SMP vs FUE for scar repair?

I'd like to ask the brothers out there with experience on this forum for advice on the best scar reduction techniques for my situation.

I am on a multi year journey to reduce / hopefully eliminate my hair transplant strip scar in order to shave my head down to a 1 or 0. I've had 3 successful FUE into scar procedures with Dr. Robert Jones, that has greatly reduced my scar, the last of these being a few years ago - see the photo albums in my profile. While the improvement has been vast, the scar is still quite visible at a 1 or 0 shaver setting.

It sees that I got diminishing results with the subsequent FUE into scar sessions. My best guess at noticeable improvement to the scar 6 months after each session was:
1st op: 50% improvement
2d op: 20 % additional improvement
3rd op: 5% additional improvement.

I'm not sure if my case of diminishing returns is to be expected, or not.

I would like to have further work done, and am not sure whether to go or a fourth FUE into scar session, or whether to try scalp micro pigmentation (SMP).

Anyone have any thoughts on which way to go first?

Hi Varonil,

The blood supply in scar tissue tends to be reduced, making it a less nourishing environment for the grafts to grow. It can be highly successful (and you've obviously had some success yourself) but it can depend on individual healing characteristics. The thickness of the scar tissue can vary from person to person.

Did you apply Minoxidil (Rogaine) to the grafted area post-op to help increase blood flow?

It's possible that further improvement could be achieved with another FUE session, but if you're looking to shave your hair very short then SMP is a good option.

I think you should ask yourself if you have the patience (and budget) to attempt another FUE session - which might be unsuccessful - before opting for SMP.

Hi Mattj,

Thanks a lot for the reply and sound advice brother; very helpful.

I did not apply minoxidyl to the grafted scar area post-op. I presume if I go for another session, then I would have to wait a week or so for the area to heal before applying minoxydil to the newly operated area?

Yes, you'd need to wait for a couple of weeks at least, but after that it could, potentially at least, improve the success of the procedure. Minoxidil is a vasodilator, so it widens the blood vessels and allows more blood flow to the area. I can't say for sure that it'll have any effect.

Thanks again Matt, truly appreciated.

hi

whats the main reason fue and use of more grafts would be worth another try?

if its just in his doner area where he will not lose more hair surely blending in SMP would just be better for sure?

thanks

Hey. Congrats. How wide was your scar? In similar situation.

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Originally Posted by jetfan11

Hey. Congrats. How wide was your scar? In similar situation.

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One of our patients today had 4mm plug surgery many years ago. He wore a hairpiece for several years and recently began shaving his head after having SMP. The color looks pretty good and I think it has done a reasonable job of concealing his previous transplant work. I prefer trichopigmentation to SMP though, because the "dots" don't spread. Today he's having scalp hair grafted into the pattern of round scars in the traditional donor area on the back and sides of his head. This is the kind of situation where perseverance will pay off. I believe he will eventually be able to achieve a very natural look. He told me today that he is very happy to be out from under his hairpiece.

I can't stress enough the importance of having an artist perform your trichopigmentation procedure. Aggressive hairlines don't look natural and are a dead giveaway. Novice technicians have a tendency to place hairlines too low and don't vary the hairline color or "dot" density to a realistic degree.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
I am not a doctor and the content of my posts are my opinions, not medical advice.
Please feel free to call or email me with any questions. Ask for Chuck

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I prefer trichopigmentation to SMP though,

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Just curious, have you seen trichopigmentation in person?

To my knowledge Trichopigmentation and Scalpmicropigmentation are interchangeable terms. Tricho comes from the Greek or Latin meaning "hair."