Dissapointed with plucking and acell any advice going forward !

Hi guys had acell and hair plucking 13 nonths ago , didnt really go my way , has anyone been in similar situ any advice would be greatly appreciated

thanks guys

ejj

I'm not clear -- what was the intended purpose of your procedure?

basically 2000 grafts to the frontal third , donor area treated with acell as shown and beard plucking into prior scars
ej

Which aspect(s) of the procedure didn't work for you?

Well the purpose of the transpalnt was to cover bare scalp not create bare scalp ! sorry to rain on the "acell parade "

ej

Quote:

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Originally Posted by ejj

Well the purpose of the transpalnt was to cover bare scalp not create bare scalp ! sorry to rain on the "acell parade "

ej

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So then, what are you gonna do next? Any plans like any surgeon for example?

hi ejj

thanks for posting, just so i can understand this correctly.

the first three photos are pre-op, the others are immediate post op 1 week) and the last few are post op 11 months.

so you had an attempt at a scar revision because your scars were wide pre op (back and right side), correct ?

you had 600 beard plucked hairs (from your other post) inserted into the back-right side scar with zero growth ?

where did the 2000 strip grafts come from ? the reason i ask is that this is not a small amount to take while at the same time also trying to reduce the size of the existing scar. this would have been a large opening to bridge.

cheers

Now i understand. You had a hairtransplant prior to the Acell rstoration thing. Or am i wrong

3 strips removed to get the 2 k grafts , chrono of the pics is right , the plucked beard hair went into the right scar as picture 5 shows , no scar revision was undertaken at all . The before pictures show the problem scar back right hand side where the plucked hair was grafted in to , 13 months later i now have a larger scar pictured at the lower area above the neck and another scar left hand side above my ear , I believe acell creates tissue rather than scar tissue , however it is hairless therefore I think a standard closure is more beneficial

regards
ej

thanks for clarification

have you been back to see the doctor ? if so whats his thoughts ?

this question might be hard to answer, but do you think the area of beard that was plucked grew back the same ?

hope it all works out well for you in the end

Hi Richard
Options are limited at the moment obviously , which is why I came to the forum I want to see if anyone has had similar experience and if so what did they do or are going to do , im trying be positive and get sorted I have good beard hair I just want to get the right advice to move forward

many thanks

ejj

Thanks now we got it. i was under the impression you went to Dr Cooley and got those strips done and then additionally Beard hair.

Ah ok limited options, does this mean that you are in fact a repair oatient? :-(

Maybe you should get in touch with Hitzig and Cooley in the case of scalp hair plucking, because this is used for limited cases.

At least you could test in a a small scale for example

Richard you got it right
3 strips to get 2 k grafts to the frontal third then acell on the strips( donor ) then 600 plucked hairs to the prior scar which was allready there before i went in to Dr Cooley , sorry if not explained situation clearly thanks for you understanding , yes I am repair

Cheers

ejj

Ok ok sorry for my misbehaviour then.

But i have some questions

Do you think, that your scars in general are more softer and "less" visible then before the Acell treatment?

Caus i think in your case there have to be two or three steps for a good looking result because your scars PRE look that way

Hi Richard
Less visible no , smoother yes , The goal was to thicken the frontal third . I think I went in with one problem scar and came out with 2 more , the one above my left ear and the one on my lower neck , at the end of the day its a cosmetic procedure I would of preferred a regular closure non acell

thanks

Eddy

To Clarify :

I have had 5 prior strip procedures .

December 09 I had the most recent whereby 2000 grafts were taken from 3 strips and grafted to the frontal third of my head .

The donor area where the strips were taken from was treated with acell, to aid healing , there was NO scar revision . the donor area was sutured not stapled .

600 Beard Hairs were plucked from my chin and placed in and around the PRE -EXISTING scar shown in the 3 before pictures none grew .

The photos show 3 prior, 3 at one week and 3 at 12 months , with 2 added of the lower scar .

Allthough I am a repair patient , I was told this acell treatment is beneficial to repair patients .

