FUE vs scar revision

[HairTransplantOops]

I am 32 and made the mistake of having a hair transplant when I simply do not have a enough hair on my head to fill my frontal or crown. Not enough supply for the demand. I should have paid more attention in economics class before undergoing the procedure. So, now I am stuck with the typical ear to ear FUT scar with a balding top of my head. I think I can maintain this for at least 10 years and look simply like a thin 30 something old. My question is should I attempt an excision/revision or simply put FUE into my scar in attempt to trim it down to a respectable level all around (hoping for 1/4 inch or less with slight scar showing only)? My scar is 2-3 mm wide all around. I know there are plenty of you out there that have had this decision to make and it either bit you or you were successful. Maybe it is not worth the risk for the possibility of a 50% improvement?

Let me know what you guys think?

[doinmyheadin]

I am interested in this as well. Similar situation, 2-3mm scar which I think is very common. Personally I think if I had a scar revison it would not get much better. There are a few results online (but not a many of them) of fue into scar.

With fue into a scar the width mentioned would you be able to cut the sides and back down to a number 2 or 3mm clipper without seeing the scar line? Outside in bright natural light of course. I dont want to shave to zero or anything and dont want to do the SMP thing every few years.

[doinmyheadin]

Are there any Veterans out there who can recommend or have been through this?

[doinmyheadin]

Bump anyone?

[HairTransplantOops]

I am somewhat skeptical about your 1 mm or less scenario. From what I can gather, revisions are somewhat like playing with fire and can be unpredictable. To believe that you can completely make a scar "disappear" does not sound realistic. By no means, do I not think that it is possible but the fact of the matter is that there are risks with revisions. I have been advised by a couple of the top docs (3 MD with combined experience of over 60 years) in the U.S. that my scar is not worth the risk, but it does keep going through my mind to try a revision and simply see what happens (hoping for the best with fingers crossed). If there were a guarantee that it would be smaller by all means I would say slice me up.

[doinmyheadin]

HairTransplantOops I tend to agree with you. I have had two tranplanst one with a Australian doctor who used staples ( he was previously a plastic sugeon) and another with probably the most popular doctor around who uses satures, both did the trico closure. The second doctor cut out one side of the scar and extended it further up the side of my head. The scar from both operations eventually healed at about 2-3mm which I think is a lot more common than the 1mm scar FUT doctors promote.

Surely there are some veterans who can give some advice on the topic.

[arfy]

You could certainly try doing a small FUE session on a limited area, and see if the grafts survive. That way, if it doesn't work, you didn't waste a ton of money.

Be careful, the repair process is just as treacherous as a regular HT, with lots of unscrupulous doctors who are not qualified to do that kind of work. One guy goes to Dr. 1 for his first transplant, then he asks Dr. 2 for corrective surgery. In the meantime, another guy goes to Dr. 2 for his first transplant, then asks Dr. 1 to do HIS corrective work. It can be a merry-go-round of incompetence.

[GNX]

no offense Doc but I strongly disagree! there have numerous cases of patients having stip surgery buy great doctors and have been left with the typical ear to ear scar that had widened. the 1mm or less visible scar is just not accurate.

if I took the time I cud posts countless patients who have presented POOR strip surgery results that have a much larger scar then 1mm and the doctors were not no-name doctors either.

bottom line is you just don't how a patent is gonna heal and to say its most likely due to a poor surgical procedure is absolute nonsense!

With todays refined techniques and knowledge on how wounds heal favourably, a strip scar should be 1mm or less in width.

Having said that, unfortunately the most frequent cause for a bad strip scar is poor surgical technique. Unfavourable healing characteristics of the patient is a rare cause.

When a patient enquires with a bad strip scar the first thing I do is to ask who did the procedure. If the surgeon isn't someone that I know with an excellent surgical technique I will assume the cause is poor technique. In this case the most effective surgical treatment is a scar revision that involves a direct excision of the scar and closure with the best possible technique.

FUE grafting and SMP have limited efficiency in these situations as they do nothing to remove the existing scar. They only camouflage the scar to some extent. I will consider these methods only when I know the previous procedure was done by an expert and I suspect that the patient has unfavourable tissue healing characteristics, or when a proper scar revision is done with success and I still want to improve the camouflage.

In my experience, there hasn't been a single case when I did a scar revision and the scar didn't improve. The results ranged between complete disappearance of the scar to a significant improvement. There were a couple of cases where the scar improved but with less effect than I expected. I diagnosed that these patients had unfavourable tissue healing characteristics. I had an interesting case where both a body hair transplant and SMP on the scar done by reputable surgeons were not effective and a scar revision done by myself that removed all of these with the scar led to a significant improvement. The previous interventions had actually increased scarring and made it more difficult to do the repair.

[HairTransplantOops]

Could be worse

doinmyheadin, from the research i have done on scar width following fut surgery we are still on the low end of width and it could be far worse.

[ejj]

I would go FUE into scar. At the width your talking about, you may only need a few hundred.
Always go with the procedure with the least risk
Regards
ej

[doinmyheadin]

doinmyheadin, from the research i have done on scar width following fut surgery we are still on the low end of width and it could be far worse.

