I frequently get asked if transplanted hairs will grow well in scar tissue. This is a woman who came in several weeks ago to see me in follow up and she was 1 year post hair transplant surgery. She had previously received several pluggy grafts many years ago and was unhappy with the appearance. Last year, she received 101 single grafts, 171 double grafts, 73 big grafts, for a total of 345 grafts.
As you can see in the 1 year postoperative photos, the grafts follow her natural hair direction and have grown well, and the patient is very happy that she no longer has to be concerned about that area becoming exposed to others. In the closeup, you can still see the scar tissue surrounding the transplanted follicles.
The other option in this case would have been to simply excise the scar tissue but we decided to transplant it instead. I do warn patients that growth rates in scar tissue may be less than in virgin scalp, but that there is still excellent take despite the impaired vascularity of the tissue.