The lower scar is approx 10 cms x 2 cms , this is unlike scar tissue as its smooth and flat however to me it is non hair - bare-ing scalp .

The 2 nd scar above my left ear is similar , however a lot wider in parts

The 3rd scar above my right ear appears to have healed a lot better than the other 2.

I expected the donor area to be improved , not made worse , Im devastated about the results of the donor area, in particular where the 2 strips ( pictured ) were taken from which have clearly widened .

In my opinion I had one large scar to address when I embarked on my last surgery whereas I now have another 2 to deal with .

If anyone has been in a similar situation it would be interesting to see how you moved forward , revision , fue ,etc

I have on many occassions spoken with my Dr and yes , I have been offered a free revision , however i dont think that is an option for me at this moment in time .

Thanks in advance for any advice

Ej

Quote:

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Originally Posted by ejj

The goal was to thicken the frontal third.
Eddy

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Eddy, I took the time to seriously review & reconstruct your case (derived from all your given information). Without any further comment, I have 1 question:

You mentioned that you had 5 strip procedures (all in all, prior and including the procedure in Dec 2009). I guess (you didn't mention that) that you had all in all (derived from all 5 strips) about ~4000 grafts into your frontal recipient area? Am I right?

So, my QUESTION is, are you -at least- satisfied with the results (from ALL 5 strips) in your recipient side (including from the 2 new strips by Dr. Cooley)? Did the most of all your transplanted grafts into the recipient side ever grow? Are you satisfied with the recipient side results (hairline, density etc)?

YES or NO ?

Quote:

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Originally Posted by ejj

To Clarify :

I have had 5 prior strip procedures .

December 09 I had the most recent whereby 2000 grafts were taken from 3 strips and grafted to the frontal third of my head .

The donor area where the strips were taken from was treated with acell, to aid healing , there was NO scar revision . the donor area was sutured not stapled .

600 Beard Hairs were plucked from my chin and placed in and around the PRE -EXISTING scar shown in the 3 before pictures none grew .

The photos show 3 prior, 3 at one week and 3 at 12 months , with 2 added of the lower scar .

Allthough I am a repair patient , I was told this acell treatment is beneficial to repair patients .

The lower scar is approx 10 cms x 2 cms , this is unlike scar tissue as its smooth and flat however to me it is non hair - bare-ing scalp .

The 2 nd scar above my left ear is similar , however a lot wider in parts

The 3rd scar above my right ear appears to have healed a lot better than the other 2.

I expected the donor area to be improved , not made worse , Im devastated about the results of the donor area, in particular where the 2 strips ( pictured ) were taken from which have clearly widened .

In my opinion I had one large scar to address when I embarked on my last surgery whereas I now have another 2 to deal with .

If anyone has been in a similar situation it would be interesting to see how you moved forward , revision , fue ,etc

I have on many occassions spoken with my Dr and yes , I have been offered a free revision , however i dont think that is an option for me at this moment in time .

Thanks in advance for any advice

Ej

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You should consider the free revision and try to go for plucked scalp hair rather then ebard or bodyhair.

It seems that due to the years passed since your ht strip transplants, the scars need some time to getting better.

And i know that the large scar is softer but blank without hair. But believe it or not this could be a good sign for future approaches to plant hair.

You should really try to go for the free revision and also get another round of acell done. It could be especially important because one scar is going flatter and softer. You should try to work with this scar first and secondly with the one above your ear which seems to heal better then the other ones.

Can you say something about the time you got those transplants done, also which year and if its ok which doctor did perform this.

And i have another question, do you think that ypur laxity has increased? Like before it was a little stretchy and now its more comfortable?

Because on the pictures it seems that Acell has in fact grew normal skin

ejj:

you say that Cooley took you 3 strips, but from the pictures I see:

-you had had 3 previous strips (back, left and right). The right scar being overexpanded (and bald).
-Cooley took you 2 new strips (left and back), resulting in 2k grafts for the frontal area. Not clear if these were done over the old ones or in paralell.
-These 2 new wounds were treated with Acell.
-Cooley placed 600 beard autoplucked hairs on the (previous) right scar (which was quite expanded and bald).

