Hair Transplant Strip Scar, What's The Big Deal?

[Jkel]

Maybe this was asked before, but why do people make such a big deal about not wanting to have a strip scar from their hair transplant. I've been spending a lot of time here and read other websites and this seem to be an inflated problem and concern. If I decide to have surgery I am aware that I will have a scar. The reason I would have a hair transplant is because I do not want to shave my head so who cares if I have a scar that is hidden by my hair. If I choose FUE or Strip and the back of my head thins out, I will still have noticeable scaring apparently and worst of all my transplant hair will fall out or at least some of it. I think this is a chance we take when we decide to have surgery. From the photos that I see here and elsewhere most strip scars look very thin and unnoticeable. So what's the big deal?

Any thoughts?

[Jotronic]

I think this is a very common sense question. The issue of strip scars being "horrible" is partially rooted in history as well as, and to a greater extent, the fear, uncertainty and doubt (FUD) spread by clinics that wish for you to be deathly scared of strip surgery.

There is no question about it that there is good reason to be concerned when FIRST researching your options for hair restoration. How can one not be concerned when you have FUE clinics sharing their results not based on their actual growth rates and naturalness but rather by showing how horrible some results have been with strip. The horrible strip scars however are usually from fifteen years prior and from a doctor that no one has ever heard of. In other words, the results from strip are shown from a clinic that just didn't care about the quality of their work. Of course there are caveats to anything and everything but you get the idea.

Modern strip surgery in the hands of a reliably competent clinic produce BETTER growth rates on a consistent basis which is what patients want. I've yet to have a patient tell me they wish to go through with a hair transplant in order to have "minimal scarring". They want a hair transplant to have natural hair where before there was none and lots of it to boot. The most reliable way to get this is through strip with the understanding that the only limitation afterward is that one will not be able to shave their head as short as if they never had surgery. This doesn't mean that one must wear their hair style as long as Black Sabbath at Woodstock. It means that most modern styles are easily attainable except a very short shaved style.

[Gregory Pistone, MD]

Strip Incisions are Fine for Most

Maybe this was asked before, but why do people make such a big deal about not wanting to have a strip scar from their hair transplant. I've been spending a lot of time here and read other websites and this seem to be an inflated problem and concern. If I decide to have surgery I am aware that I will have a scar. The reason I would have a hair transplant is because I do not want to shave my head so who cares if I have a scar that is hidden by my hair. If I choose FUE or Strip and the back of my head thins out, I will still have noticeable scaring apparently and worst of all my transplant hair will fall out or at least some of it. I think this is a chance we take when we decide to have surgery. From the photos that I see here and elsewhere most strip scars look very thin and unnoticeable. So what's the big deal?

Any thoughts?

I must say I agree with you, especially in these modern times when we have trichophytic closures which, for the most part, minimize or sometimes completely eliminate visible scarring to the naked eye. Many of my patients are police officers and military and can get away with a 2.5-3 clipper setting. Having said that however, there are still are few caveats to consider: not everyone heals well and this is generally not predictable; some surgeons try to take too much in one procedure and struggle to close the wound under tension, leaving a wide scar; inexperience or poor technical expertise. In my hands, I find that surgical staples (ala the late, great Dr James Arnold) are much more secure and leave an excellent scar compared to my suturing days. In general, I think that absorbable sutures leave the worst scars for a variety of reasons. There is no right or wrong here, just what works best for your experienced doctor. But, in conclusion, there is no doubt that strip excisions yield much more hair and generally heal very nicely.

[gillenator]

Maybe this was asked before, but why do people make such a big deal about not wanting to have a strip scar from their hair transplant. I've been spending a lot of time here and read other websites and this seem to be an inflated problem and concern. If I decide to have surgery I am aware that I will have a scar. The reason I would have a hair transplant is because I do not want to shave my head so who cares if I have a scar that is hidden by my hair. If I choose FUE or Strip and the back of my head thins out, I will still have noticeable scaring apparently and worst of all my transplant hair will fall out or at least some of it. I think this is a chance we take when we decide to have surgery. From the photos that I see here and elsewhere most strip scars look very thin and unnoticeable. So what's the big deal?

Any thoughts?

Great post Jkel. You know I rarely and I mean rarely see HT patients cut or shave off all of the hair that just grew in from a HT. I mean that's the reason they went in to get the procedure done, to have hair again! And most of them, if not all of them, are extremely estatic when the growth matures out. The last thing they want to do is cut it off! Obviously there will be exceptions that Dr. Pistone mentioned.

I tell every patient and I don't care where they go as long as the doctor/clinic is reputable, that their scalp will be compromised in the donor area after the procedure. That's part of the trade-off. Surgery will leave scars period, strip or FUE. Count on not being able to shave or buzz your head below a three guide. If a patient can live with three guide or longer, they should be fine. Yes maybe a fair amount of them will be able to get by with a number two guide, but if you tell them three, it's a more conservative expectation.

