View Full Version : Scar Repair

09-11-2012, 01:06 PM
Was thinking today that it might be a nice idea to have a thread to talk about our strip scars, big and small and what we want to do about them.

So far all of our discussions regarding this has been piggybacked onto other peoples repair threads, so in this thread we can talk about our own problems with scars without hijacking other peoples threads.

We can talk about FUT scars and FUE scars, and if you have scars from accidents that you want fixed as well.

All treatments can be talked about, whatever you can think of that will make your scars less visible, throw it out there and talk about it.

Please add pictures to your posts if you can, as it will help other people to know what you are talking about.



09-12-2012, 03:07 AM

You are a sound veteran and your help and guidance is always appreciated to many readers and you are defo one of the level headed good guys on the boards.

There are a variety of successful options for repairing scars now days - patience is key though as you well know!

I had FUE into my old Bosley scar (4x strip sessions) with great success in the areas worked on and its been documented online over the years. I have have multiple small FUE sessions into my old Bosley scar. The yield was high and it helped break up the appearance. It allowed me to have some greater flexibility but i wanted more ( dont we all.. ) i didnt want to waste or throw more FUE into my scar or use BHT as i'm not a fan of it, so i recently attempted temporary SMP ( scalp micro pigmentation) into the scar area and in weak areas along the scar and areas of the scar that had continued to stretch and caused me concern on a shorter grade, which so far has really helped. I have documented this also.

FUE and BHT are both good ways to get hair growing in scars again. It is important that patients understand that scars generally only can get diluted down and camouflaged however, not removed. Some do have delusions of grandure initially when it comes to scar repair, i have seen this over the years and these patients reside on somewhat wishful thinking and hope - This often boils down to their desperate and vulnerable state. Often these patients feel they have been violated and often they have - Its all understandable and patients want to attempt to back out the one way tunnel! Its important to stay grounded when entering into scar repair especially, and keep expectations in check at all times and be very patient. Nothing wrong with a positive attitude, but be realistic is all i'm trying to say, otherwise you might well be disappointed.

Scar repair and yield into scars is unpredictable whether via revision, FUE or BHT as you well know Sparky and its impossible to say how successful a revision will be or growth will be into scars until 12-18 months post op minimum. Growth is generally slower in scars and yield generally lower. I tried to explain this recently that in some cases yield can be very low ( generally speaking) as all depends on the individuals scar, blood supply etc. If the scar is small then chances are % yield will be high and the outcome more visually successful. My statement was a general one regarding grafting into scars generally - as its a fact, yield can and is lower into scars than say a virgin scalp. be prepared for every eventuality.

See write up on BHR site. I clinic well known for helping repair scars with FUE and BHT.

To add grafts into the scar can be a good option depending on the size of scar and how well it has healed. It is considered that the yield will be lower when placing in a scar line and it is prudent to place a lower density initially and measure the yield before using too many precious grafts that might not subsequently grow.
Body Hair FUE (BHFUE) uses the same principles of extraction as FUE, but the hair is extracted from various parts of the body and not from the scalp. BHFUE is recommended in cases where there is insufficient scalp donor hair.To add grafts into the scar can be a good option depending on the size of scar and how well it has healed. It is considered that the yield will be lower when placing in a scar line and it is prudent to place a lower density initially and measure the yield before using too many precious grafts that might not subsequently grow.BHFUE is a relatively new form of hair replacement; it is important to appreciate that because of genetic variants, hair characteristics and growth rate, BH will behave differently to scalp hair and the yield can be much slower and lower. BHFUE in certain special instances may be the answer to repair or restore hair but only after an extensive consultation period. A patch test would also be undertaken.

Its important that patients understand yield can be lower into scars so always go with a test patch FIRST , based on the outcome you can then determine the best way to proceed with YOUR scar. ALL scars are unique!

FUE into the scar is a good first port of call if the scar can not be revised. If the scar is wide and long then revision might be the better option as minimising the scars surface area will make it easier to camouflage with fewer alternative session whether via FUE or BHT or even SMP.