The results:
-None of the 600 beard autoplucked beard hairs grew.
-The 2 new wounds, treated with Acell, expanded wildly after 13 months, and new tissue was normal (not scar) and bald.

Total result: now you have 3 wide bald "scars" (L,R,B). Two of them of normal tissue (new, L,B) and the other one scar tissue (old, R).

Well, maybe you have 5 scars, not 3, if the new strips were taken in paralell, and not over the old ones.

ejj, tell me if I am right in my observations.


Q: do you think the "expansion" has ended in these 2 new wounds, or do you think they will expand further in the next months?

thanks for sharing your experience.

EJ, obviously the area where the strip was taken and Acell was used looks worse than when you started, not really one’s objective when going in for cosmetic surgery. With that being said I don’t think I would try revising that scar and certainly not with the same doctor. The skin can stretch only so much before you experience unintended consequences. For instance I have the white wall tire effect around my ears along with a very high neck hairline, something Dr. Brandy conveniently left out when he explained his new and improved procedure. I speak with dozens and dozens of patients and all the Brandy patients have this same problem.

This Acell and plucking is very experimental and I have yet to see pictures of a small test area of approximately 1 sq cm with and appreciable amount of hair growing. Plucking 600 beard hairs seem like an awfully high number for something that has no proven results. These doctors have a moral and ethical obligation to only perform a very small test procedure and prevent patients from doing anything drastic. We look to physicians for guidance and this is why they take the Hippocratic Oath. Maybe it’s just me but there are things that in my line of work my customers will ask for, but if I think it’s not safe or dangerous I will refuse to do it. I have to be able to go home and sleep at night and live with myself if something bad happens.

Thank you for taking the time to share your experience as it takes effort. Of course we all hope for advancements, but no one should be taken advantage of. As for those that reply negatively to your words, I suggest they grow a set and get in the chair. We all would love to hear about your experience.

Pvtpoint, when will you be posting your results, it’s been a long time. I love how these posters just disappear and where is that Nalts guy while I am on the subject of disappearing acts.

Dr. Cooley do the right thing and give this patient his money back you should be embarssed to keep it.

Lets wait until ejj is back and can give us more informations about his strip ops in general.

And he should try for the free revision

before we start questioning ethics etc lets get the whole picture. i for one would also like to hear Dr Cooley's perspective on the case as well. in particular what i am trying to get my head around is why the doctor attempted to even take 2000 grafts in the first place. the writing was already on the wall from the right side scar and the left back scar (picture 2) pre op should have sounded the alarm bells that it was going to occur on the left if any fuether strips were taken.

@rapunzal : Nope there is no real threat from HM researchers because in the short run, the only option will be HM performed to grow hairs back the natural way and stop hairloss. And the second thing will be a hairtransplant with Acell to fill in gaps if they are around

As i said before " CAN lead to a solution" and as long as ejj didnt answer the questions, we dont know exactly what has happened here and if he is speaking the truth.

Even you dont know if he had switched pictures or whatever is happening here. And if you put have attention and effort in your studies you would know that bodyhair and beard hair has not a good yield rate. And scar tissue also no high yield rate, especially when it comes to bad scars.

And here in this case those factors come together like horse and carriage. It is remarkable that his scar has even become softer. This shows that in a hard case there can be improvement but maybe in two or more sessions.

Thats why he should do the revision and use plucked scalp hair to see what will happen there.

Here in this case we have a repair patient as i stated and saw it (ejj confirmed it without even mentioning it in the first place) so there are other laws of Acell then on a person without a prior hair transplant.

I think you catch me drift here.

For those that suggest EJ have another revision you can check my donor photos towards the end of my "follow my major repair" thread. Notice the side scalp view and the raised hairless area around the ear. This is what I believe will be the likely outcome of another revision for EJ. You can only stretch the scalp so far before you experience unintended consequences.

Some of the posters here and on the other forums would do best to listen to some of the long time vets that have been around for a long time. There only seems to be handful left.

