Two-Stage Procedure to Correct Scalp and Facial Scars: Autologous Fat Grafting Before Hair Grafting

The document describes a two-stage procedure for correcting scalp and facial scars by first using autologous fat grafting followed by hair grafting. The authors argue that traditional hair grafting alone may not be effective in atrophic scars or areas with a loss of subcutaneous tissue, as poor vascularity in scar tissue can lead to inadequate blood supply and unnatural hair growth. They suggest that adipose tissue injection can minimize these risks and enhance hair regrowth. The method involves harvesting adipose tissue from a donor area, purifying it, and injecting it into the scar tissue. After three months, once the survival of the fat graft is assessed, hair transplantation is performed. The authors observed increased bleeding during the making of recipient sites post-fat transfer, which suggests induced angiogenesis by adipocytes, leading to better blood supply, softer scar tissue, and improved hair graft survival and regrowth. The authors conclude that this two-step procedure is a promising method for treating facial and scalp scars, with the potential for further studies to explore the use of fat in treating other hair loss conditions.