How it works
Everything starts with an exam and a conversation. Your surgeon looks at the size, thickness, and stretchiness of the scar, checks the direction and density of the hair around it, and asks about what caused the scar in the first place. From there, your surgeon works with you to choose the right path: removing and stitching a small scar, using nearby scalp as a flap to cover the area, or transplanting follicles into the scar. Many cases need a few of these steps combined and spread over more than one session.
Depending on the scale, your surgery may be done under local anesthesia (numbing only the scalp, with you awake) or under general anesthesia, sometimes with sedation to keep you comfortable. Your surgeon will talk this through with you beforehand, because the choice depends on how much area needs work and on your health.
For a small scar, your surgeon removes the strip of skin that does not grow hair and brings the two healthy edges together, placing the stitch line hidden within your hair. For a wider area, your surgeon may rotate a hair-bearing flap of scalp from beside the scar to cover the gap, or use a tissue-expansion technique to gain extra healthy skin before covering it. With a transplant, your surgeon takes healthy follicles from a donor area (often at the back of the head) and places them one by one into the scar, following the natural direction of growth.
Your surgeon always plans the stitch line and the angle of the hair so the remaining scar stays as hidden as it can be, and so the new hair grows in looking continuous with your existing hair.