Not A 'Pencil Thin Scar'

[teg_101]

Hi 'ejj' I don't plan to going in for a revision, as that was my intent as a part of my 3rd OP, one to revise the scar, and two, gain additional density. The scar itself isn't horrific, but its something that I'd like to improve, as I'd like to be able to have the option to wear my hair short (grade 2-3) I'm planning to wait till the full year mark to see if I will see any dormant hairs grow through the scar, but at this point it doesn't look too promising.

Now that I look back, I'd say my scar from my first OP was pretty darn thin... (see below) It was the base of the scar that had stretched, as shown in my pic at the beginning of the thread, which I was concerned about. I was hoping to have that addressed, but didn't imagine that it would have stretched out the rest of the scar at the side of my head. Well, whats done, is done, can't go back now. Thanks for your input. I'm will look into the possibility of undergoing two sessions, if required.

[ejj]

Hello Teg,

I am sorry you are in this position; scar revision, in my opinion, is a gamble.

I actually do not think that your scar is that bad going off the photographs provided. I agree that it is best to wait a full year and after that formulate a plan.

I would go with FUE into the scar over two procedures. I would go with small sessions to increase the vascularity in the scar tissue and optimise the yield.

I know this is hard but in the scar repair department, slow and steady with minimum risk is the best way, in my opinion.

Best Wishes and keep us updated.

ejj

[teg_101]

Thanks for the input 'northeastguy'. Yes i plan to wait till the 1 yr mark and assess things at that time. Im planning on contacting the clinic to provide an update. I'll be sure to mention my concerns regarding the scar. Not sure what they can do about it other than a revision, which is completly out of the question! Im a little pissed to say the least since i was 'convinced' to undergo another FUT procedue, because i had already been cut open from past surgeries.. I was told the scar could be improved because of the 'tighter' closure method that the clinic uses, (staples vs sutures), but clearly that was not the case.

While FUT still produces some stellar results, the surgery is far too invasive, and leaves the possibility of some bad scarring, as is with my case. I see that you have undergone some revision work as well, and things are looking good for you at this point.

[northeastguy]

Teg...... so sorry your dealing with this. Make sure you follow up with Dr Rahal and like you said do nothing for 1 year... let that scar fully heal and any hair that may still be in shock, return. Be patient. Then address it. you have options. Lots of good threads on this forum regarding FUE repair and scar grafting. Find and talk to the docs who have lots of success grafting scars.... there's a small handful of them.

I hope others leaning toward FUT get a read of your post. Once your cut, your cut. It won't be long before FUE becomes the gold standard and all Physicians will be forced to learn and improve their FUE skills. Just as micro and mini's advanced to FUT, FUT will also be fazed out. More advanced methods of FUE i'm sure will surface and newer techniques will improve outcomes. To do FUT in this day and age is just to risky I feel.

Thank you so much for sharing.....

[teg_101]

Hi all, wanted to provide an update on the my current status. I am currently 6.5 months post op from my procedure with Dr Rahal. Growth of the transplanted hair seems to be somewhat on par as it should be at this stage of the journey.. My scar however is a different story.. :-/

The shock loss around the scar appears to have gone, but the scar itself is alot wider than I had hoped it would be. In some ways it is worse than it was pre-op. I suppose this may be due to the trauma that the scalp has undergone after having three strip surgeries.

I've read many cases where patients which had FUT from previous surgeries opted to go with FUE, to avoid being cut open again, and to eliminate the possibility of a much wider scar altogether. I, for one should have taken this route instead..

I was warned prior to the surgery that this could possibly happen, and unfortunately it did. In any case, I am hoping to move forward and have the scar repaired. I've taken some pics of the scar (sorry their aren't the greatest, the best I could do). My plan is to have the scar repaired using FUE, followed by SMP if required. I'll be looking into this after the one year post op of my 3rd procedure, which will be this December. Any thoughts, options are much appreciated..

[drybone]

Hi ejj,

I'm glad you're having success with disguising your scar with FUE. I'm not saying that this approach can't work and I'm not saying that there aren't possible drawbacks to scar revisions. Both are options Dr Rahal makes available. I'm just saying that in my opinion, based on what I've observed, scar revisions are probably a better choice in most situations - especially if the patient requires more grafts in the balding area. In some cases a patient will be at a high risk of the new scar stretching and in some cases the scar just can't be extracted, for whatever reason (such as if it's positioned too high or too low).