My recommendation depending on the individuals goal is FUE into it first then possibly try BHT after that. These are permanent options and realistic options and ones i personally recommend especially FUE. Be realistic and keep expectations in check however. The smaller the scar the easier it will be to repair via FUE /BHT with fewer sessions required for a permanent solution. I mentioned and recommended an individual do FUE initially into his scar recently given his goal and advised this was defo the best way to go initially for HIM given the size of the scar ( very small ) . I mentioned yield can be low in scars and tried to help him understand the general risks however.

I want this guy to know whilst i'm here i actually only ever wanted to educate him and was not trying to down play FUE into scars in anyway shape or form. I'm pro FUE into scar - as i personally like this option better over all other options, including temp SMP. SMP is an option but not permanent. FUE is the way to go initially especially with small scars for a permanent solution. SMP has its place, and a small one at that. Its very early days too for it and hopefully it will become a good option for certain people and also give them hope and realistic options. We are doing our best to provide info on this and time will only help.:cool:

Depending on the individual and their goal SMP is now a potential option into scars, however, as i told the same guy previously mentioned, explore more proven methods/ options first and be patient and lets wait to see more scar sessions documented online. Every scar is different and some scars are not even conductive for SMP ( This is why a small test patch is advisable also a minimum of 10 days prior to any large session) as the scar might not be able to carry the ink, the ink can disperse as the scar tissue can not hold it.

Fortunately my scar took it very well and it has completely camouflaged my scar, however its a temp solution, one which will only last a couple of years. The temporary ink SMP has and is becoming more appealing over the permant ink tattooing we have all seen previously as if the temp ink temp doesnt suit or work, it fades over the course of 2 years approx. There is a back out option so to speak.

Scar revision is a viable option for many too, especially with larger scars from poor surgery or previous multiple surgeries if the scalp has laxity. Many cases of scar revisions online too. However there are NO guarantees with scar revision. Every time you cut the skin it will leave a scar. Laxity and physiology play a vital role in scar revision. Research this in great depth and always get examined by a recommend Doc in person to assess all your revision variables. You have more than you think ;)

Be aware that scar repair is a time consuming matter regardless of size and regardless of age of scar. Every patients goal and scars are different and there are options out there for repairing scars, just be aware that there are limitations and impossible to completely reverse the strip scar process. It can be camouflaged and diluted down but it will always be there!

Be REALISTIC and PATIENT despite what a Doctor thinks he can do to improve ones scar the proof is only ever going to be in the pudding despite all best intensions and ability.

Would you agree Sparky ?

Best Regards,

Spencer (Spex)

09-12-2012, 03:05 PM

I think as you say there are several options available.

From personal experience my FUE into scar has made a great difference for me, my hairdresser sees a massive difference in it and has trouble finding the scar. That's one of the things I wanted to get out of it, I don't have to give any hairdresser special instructions anymore.
The scar will always be there, whether it's treated with BHT, FUE or SMP.
My scar is still there, it just has hair growing out of it now.
A good thing appears to be the FUE work primes the scar and brings more blood and vascular activity so the person may then go back for more if needed, think that's why they go with lower density on the first pass.

I think that both scalp FUE and beard seem to grow well, beard seem well suited for planting into scar tissue but again if I am right there are different ways of planting and it is very specialist with regard to density, angles, site incisions etc.
One thing about using body hair is looking at the quality of it and if the patient is on Finasteride as although great for scalp hair they can effect body hair, although beard even less.

BHR from what you pasted appear to be wise in that they do not have a full speed approach but flag up as they did with my own case the necessary cautions and go from there.

I think it is exiting that options are out there and hopefully the patient will benefit from a multitude of options. SMP looks exciting and certainly hope it will be a safe and effective option for people.
Like beard hair usage, it will not be without problems and interesting to see how the skin is after 2 years, does the SMP effect further FUE into the scar? how is the skin if the process is repeated every two years for example and of course the respective health issues with regard to the absorption and discard of the chemicals used as the SMP fades.

I would hope in the future, such scars become less and less common, on that I think we can all agree.

09-13-2012, 01:10 PM
Well said sparky.......

I'm hoping to get the same Results with FUE.... Very early and a long way to go for me. 3 month mark on sept 18.

09-13-2012, 01:45 PM

I'm sure you will get the result you are after!

Keep us updated. It's really nice to see scars getting fixed and people being able to leave their mistakes in the past.

