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Scalp biopsy to test scar tissue


Hey Guys,

I am looking to at least camouflage my outdated mini-and micro graft plugs. Now, my last procedure was at the age of 21, there was no growth. This was performed by way of micro grafting. So, because there was no growth, I was advised to have a scalp biopsy to test the significance of scar tissue. This certainly is not something i want done. Is there anyone on here that has had scalp biopsy ? Please share your experiences if you have.


Oh man. The dreaded LPP scalp biopsy. Since no grafts grew, it may be worthwhile to make sure. Hopefully, your results do not come back inconclusive. I know folks that had this biopsy done. Just be careful of the healing in the area where they take a biopsy. It is a big punch they use. Your ht surgeon should have done this during the procedure. The cost of the biopsy varies and can be expensive. One risk is infection and necrosis. The biopsy is a surgical level procedure with numbing and possible stitching. Good luck.


Someone gave you a hair transplant at the age of 21??? :grimacing:


No actually at the age of 20 and then again at 21. I had way to much hair to begin with. I have never met such a cold hearted human being in life. And I am now 37. I just can’t get over the things this guy told me. Its very shocking that he runs this clinic in a small community of about 5,000 people.



Hi Pinny, Im sorry for your bad experience, I’m a butchered patient also so I know very well what you are passing through.

I think that in order to give you the better advice it will be helpful to see some clear photos of your current situation.

The biopsy usually it is recommended when there is a hidden factor that may cause different conditions to the scalp/hair, but for a procedure with no growth you don’t need a biopsy, for what you described it seems just a malpractice from your surgeon and this is probably the reason why nothing has grown.

A possible solution for your case could be to have another hair transplant, this time with the proper surgeon.

Let me know what this sounds to you and if you have more doubts, questions,




Are you able to upload some photos so that we can better understand your current condition?



Hi Escar,

There is really no visual scarring in the recipient area. Though, considering there was no growth, I was instructed by Dr. Rahal to have a scalp bio.


I could upload pics, but there are no signs of any scarring. The bio was advised by a consulting of Dr. Rahal. This was recommended considering there was no growth.


Really? Was the request for scalp biopsy asked during the initial consultation or after surgery? What procedure are you going for FUT or FUE?


I didn’t even have a proper phone consultation. This was there concern that they wanted to address before taking the next step. So, I don’t even know if I want Rahal performing the surgery.

I use to often visit this site and I have never heard of a failed transplant from recipient scarring and or someone having a scalp bio.

This would be FUE. My goal at the very least, would be camouflage the hair line.


This is also the first time I heard of a scalp biopsy request before a hair transplant. Isn’t Rahal in Canada? Do you have to go to Rahal clinic to do the biopsy or can you just go to your local doctor? Who’s paying for the biopsy?


IMO In general, Be very careful with FUE. I am talking from a lot of first hand experience. If you have courser, wavy, higher caliber hair,it may be easier to extract and pull out the graft bulb so FUE may not be detrimental. If you have straighter medium to thinner caliber hair, IMO, FUT may be better option. It also depends on your ethnicity, asians and indian folks in general probably are better off with FUT. Also, evaluate a surgeons surgical protocol. Who will donor extractions and surgical aspects? What tools do they use? How long they used that particular tool? Manual FUE may be a safer option and if you need over 2000 grafts via FUE, consider separating procedure into multiple days to increase probability of graft survival and yield. Do not pay any deposit until all your questions are answered via email and in writing. Be very careful on what route you take, you do not want to become a patient that needs repairs to repair repairs and more. A good resource to talk to is a hairloss mentor and definitely consider reaching out to real unbiased patients for reviews or if they want to meet in person.

Scalp biopsy may or may not be conclusive when the results come back. It requires stitches and can cause shockloss in area they take the sample. I know some folks that had it and if you have strong symptoms of LPP it is something you can consider. There are risks with the biopsy and it is done by a dermatologist and it isnt cheap. Not sure if insurance covers it but it can cost like around $1000 bucks from what I heard.

Be careful though and weigh the pros and cons of the procedures. I really am passionate about helping folks and know how things can be if you end up not where you want to be.

Do not believe anyone that tells you FUT yield matches FUE yield. No one can put a number on how much yield they can achieve for FUE. Do not believe the hype or be decieved by some clinic posted results by some clinics. Be safe and stay safe. Wish you the best with whatever you decide. See if you can talk to Joe Tillman regarding FUE and see what is the best approach.


I have a consultation with Dr. Gupta of Surehair. He is a Dermatologist and also a hair transplant surgeon. I didn’t realize a scalp bio could cost that much money. There is no way i am payment that amount.
Considering the risk, i am only looking for a 500 grafts procedure.


I have an appointment with a local Dermatologist, he is also a transplant surgeon.


@pinny it is strange that a hair transplant clinic would advise getting a scalp biopsy, I think the doctor who worked on you probably transected a bunch of donor grafts during the extraction process (not uncommon for inexperienced doctors) and that is the reason you had very poor yield.

If you were to spend the money on a biopsy, you might as well use the money for a small FUE session from a reputable FUE doctor and see if they grow or not. This is better proof than getting a biopsy which probably tells you nothing anyway. A small FUE surgery with say 50-100 grafts will probably cost less than a biopsy.


What does LPP stand for?

I agree with everyone here, I am not sure how a scalp biopsy will help especially if you have to pay for it yourself.


More information about it here: https://www.dermnetnz.org/topics/lichen-planopilaris


Hey LIG,

I saw Dr Gupta on Friday. Unfortunately, it was a waste of time. I guess he hasn’t done a bio in awhile, and the last one came back inconclusive. He also has never heard of a scalp bio performed on scarring from previous transplants. He did refer me to a specialists.

A scalp Bio for medical reasons is free in Canada. Well, at least they make you think it is.Taxes, taxes and more taxes covers the surgery. As well a covered procedure with a consultation could take an entire year.

I am going to put this to rest. I am not having a scalp bio. The reason i believe there was no growth in the transplant is due to the significant damage his scalpel did to the back of my head. I now suffer from permanent inflammation and pain. Not only was a lot of my donor wasted, a lot of donor fell out from the damage. So, i am only looking to have a small session above the scars, in the Norwood 7 zone.


The reason we sometimes suggest doing biopsy is to confirm the diagnosis.
If a patient comes in with hairloss that suggests something other than genetic alopecia, then a biopsy can determine if its’ a scarring type of hair loss. In these cases a hair transplant may not work.
If a patient had 2 previous surgeries elsewhere that failed, we would want to confirm if there is something else going on before doing any work.


@mattj who are you? are you posting on behalf of one of the hair transplant clinics?