the clinical situation. The paper concludes that preoperative management using non-ablative fractional lasers and fat transfer can significantly improve the quality of the scarred recipient areas, thereby maximizing hair growth in these difficult cases.