09-16-2012, 03:46 AM
Took this the other day, fue into scar, long hair atm as I am waiting for some fue donor areas to grow out, but should be able to go to 3-5mm now.


Stevie R
09-16-2012, 09:31 AM
Looks great man, happy for ya, but why don't you think you will be able to take it down to a 0 grade?

09-16-2012, 09:45 AM
Only because of the stitch marks, I don't understand how fraxel will remove them. I think there maybe 1 or 2 grafts lost per stitch mark.

Stevie R
09-16-2012, 10:39 AM
Well IDK why it does but many think it does such as IWANTMYHEADSHAVEDBACK if you read his thread somewhere in the Hairloss Help repair section as well as many others that say it eliminates the stitches. All I am saying man is look it up, the fraxel lady told me it can reduce the scar 25-35 percent in width put the most common effect is the skin gets closer to native skin. So I think that since stitches are small to begin with and fraxel does reduce it then perhaps that is why they say it has disappeared from their head, if this makes since to ya.

09-16-2012, 10:53 AM
I have seen his thread, dunno about tattooing your whole head though!

Stevie R
09-16-2012, 10:54 AM
I think the reason we don't hear much about fraxel is because the industry wants us to do FUE but I have not heared of any that have done it and were disappointed. The fraxel ladies and clinics I have talked to have said that it will cost me only around 100 dollars a session because my scar is small it shouldn't be too much more I would think for yourself, but I don't know where you are at. Again I am not trying to push it down your throat it is just that people should know about this and I figured it would help ya.

Stevie R
09-16-2012, 11:00 AM
I am not saying tattoo the whole head looks good, but look at what he did after one fraxel and FUE, it looks great man I think he was still not over being bald and that is why he tattoed his whole head. Also there are more dudes who have said fraxel is legit and have done it I will try to show some example when I have time.

09-16-2012, 12:01 PM
I don't know where you are at. Again I am not trying to push it down your throat it is just that people should know about this and I figured it would help ya.

I know you are trying to help, I'm at the same place as you, I don't want the scar to exist, except in a memory.

09-16-2012, 12:01 PM
So Fraxel 100% won't cause hair to be damaged, transplanted and native?

Stevie R
09-16-2012, 12:21 PM
From what I have read from prior experiences, been told, and have researched the laser doesn't go deep enough to damage hair follices unless you do it right after FUE into the scar then those hairs may be damaged, but just the transplanted ones. Bisanga told me wait a year, Feriduni said wait 6 months to be safe, Cole's staff didn't know and recommend anything, Doctor True as I recall didn't know, two dermatologists said they didn't know much about it, everything I have researched says it won't damage hair and the Fraxel ladies all say it does not damage hair. However, Feriduni said fractional Co2 (not fraxel restore or repair) laser may damage hair as it lasers much deeper so that is why I have backed off that one. Look on Hairloss Help forum as that is where I have found a lot of info on it as well as just Googling it, others I think know a little about it on the forums but I can't remember who as I have been talking with everyone I can that has knowledge on this. You can always have a consultation with someone near you...I will try and find some more examples another day I saved them on the other computer.

09-16-2012, 12:40 PM
I will google it from both sides of the coin, bad and good experiences.

Stevie R
09-16-2012, 12:49 PM
Let me know what you come up with, I have not found any negative stuff yet only positive.

09-16-2012, 12:56 PM

Think it's mainly when people have it done to their face.

Stevie R
09-16-2012, 01:10 PM
Huh, I will read in a bit gonna take off for a bit... I sent you some pics of my case btw.

09-16-2012, 01:29 PM
ok mate cheers, its just a general google link, not to any specific cases.

Stevie R
09-16-2012, 02:11 PM
Here is one still researching bad stuff though http://antiagingwithsasha.com/laser/fraxel.php here is what guys with HT scars have to say about it though http://forum.hishairclinic.com/topic/fraxel-laser-repair-can-anyone-share-their-experience.

