When researching hair transplants, you often come across the concept of a "team approach" or "collaborative surgery." It implies that multiple doctors work together on a single procedure, which can sound more structured, efficient, and safe at first glance.

It is true that hair transplantation is a lengthy procedure. It often takes several hours and requires significant physical endurance and concentration. For this reason, many believe that having multiple surgeons split the workload is better than relying on a single doctor.

However, I view it a bit differently.

I firmly believe that a hair transplant is best performed when a single surgeon takes full responsibility from start to finish.

A Hair Transplant Is a Series of Choices, Not Just "Planting"

Let’s take a 3,000-graft transplantation as an example.

During the extraction phase, the surgeon makes well over 1,500 decisions. During the placement phase, another 1,500+ decisions are made. In total, a 3,000-graft procedure involves more than 3,000 individual judgments and choices.

• Which specific follicular unit should be selected?
  
• Is it a single-hair or multi-hair graft?
  
• Should fine hairs or thicker hairs be used for this specific spot?
  
• Where should each graft be placed?
  
• What angle and direction should be maintained?
  
• How dense should this area be?
  
• What distance should be kept from the existing native hair?
  
• How deep should the graft be implanted?
  
• How should the boundary be softened to look natural?
  
• Where should grey or white hairs be positioned?
  
• Where should wavy or curly hairs go?
  
• How can we preserve and utilize soft baby hairs?
  

These meticulous choices are repeated thousands of times throughout a single session.

Crucially, most of these decisions cannot be predetermined before surgery. They must be made continuously in real-time as the surgeon evaluates the scalp and handles each individual graft.

Even if two surgeons work in the same clinic and understand each other’s techniques perfectly, their choices will never be identical. This isn't a matter of skill or capability—it is simply because every individual possesses a unique sense of aesthetics and personal judgment.

Even a detail as small as taping the donor area can feel off during surgery if it isn't done in the precise way a surgeon is accustomed to. Such small discomforts directly impact extraction accuracy and surgeon fatigue. It is the accumulation of these tiny details that dictates the ultimate refinement of the outcome.

Hair transplantation takes time, and performing it alone is demanding. Maintaining absolute focus over several hours is a physical and mental challenge.

However, I view that burden as an integral part of the procedure itself. Sustained concentration is a core surgical skill. While it is never easy, maintaining a consistent standard and vision throughout the entire procedure is an essential responsibility of a hair transplant surgeon.

Patients choose me after seeing my designs and trusting my work. Therefore, I believe it is my duty to oversee and execute the surgery personally, from beginning to end.

Thousands of small decisions come together to create a single final result, and the responsibility for those choices is not something that can be passed on to anyone else.

Warm regards from Jamwon-dong,

Dr. Sooho Park

Many people struggle with scar tissue on their scalp where hair no longer grows, usually caused by accidents, burns, or past surgeries. They often try to cover it up with surrounding hair, but on windy days, they’re constantly worried about the wind exposing the scar. It’s a very different kind of stress compared to simply having a broad or high forehead.

 [Before Hair Transplant on Scar Tissue Surgery]

Yes, hair transplants can actually be performed over scar tissue! Surprisingly, a lot of people aren't aware this is possible. When patients learn about this after surgery, they often express regret, wishing they had known sooner so they wouldn't have spent years trying to hide their scars.

 [Before Hair Transplant on Scar Tissue Surgery]

People often worry: "Will hair actually take root and grow on a scar? What's the graft survival rate?"

The good news is that it actually grows quite well! While it depends on the condition of the scar tissue, the graft survival rate typically ranges between 70% and 90%.

In the past, we were taught that the graft survival rate for scar transplants was only around 50%. Because scar tissue lacks proper blood circulation, we were advised to plant at lower densities to prevent grafts from dying. On top of that, scar tissue is tough and prone to tearing, making high-density transplantation extremely challenging.

[Before Hair Transplant on Scar Tissue Surgery]

However, over time and with accumulated experience, I noticed something remarkable: the density we could achieve on scar tissue was gradually increasing, and the graft survival rates were steadily improving. To be completely honest, it was hard to pinpoint the exact reason at first. But one thing was clear—both density and survival rates were improving, and the issue of hair texture turning excessively curly was significantly reduced.

[Before Hair Transplant Surgery (Left), 1-Year Follow-Up (Right)]

These days, performing scar hair transplants brings me genuine joy. Even if my fingers get a bit sore working through tough scar tissue, seeing a patient smile and tell me, "I feel so much more comfortable now—it feels like both my body and mind have healed," makes me feel completely fulfilled. It honestly makes all the hard work worth it.

 [Before Hair Transplant Surgery (Left), 1-Year Follow-Up (Right)]

Of course, given the nature of scar tissue, there may always be cases where graft survival rates vary. I will never get complacent or overly greedy, and I will continue to refine my approach step by step.

[Before Hair Transplant Surgery (Left), Pre-Op Design (Center), 1-Year Follow-Up (Right)]

For those who have struggled with scalp scars for a long time: I hope you can enjoy windy days again, completely worry-free.

