Complex 3 layer scar excision and trichophytic closure with intraop pics Dr. Lindsey

This world travelling health professional had 3 strip cases by reputable doctors but has a pretty wide scar across his donor region. He's been doing scalp exercises for a few weeks and today we'll excise this, and close the deep and subcutaneous layers with dissolvable sutures, and the skin with sutures we'll take out on day 7.

In these GRAPHIC pics...viewers warned...note the preop pics with about 1.8 cm of scar width on the left and right, and on the right clearly a couple of strips were taken leaving some hair in between.

Once the scar is out, it contracts pretty quickly and when put back by the now widening scar defect you can observe the tension on his scalp.

Then I show the deep layers in and the resultant skin edge space is about a millimeter. IN THEORY...the scar ought not be able to widen more than this...but people aren't theories.

In practicality, I've done lots of scar work, and on average I get about 50-60% improvement, occasionally getting a perfect result and occasionally not making much headway. There is an element of individual patient physiology involved, and as always, the best predictor of future scarring is past scarring...

I know from seeing other patients that these doctors primarily do a single layer closure left in for 2 weeks. You may note in the preop pics that there are a few "rail-road" tracks from sutures staying in a while.

Dr. Lindsey