Stevie R
09-16-2012, 02:30 PM
Check out workinginprogress here on Hairloss Help Site http://www.hairlosshelp.com/forums/messageview.cfm?catid=50&threadid=83687&enterthread=y as he has had fraxel dodne with great affect here is another post http://www.hairlosshelp.com/forums/messageview.cfm?catid=50&threadid=90537&enterthread=y, I will continue to look but it is clear that it has helped all users. However, I have to find out why one lady wants to charge me 100 or so dollars and the other wants to charge 450....the 450 dollar place was less knowledgeable on HT scars but they used the same laser...so IDK, I will however, fraxel my recipiant area just so I don't worry anymore about it.

Stevie R
09-16-2012, 02:41 PM
Here is another link http://www.hairlosshelp.com/forums/messageview.cfm?catid=50&threadid=94841, still looking for negatives but it is hard to find any besides women who do their whole face or those who say their is some swelling but I don't think that matters really. But everyone swears it doesn't remove surrounding hairs.

Stevie R
09-16-2012, 03:15 PM
Here is another link http://www.realself.com/question/fraxel-repair-on-surgical-scars, and it seems Umar says it is legit....I will do the least downtime and low level and go up from there. Most have said it isn't worth it because it is painful, but you can take a pill before hand if you want, let me know if you find out more stuff I am looking...

Stevie R
09-16-2012, 03:27 PM
There is some negative stuff on this site but mostly it is people that have had fat removed below there eyes because of fraxel, it hurts, or they went with the full blown method I think it is called fraxel repair. This lady had a tummy tuck scar fixxed http://www.realself.com/review/phoenix-fraxel-laser-fraxel-stretch-marks-and-tummy-tuck-scar and that was the same site btw.

09-16-2012, 04:38 PM
Are you going to use the restore method? when are you starting?

Stevie R
09-16-2012, 05:22 PM
I am going with the method that is the fastest healing, I think it is restore. I am gonna do a small area on my recipiant area next week. I want my scar to heal more as I was told since it is raised it can come down quite a bit still and that fraxel could raise it more, but the last month and a half the bump has come down quite a bit, still I think I will do fraxel on my scar in November/Decemberish just to make sure. Honestly thogh I don't think there is any worrying when it comes to the fraxel that heals the fastest and I have not seen one guy that has done fraxel on his scar or recipiant area who has complained, in fact all are jubilant and the way I figure every guy that says his work was good there must be at least 10 others that got the same result but they just don't post pics or their story online.

10-19-2012, 02:34 PM
Strip scars can be big and ugly, but I think shotgun scars compared with a good strip scar are worse from a cosmetic point of view. I think it was Hairsite where I saw an Indian doctor post that he has never had a patient request repair of shotgun scars.

Anyway, I'm in the process of having shotgun scars repaired by Dr. Cole. A week and a half ago, he used beard hair and grafted into the scars and what appears to be at the edge of the round scars. The numbing injection process into the scars was a bit painful at first, but tolerable. Dr. Cole is using Acell. Not sure if it was the Acell or the beard donor area characteristics, but the extraction sites didn't scab. They just kind of shrunk into what looks like untouched skin within 4 days. There is still very minor redness, but no sign of round extraction dots at all. Several years ago, I had body hair grafted into some of the scars and it is still growing. In fact the grafts seemed to grow better on or near the shotgun scars than they did on my crown. The body hair growth is still strong in the frontal area of my head. I should probably use Rogaine, but I haven't used anything for about a year. I'm confident the beard hair will grow because the less predictable body hair grew without Acell.

Stevie R
10-19-2012, 04:11 PM
Thanks for that man, how long has it been since the beard hair treatment? Hope you get over this, could we see som pics of your scars? Are they big, small? How many grafts? I understand if you don't wanna show pics, thanks again for sharing bro.

10-21-2012, 10:39 AM
I am trying to take photos. What I really want are sharp closeup photos. So far my camera/lighting isn't cooperating. If I can catch the beard hair donor area right, it will show that there isn't any evidence of extraction holes at all. It surprised me. In the early days of BHT, I had leg hair removed and in the right light I can see some hypopigmentation or little lighter than normal skin colored dots. No one would ever notice them, but if I look closely they are there in a couple of areas. One of the complaints strip patients have had about FUE is the white dots. As I mentioned, it was either the Acell or the natural beard skin characteristics, but the obvious dots the first day on the beard area seemed to shrink up and disappear. My wife took a close look and couldn't find any evidence at all of extraction of hair follicles.