Warmly,

Dr. Sooho Park

Banal Plastic Surgery

Hello, this is Dr. Seungkyu Shin from Banal Plastic Surgery.

When men visit our clinic, they usually look to restore deep M-shaped recessions or transplant hair to thinning areas around the hairline and crown. While many lower their hairline slightly to fill in the M-shape, few initially ask for forehead reduction simply because forehead height itself hasn't traditionally been a primary concern for male patients. Recently, however, more men are preferring a smaller face and a narrower forehead, which has naturally led to a growing interest in male forehead reduction.

The biggest advantage of forehead reduction is that it doesn't use up donor hair from the back of the head, allowing patients to preserve their overall density. Since men don't have an infinite supply of donor hair either, more patients with high or broad foreheads are choosing forehead reduction when they need significant coverage while keeping their donor area intact.

That said, there are a few important considerations: male patients with underlying hair loss must consistently take hair loss medication. Additionally, because men's scalp tissue tends to be somewhat firmer than women's, the target reduction height needs to be planned a bit more conservatively.

Today, I’d like to share the case of a male patient who recently visited our clinic for a 6-month post-op checkup. He originally underwent forehead reduction with me back at Mojelim Plastic Surgery and visited Banbal Plastic Surgery for his follow-up. (A sincere thank you to the patient for generously allowing us to share his photos!)

First, here are the photos taken at Mojelim Plastic Surgery:

We lowered his hairline by approximately 1.5 cm. About a month after surgery, three small, rice-sized patches of alopecia areata (spot baldness) appeared near the right side of his crown. We decided to observe his progress closely, and he returned to our clinic at the 6-month mark.

Here is how he looked at 6 months post-op:

At 6 months, the incision scar looked very clean and stable, and it will undoubtedly continue to fade over time. The patient was very pleased with the outcome. I advised him that applying scar ointment and massaging the area over the next 6 months will refine the results even further.

As for the small patches of alopecia that developed during the first month, hair had already grown back nicely in those areas. I mentioned that if any sparse spots remain at the 1-year mark, we can easily touch them up with a mini hair transplant.

While extremely rare, forehead reduction can sometimes result in visible scarring or temporary hair loss. However, not many clinics are fully equipped to address both of these issues directly.

Noticeable scars can be further concealed through hair transplant, and while shock loss usually resolves on its own as hair grows back, any area with permanently damaged follicles can be effectively restored with a hair transplant.

From the initial planning phase—determining how much height to safely reduce—to the surgeon’s technique and experience in creating minimal scarring, choosing a doctor and clinic that can manage every aspect of post-op care (including scars and hair loss) is essential.

I hope this post helps you in making an informed choice for your journey.

Warm regards,

Dr. Seungkyu Shin

Banal Plastic Surgery

After committing to a hair transplant, the most common dilemma patients face is choosing between Strip Harvesting (FUT) and Follicular Unit Extraction (FUE). Both are excellent, proven methods. While many cases can be addressed successfully with either technique, certain factors—such as hair thickness, density, scalp elasticity, and the stage of hair loss—often make one method a superior choice for achieving the best aesthetic outcome.

To provide some perspective, I’ve broken down the likelihood of me recommending FUE across various scenarios.

Note: These percentages are intended to help your understanding and do not substitute for a professional, in-person clinical assessment.

When Strip Harvesting (FUT) May Be Difficult

1. Low Scalp Elasticity: (100% recommendation for FUE)
   When scalp elasticity is low, closing the incision under tension can lead to severe pain, wider scarring, or even tissue necrosis. We must accurately assess elasticity prior to surgery.

2. History of Multiple FUT Surgeries: (90% recommendation for FUE)
   Multiple prior strip surgeries often mean limited remaining donor space or diminished scalp elasticity.

When FUT Is Possible, But FUE Is Preferred

1. Fear of Incisions: (80% recommendation for FUE)
   For patients who feel significant anxiety about the idea of a surgical incision, FUE is the more approachable option.

2. Aversion to Linear Scars: (70% recommendation for FUE)
   While FUT scars are typically fine, linear lines that can be easily addressed with scar revision later, some patients simply prefer the tiny, dot-like scars of FUE.

3. Sensitivity to Pain: (60% recommendation for FUE)
   While neither procedure is pain-free, FUE generally involves less post-operative "tightness" than FUT.

When FUE Is Possible, But FUT Is Recommended

1. Cost Concerns: (50% recommendation for FUE)
   FUE is often more expensive because the harvesting process is significantly more time-consuming for the surgical team. If you prefer FUE but are concerned about the cost, I am happy to explain the benefits of the FUT method to put your mind at ease.

2. Physical Comfort During Surgery: (40% recommendation for FUE)
   Patients with back or neck issues, or those prone to claustrophobia or panic attacks, may find the shorter surgical time of FUT much more comfortable.