You've actually highlighted a drawback of FUE-into-scar in that you're apparently in need of a third procedure to complete the work. It's not uncommon for doctor's to prefer this step-by-step approach to ensure that the grafts are taking. The length of time and in many cases the travel involved for return visits won't be convenient for many patients.

Ultimately the best choice will depend on the individual circumstances of the patient, which is always a combination of what they want and what is best or possible in their case.

This is why I chose FUT .

1) the donor survival rate is 99%

2) the cost per unit is far cheaper



This is my hope. I have had the 1st FUT and am delighted with the fact the hair grows and my hairline has been restored. It really works!

My second procedure is to 'dense pack' the new hairline so my hair will have a natural full look to it and hopefully i wont need a third but if i do it will be FUE to fill in the scar..

[northeastguy]

Pencil thin scar...... that still makes me chuckle.

[ejj]

I think its very early days to arrive at any conclusion, best to wait for at least twelve months and see how things are then . May be worth applying a little minoxidil to see if you can speed up the recovery of the shocked out hairs.

Hope this helps

ejj

[mattj]

teg_101: as I understand it, this was your first procedure with Dr Rahal. I was confused for a moment as it sounded like you had all three with us.

A minority of patients can experience temporary shockloss around the scar. This is unpredictable and although it might cause some worry for you now, you should see re-growth in the months ahead - along with the growth of the transplanted hairs.

The scar looks to be healing well and the end result should be an improvement over where you began. Please don't hesitate to contact Patient Care at any stage. They're there to help you with your concerns.

[teg_101]

Update

Hi all,

I wanted to provide an update regarding my situation. I ended up undergoing a third procedure with Dr Rahal in Ottawa for 1675 grafts, to add additional density in the frontal zone, and to address the continuing loss behind my temple points.

With my procedure, I decided to undergo another strip (FUT) as apposed to taking the FUE route. I am now two months post op from my procedure, and growth in the recipient site seems to be on par at this point. My donor site, however is a different story..

In my first two procedures, my donor site was closed up using staples, producing which I thought was a less than optimal scar. With my latest procedure, the clinic used sutures. It seems as though I've lost a great deal of hair in the donor area (see attached), something which I did not experience from my first two surgeries. Is this shock loss that I'm experiencing?? I am extremely concerned, as my goal from an additional procedure was to help refine the scar.. and it seems that may not be the case. Any input would be appreciated, thank you.

[ejj]

appreciate your honesty Dr , too many fall for the ` whip it out in one ` sales line that rarely improves the situation

regards

ejj

[sp8rky]

I was referring to pullback at the hairline where I have had zero, but I couldn't say the same for the neck, I honestly don't know about my neck.

My 4 strips were all taken from the same place and all just below the occipital bump, and I am told this is too low for a successful revision, especially after 4 strips from the same place.

[DAVE52]

You've actually highlighted a drawback of FUE-into-scar in that you're apparently in need of a third procedure to complete the work. It's not uncommon for doctor's to prefer this step-by-step approach to ensure that the grafts are taking. The length of time and in many cases the travel involved for return visits won't be convenient for many patients..

Same drawback as getting a HT in the 1st place

The need to go back for further sessions as hairloss progresses -----as it usually does

[ejj]

The slight disagreement between me and other posters above might just increase the confusion for you over what you should do.

[/QUOTE]

You could say it might ` decrease any confusion as to what he should do `
as stated earlier a good point of call would be to consult with Dr Lindsey who has vast experience in scar revision , from this consult i believe teg 101 would be completely clear on which way to proceed

all the best

ejj

[mattj]

Thanks for the input guys. I will let you know what route I end up going with. Since I do require a 'fill in' for my recipient zone, and want to address the scar at the same time, perhaps giving another try with the FUT method might be the better option?? One drawback I've found other than the obvious is the 'pulling back' of the scalp that occurs with the FUT method. For someone that naturally has a larger forehead/ higher hairline, this is something that I will also need to take into account. I know this is a heavily debated topic, one which I believe does result in some pullback, despite what clinics say.

Are you saying you've actually noticed 'pullback' yourself?

I think it must be rare as I've only read occasional reports on the forums over the years and nothing else. I certainly don't dismiss the idea and it's possibly something that only the patient would notice, being the most familiar with his or her own face.

The slight disagreement between me and other posters above might just increase the confusion for you over what you should do. Scar revision and FUE-into-scar are both good methods and if you consult with a number of doctors you should get a clearer idea of which is the best option for you. With scar revision you would need to perform scalp exercises to increase your laxity. This would increase the chances of a thinner scar and should help eliminate the 'pullback'.