Quote:

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Originally Posted by topcat

For those that suggest EJ have another revision you can check my donor photos towards the end of my "follow my major repair" thread. Notice the side scalp view and the raised hairless area around the ear. This is what I believe will be the likely outcome of another revision for EJ. You can only stretch the scalp so far before you experience unintended consequences.

Some of the posters here and on the other forums would do best to listen to some of the long time vets that have been around for a long time. There only seems to be handful left.

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Thats the reason why ejj should come back and talk with us about his matter cause he said that he has different results, in a good and a bad way. And there its interesting to hear whats behind this for future repair patients.

The only thing i believe in is: No strip transplants anymore. Cause what do we see? Almost weekly more and more repair patients arrive on the scene. And thats why its important to get Acell working at his high prime and also get unlimited donor with using FUE and/or plucking but not with strip transplants.

And if i would believe we were in the 80s or 90s in concearn of options, i would say "Hey folks get your mega FUT session done and a flap" but i dont say it because i believe in regenerating technologies.

Even with my strong beliefs in Acell i wouldnt say it can be that perfect to FUT in general. That Acell can guarantee unlimited Donor by using FUE this is plausible and achievable when researched further into. But with a FUT scar, your only option is to resize the scar even with Acell no miracles can be done "so far". But this can change when a little bit more fine tuning is done.

And no i wouldnt call anyone butchered bastard or stuff like this, this is just plain horrible to assume such things to my persona.

Especially not in topcats case. I would rather call him realist who knows exactly what he wants.

Hi Rapunzal ,

Yes I have spoken to my Dr and continue to do so , but as of yet have not seen him , basically he is as dissapointed as I am with the donor area . The beard area where the extractions were taken from healed perfectly and the beard continues to grow as normal in the extracted sites .

Richard sorry if I did not make it clear in the beginning that I am in fact a repair patient I assumed my clarification post with the 3 before pictures would of confirmed this , sorry for any confusion .

Robin Hood , I think you are approx right with around 4k grafts to the frontal third , its hard to determine the results when you graft into existing hair especially for the 6th time , I think vascularity may be compromised being a repair patient is very different to working with virgin scalp .

In the interest of transparancy and to be fair , somewhere between 10 - 12 days post op I had a family member drop a trunk ( car boot ) on my head that resulted in a 1 cm in length and 2mm width scar about 2cms into my hairline , I am a medical ` layman ` and unsure if this compromised or affected growth , as for satisfied I would say be nice to have more density , I must stress that growth in the frontal third was not the reason for my post , I wanted opinions advice on the donor area thats why I was specific towards that area .

Richard Re Laxity I have not noticed any difference other than the usual tightness after the procedure and the few months after , regarding new skin thats exactly my point !! Its new hairless skin hence perhaps a standard closure may of been better in my opinion

Spanish Dude , yes I believe the expansion stopped shortly after the 3 month time period

Previous strips are 5 not 3
right scar more of a permanent shock loss that never grew back hence the smooth appearence .3 strips were removed one from above the left ear , one from the lower back of head , one from above right ear , only the lower one back of the head was in an untouched area .

Robin Hood your qs mark in red does point to the 3rd strip

Richard the PRIOR Scar was allready soft , in photos it looks like a huge scar the majority of it is permanent shockloss , this right hand side scar was my major concern it was caused by NHI Greece about 8years ago , this area troubles me , the two new areas are very UNLIKE regular scar tissue they resemble slightly discolured scalp , options as you state are to either revise them with more trauma to the scalp of graft into them , taking in to account the costs involved would it not be better just to have a standard closure ?

Richard strip vs fue controversial subject , I would obviously say Fue only , however patients who have had good strip would dissagree with me !!

The donor area above my right ear seemed to heal a lot better than the others , my purpose of posting was not to attack or accuse anyone , but to try and get some informed opinions from people who have either undergone revision repair or our considering it , Basically Im looking for opinions on how to proceed .

regards

ejj

Trust me I am way behind anyone hurting my feelings by commenting on my photos. I get along very well in life, but unfortunately I can’t say that about so many others that I have spoken to which is too bad.