Yes I agree, thank god. The 1mm scars are the trophy results posted by FUT doctors.

Guys thanks for the replys and thanks EJJ and Arfy I know you guys have been through a lot.

[GNX]

I have been on these forums for over 15 years now. ill bet and I've seen hundreds of cases throughout the years presented by GREAT doctors as well as POOR doctors.

I've seen doctors I wud not go to if it was free perform FUT and leave the patient with a perfectly healed 1mm scar and I've seen doctors leave the patient with a stretched scar that needs FUE to repair them. I'm referring to the doctors who have an extensive waiting list. do u have a waiting list? IDN I'm asking?

you state that its YOUR experience and that shud somehow mean more then observing 100's if not thousands of HT procedures over the years that simply refutes wat u are saying so no ur own personal experience its not more valuable to be honest.

or maybe ur saying that ur skill level is just better then any other doctor on the planet and therefore ur patents are not subject to a widened scar. You or any other doctors can predict how a patient is gonna heal.

plenty of ppl seek out FUE doctors to repair their FUT scar and their often from top notch doctors.

GNX,

There is nothing to agree or disagree in what I am saying. These are my experiences and I just wanted to share them. You may choose not to believe me, that's another thing. You may have seen more results that were not so good, but this doesn't disprove my claim. Also I would appreciate if we could be civil in the way we talk and not call each others opinions 'absolute nonsense'. The MOST important determinant of the quality of a strip scar is DEFINITELY surgical technique. We are now comparing the results you have seen from various doctors with my experience from my own results and those from surgeons that I consider as experts. The latter is obviously more valuable assuming everyone is honest. I believe in the results you have seen, however what you may not know is that most 'known' doctors do not have a good technique to consistently get scars 1mm or less. There are surgeons that I know that can do this, but I will not name them without their permission.

[JoeTillman]

Hi GNX,

I don't understand how looking at pictures of different results from different clinics disqualifies what Dr. Karadeniz has said he has experienced in his own clinic. I also don't understand how his statements about his OPINION on donor wound closure is justification for you to say that you don't like his results. What does your opinion about his results have to do with his opinion on donor wound closure? Dr. K does have a waiting list but what does any of this have to do with anything?

you state that its YOUR experience and that shud somehow mean more then observing 100's if not thousands of HT procedures over the years that simply refutes wat u are saying so no ur own personal experience its not more valuable to be honest.

Actually, it should. You looking at pictures is irrelevant to the experience that a surgeon has in his own OR. Let's be honest here, the comparison is silly. I've read for several years how patients have had sexual side effects and other sorts of side effects from Propecia. I've met them in person in the various clinics I've worked in and I've spoken to them live on the show (The Bald Truth). I've been taking it myself for thirteen years. Does this mean that my own personal experience, side effect free, is null and void because these other people have a different experience?

or maybe ur saying that ur skill level is just better then any other doctor on the planet and therefore ur patents are not subject to a widened scar. you see that where ppl raise the BS flag cause not YOU or any other doctors can predict how a patient is gonna heal and to infer that YOUR patients will never have a scar that stretches is yes absolute NONSENSE!

You're putting words in his mouth. Dr. K didn't say that his patients are not subject to having a widened scar. He said that he's had cases where the scar wasn't as it was hoped or predicted and he notched them up to having healing characteristics that didn't allow for the intended result. He has also said that while some of the "top" doctors do not have the best surgical technique there are some that do but he doesn't want to start rattling off names because it is irrelevant.

One of the things you are completely mistaken about is that Dr. K is arrogant. I can attest it is abslutely the opposite. The man has very little ego when it comes to his abilities. He is as black & white as they come. And I'll say this; I too have been on the forums for 15 years but instead of looking at pictures the whole time, I've been in the OR studying how donor wound closure is done. I know about as much as anyone can possibly know without having actually performed the surgery with my own hands. I've been speaking face to face with patients that have great experiences and those with horrible experiences and on top of it all I have been looking at the same photos that you have been looking at online. I've seen many doctors perform their own procedures and I've seen the best and the worst of EVERY top name in the business. I can say with ABSOLUTE authority that Dr. Karadeniz has a donor wound closure technique that will rival ANY hair transplant doctor on the planet and will in fact surpass most. He doesn't take big risks by taking 3cm donor strips and he doesn't try to set new records. Is he perfect? No, but he is no less perfect than anyone else out there and it is his qualities as a surgeon AND his ethics that tell me he's a doctor to keep an eye on. I'm a free agent and I can work with most anyone I want to work with. I choose to work with Dr. K because I believe in him, his ethics and his abilities and I'm here to say that he's damned good with a donor wound closure. I've seen it first hand.

[Winston]

Dear GNX,

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[WHTC Clinic]

Highly consider FUE to revise the linear scar

You should treat the scar by improving its appearance with FUE but first consult with a specialist who is methodical in FUE repair. You want to ensure that you utilize the available cell therapies to give the grafts the most optimal of conditions to grow. Don't attempt to have a typical 'revision' because this will only likely result in 'stretchback' and make matters worsen. Highly consider FUE to revise the linear scar.