3. High Graft Requirements: (30% recommendation for FUE)
   For patients with smaller scalps requiring a high number of grafts, extracting from the entire donor area via FUE can be tricky for future sessions. In such cases, I often recommend FUT for the first surgery to preserve the donor area.

Cases Where FUE May Not Be Ideal

1. Fine Hair/Low Volume: (25% recommendation for FUE)
   FUE harvests from the entire donor area, which can reduce volume in the upper back of the head. FUT, harvesting primarily from the lower donor zone, better maintains volume in the upper scalp.

2. Low Donor Density: (20% recommendation for FUE)
   FUE increases the spacing between remaining follicles. In patients with naturally lower density, this can lead to the scalp becoming visible post-surgery. FUT distributes the harvest more evenly, leading to less visible scalp show-through.

3. Initial Surgery for Female Pattern Hair Loss: (10% recommendation for FUE)
   Female pattern hair loss often affects the entire scalp. Harvesting from the "safe zone" is critical for long-term survival of the transplanted hair. FUT allows us to harvest exclusively from within this safe zone.

When FUE Is Not Possible

1. History of Extensive FUE: (0% recommendation for FUE)
   If a patient has already undergone multiple FUE sessions, further extraction will likely lead to a sparse, see-through donor area. In this scenario, we must avoid further FUE to protect the integrity of the scalp.

While FUE is the "newer" technology, it is not inherently "better" than FUT. They are complementary methods, and the best results come from choosing the right tool for the specific patient. Relying on only one method means missing out on the best possible solution for your unique needs.

Just as you choose the right tool for the job, we select the method that best serves you.

Warmly,

Dr. Sooho Park

A Note from Dr. Park: I remember as a middle-schooler, I invented a tool that combined a knife and scissors—I thought it was brilliant! I was quite disappointed when my teacher didn't give it a second look, but years later, seeing a similar product on the market taught me a valuable lesson: ideas are wonderful, but executing them is what truly matters. We strive to be the ones who execute with excellence for our patients.

During consultations for forehead reduction, the most common question I receive is, "How much scarring will remain?"

While I have performed many of these procedures and take pride in consistently achieving refined, satisfying scar lines, I always explain that because every individual’s skin reacts differently and healing is a biological process, the outcome can have subtle variations. However, for the vast majority of our patients, the scars are remarkably discreet. Let’s look into the science of scar management and see real-life results.

Understanding the Healing Process

To understand scars, we can look at the study “Update on Postsurgical Scar Management.” Scars are an inevitable part of the body’s natural wound-healing process, but through proper understanding and diligent care, we can minimize them significantly.

The healing process is generally divided into three phases:

• Inflammatory Phase (Days 1–5): The body works to stop bleeding and form a foundation for healing.

• Proliferation Phase (Days 5–15): The skin begins to regenerate, new blood vessels form, and collagen is deposited.

• Maturation Phase (Up to 1 year+): Collagen fibers continue to remodel and strengthen. By 6 weeks, the tissue reaches about 50% of its normal tensile strength, increasing to 80% by 3 months.

My Approach to Minimizing Scars

A successful result requires more than just surgery; it requires meticulous care:

1. Preparation: We advise patients to avoid smoking for one month before and after surgery, as nicotine and carbon monoxide significantly impair wound healing.

2. Surgical Technique: As the surgeon, I dedicate my full concentration, technical expertise, and care to every single incision.

3. Post-Operative Care:

   • Infection Control: Daily application of antibiotic ointment for the first 10–14 days is essential to maintain a moist environment and prevent infection.

   • Scar Care: After the stitches are removed, we recommend using scar gel consistently.

   • Sun Protection: From 3 weeks post-op, diligent UV protection is required for up to 18 months.

   • Scar Massage: Beginning 3 weeks post-op, gentle circular massage (10 minutes, twice daily) helps soften the scar.

   • Laser Treatment: You can begin professional scar laser treatments starting 3 weeks post-op.

Real Patient Results

I am incredibly grateful to these patients for allowing me to share their journey. Seeing their satisfaction is the greatest reward for any surgeon.

• Patient 1 (338 days post-op): Even with a cowlick (hair growing upward), the scar is nearly invisible. The patient was thrilled, and seeing that happiness is what motivates me.

  

  

• Patient 2 (189 days post-op): Forehead reduction allows us to significantly lower the hairline without sacrificing density from the back of the head, while keeping natural baby hairs at the front.

  

  

• Patient 3 (190 days post-op): Scar maturation continues for 12 to 18 months. At 190 days, the results are already excellent, and they will only continue to fade and soften over time.

  

  

While no surgery can guarantee a "zero scar" outcome, the results we achieve are usually so subtle that they are virtually unnoticeable at a normal conversational distance. I will continue to research and refine my techniques to ensure the best possible outcomes for everyone who trusts us with their journey.

Warmly,

Dr. Seungkyu Shin

Please note: As with any surgical procedure, there is a potential for side effects such as swelling, bleeding, inflammation, or infection.

All photos are shared with the explicit consent of the patients.