[fab]

hi, Just a question... how long after HT the scar becomes unnoticeable?

[ejj]

Theres plenty of scar revision repair cases on the forums where things have not turned out to well , i think problems with strip scars are more common than were led to believe

ejj

[chrisis]

Because some of us like to wear our hair short at the back, as per trends/fashions. I currently get a guard 1 on the back and sides, and like to have the top long and spikey/messy. With a hair transplants, I'd have to revise this and just grow it all out, or maybe just have the sides short in a mohawk/fauxhawk style.

Look at some current hair trends and you'll understand. I get that with older men they're not really looking to stay with fashion as much, so growing the hair out to cover the scar is the natural choice. It might actually look weird wearing the hair style of someone in their 20s/30s.

[northeastguy]

Ahhh the debate goes on......

@ fab........ at first the scars will mostly be covered by your existing hair after the procedure. The full stretch of the scar takes somewhere between 8-12 months before you really know what your left with.

As you look at my photo, you can see what the big deal is. For me anyway. Let me say this as simple and clear as I can. THERE IS NO GUARANTEE YOU WILL END UP WITH A THIN SCAR. NONE. So that being said, you must choose the procedure that is going to not only fit your long term goals and hair loss, but your expectations. Keep in mind that the hair style you want now might not be what you want when your 55. And that is what I am dealing with now. The style I wanted at 28 isn't what I want now in my early 40's.
For me, if I could do it over I would do nothing. I'd shave my head, grow a goatee and call it a day. Then again, maybe I'd have better luck with the technology of today. Anyway, too late so I'm putting my head once again in the hands of a surgeon hoping we can fill in these scars with FUE and return my head to somewhat of some normalcy. I just want to be able to buzz my hair down to a #2 clipper without any signs of surgery. For me, anything less than that and I'd be extremely disappointed.

Little info on the scars..... Bottom was from mid to late 90's closed with staples. Top was done around 2000 closed with sutures. Bottom had 3 procedures and top had 2. Top was done by a very well respected HT surgeon who pioneered FUE.

Hair is cut with a #6 clipper and the shortest I can go before it is very noticeable dry. I wet the hair so you could see the scars a lot easier.

[Spex]

Its about comparing oranges and oranges Strip surgery in the right hands with a good ethical Doctor with modern techniques and ethical practise certainly gives the patient the best chances of a "good" scar.

Many refer to strip scars being horrendous who either had old outdated surgery or had a hack or in adequate do the job generally. The scars tend to be poorly located on the donor region and often stretch adding insult to injury.

Scars are physiology dependant however so just be aware that if you want hair back on top of your head there is always going to be a compromise and this meaning you might not be able to wear the grade 1 or 2 you want or have now but a 3 or 4 for example. Compromise is the key word.

Make sure to compare true comparisons of modern day surgery in the right hands and not outdated old school procedures performed by less than adequate so called surgeons.

There are NO guarantees on strip scars - if a clinic or salesman tells you there are, simply walk.

An example of "Spreadlocks" scar recently sent over to us after 4 months post op 2400 grafst via strip with Dr Feller.

http://youtu.be/O8AEGM72fdM

Regards
Spex

[fab]

@northeastguy, thanks for the tips!! I appreciate it!

@Spex, these results look unbelivable. Was the trichophytic technique used for the strip? Was any supplement, drug, shampoo, anything else used that assisted the hair grow?

[topcat]

Strip scars are less of a problem for young guys with super thick donor. The problem presents itself when that same patient becomes older and their donor area starts to thin out. This is why you see so many patients looking to have the strip scars repaired. All one needs to do is perform a seach on some of the forums.

Of course a clinic can show a young guy with very thick donor and comb through it and everyone is amazed, wow it's like magic can't see a thing.

Personally it took me over 10 years to get the all the feeling back where the strips were taken and I had extreme tightness it both the back of my head and neck area. None of it’s a big deal until it becomes a big deal.

[Follicle Death Row]

Strip scars are less of a problem for young guys with super thick donor. The problem presents itself when that same patient becomes older and their donor area starts to thin out. This is why you see so many patients looking to have the strip scars repaired. All one needs to do is perform a seach on some of the forums.

Bingo. Gillenator is always going on about this but it's a big issue I feel. Unfortunately some people do thin in the donor big time and were never candidates in the first place. Others have thick donor and good physiology and I've seen a Feller patient on the forums buzz the sides to a 2 without the scar being visible. Really need to be sure the donor isn't going to thin. Thankfully my old man has thick donor but is about a 6. Hoping not to go to norwood 6 myself but hey I'd have to plan for it donor wise if I ever went under the knife.

[gillenator]

The guys who tend to experience donor zone thinning typically have it in their family histories and can be on either side maternal or paternal.

I do not believe that the clinical trials of Propecia considered any long term effects on the donor zone, only the mid and post anterior regions of the scalp are tested from what I have read.