I see a lot of patients in forums who seem happy with their strip results, but always wonder what their head would look like shaved down. I have seen FUE heads shaved down and see small dots of missing hair before Acell and whatever technologies Dr's are using in the last 3 years or so. I commonly see something similar on people who have not had any hair restoration surgery at all. Not small dots but 3-4mm size areas that have no hair at all. All this to say, if Acell shows consistent positive results, this could mean that FUE HT patients could have the option of shaving their heads without worry of advertising their HT surgery.

I think it was around 77' Bosley Medical Group in Beverly hills did a number on my head. Hair transplants were experimental IMO. I remember expressing concern about the 4mm holes in the back of my head. The doctor told me that they would eventually shrink and disappear. That didn't happen, and I'm not sure that that ever did happen for any 4mm punch victim. I am SO looking forward to getting rid of those scars.

IMO, the main problem with bad hair transplants is, doctor's can say their result is great even when it sucks to just about everyone else. I had heard that when the camera came on to the scene, artists began doing work that was more subjective. I know of a guy who was butchered by a hair restoration doctor and went to court. He told me that juries are unsympathetic and doctors use the "subjective" art excuse for their horrible work. Hair transplant work should be considered objective medical art rather than subjective. I mean really... who would consider plugs anything other than freakish. End Rant.

Stevie R
10-21-2012, 12:41 PM
Totally agree with ya man, how many hairs were extracted under your chin again? And did you use any head hair? Anyway I hope you get fixed soon so you can put this stupid HT stuff behind ya.

08-21-2013, 06:49 AM
Sorry to resurrect an old thread, but I've had two FUE procedures that I can't even have my hair down to a clipper guard number three without it being kind of noticeable. I've even had people point out that it looks thin there. If FUT scars can be corrected with FUE, then is it possible to correct some FUE over-harvesting? Possibly with HST?

08-21-2013, 07:07 AM
Sorry to resurrect an old thread, but I've had two FUE procedures that I can't even have my hair down to a clipper guard number three without it being kind of noticeable. I've even had people point out that it looks thin there. If FUT scars can be corrected with FUE, then is it possible to correct some FUE over-harvesting? Possibly with HST?

Beard hair... Best option right now and should help out your density and scaring issue quite well.

08-21-2013, 07:59 AM
Beard hair... Best option right now and should help out your density and scaring issue quite well.

Oh boy, I don't have much of that.

08-21-2013, 10:15 AM
Beard hair... Best option right now and should help out your density and scaring issue quite well.

Interesting... Latisse may improve scar hypopigmentation. Also interesting is how some of the hair growth discoveries were accidental.

The Edisonian research approach is not something hair restoration doctors get excited about and with good reason... There is a possibility of disastrous results.

The Edisonian approach to innovation is often characterized by trial and error discovery rather than a systematic theoretical approach. In reality, this simple concept is a misleading description of the method of invention actually used by Thomas Edison. Trial and error alone didn't account for Edison's success with electric lighting when so many others failed miserably.
The historical record shows that Edison's approach was far more complex. Edison applied theories and resorted to trial and error only when no adequate theory existed.

I read an article yesterday describing how doctors kept hair follicles alive in vitro (out of the body) for 47 days. They experimented, storing the follicles in many different solution types. Researchers have much greater freedom experimenting on organs outside of the body. Certain chemical combinations can create toxins. For example bleach and ammonia when mixed together, create a poisonous gas that can be deadly. When I lived in Californi, I remember reading in the paper several years back that Chlorine alone wasn't adequately disinfecting the public water supply so they started adding ammonia as well.

There is a huge thread here on micro needling. The thought crossed my mind of needling a paste applied to the skin that consists of all the known things that work to grow hair, reduce hypopigmentation, fight DHT, promote the anagen phase, and increase the fatty layer under the skin.

PRP, ACell, Vitamin D3, bimatoprost, copper peptides, and minoxidil. Researchers should study combinations on rats for instance. According to Robin Williams, researchers no longer use rats, but rather attorneys. According to Williams there are some things even rats won't do. My apologies to all my attorney friends.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011