I interact with more people face to face than the average person and I have no issues whatsoever. I also do some public speaking as a hobby and have no problem being in front of an audience. Confidence is in your head not on top of your head. But of course I would still like to improve my situation because that is how I live my life. I strive to improve.

I think it would benefit EJ if some of the posters giving advice would tell us a little bit about yourselves and you experience in this industry.
It’s very easy for many here to say just go back and get the free revision as you are not in his shoes. I’m sure if some of the posters here or the forum owners or moderators experienced a similar situation, they would be singing a different tune.

Would you actually go back to someone who billed you for this work in hopes of getting some more for free? Sure take my other eye out why don’t you. I understand this is experimental but the doctor has an obligation to proceed with caution.

Quote:

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Originally Posted by ejj

Hi Rapunzal ,

Yes I have spoken to my Dr and continue to do so , but as of yet have not seen him , basically he is as dissapointed as I am with the donor area . The beard area where the extractions were taken from healed perfectly and the beard continues to grow as normal in the extracted sites .

Richard sorry if I did not make it clear in the beginning that I am in fact a repair patient I assumed my clarification post with the 3 before pictures would of confirmed this , sorry for any confusion .

Robin Hood , I think you are approx right with around 4k grafts to the frontal third , its hard to determine the results when you graft into existing hair especially for the 6th time , I think vascularity may be compromised being a repair patient is very different to working with virgin scalp .

In the interest of transparancy and to be fair , somewhere between 10 - 12 days post op I had a family member drop a trunk ( car boot ) on my head that resulted in a 1 cm in length and 2mm width scar about 2cms into my hairline , I am a medical ` layman ` and unsure if this compromised or affected growth , as for satisfied I would say be nice to have more density , I must stress that growth in the frontal third was not the reason for my post , I wanted opinions advice on the donor area thats why I was specific towards that area .

Richard Re Laxity I have not noticed any difference other than the usual tightness after the procedure and the few months after , regarding new skin thats exactly my point !! Its new hairless skin hence perhaps a standard closure may of been better in my opinion

Spanish Dude , yes I believe the expansion stopped shortly after the 3 month time period

Previous strips are 5 not 3
right scar more of a permanent shock loss that never grew back hence the smooth appearence .3 strips were removed one from above the left ear , one from the lower back of head , one from above right ear , only the lower one back of the head was in an untouched area .

Robin Hood your qs mark in red does point to the 3rd strip

Richard the PRIOR Scar was allready soft , in photos it looks like a huge scar the majority of it is permanent shockloss , this right hand side scar was my major concern it was caused by NHI Greece about 8years ago , this area troubles me , the two new areas are very UNLIKE regular scar tissue they resemble slightly discolured scalp , options as you state are to either revise them with more trauma to the scalp of graft into them , taking in to account the costs involved would it not be better just to have a standard closure ?

Richard strip vs fue controversial subject , I would obviously say Fue only , however patients who have had good strip would dissagree with me !!

The donor area above my right ear seemed to heal a lot better than the others , my purpose of posting was not to attack or accuse anyone , but to try and get some informed opinions from people who have either undergone revision repair or our considering it , Basically Im looking for opinions on how to proceed .

regards

ejj

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Thank you very much for your answers

One thing, yes the trunk can in fact cause some healing problems. Thats a problem some patients have when the bounce their head against something :-(
Its sad to hear that this was also involved.

Its good to hear that your plucked beard hair grows as normal as you would expect it.

So you are also saying that the prominent problem is, when we consider it, that Acell did heal well but it produces too much normal and therefore blank tissue without hair and you would be more happy if it would be just a tiny scar without Acell instead.

Have you spoken to Dr Cooley about this matter and what he advises you?

Thank god your are "satisfied" with your frontal growing. Its sad to hear that such things happen to you even considered a procedure 8 years ago where docs should have been more carefully.

@topcat - Same thoughts here. Couldn't agree more.

Ok topcat good point.

So why am i against FUT and highly invasive operations. I had a bad operation in the past where my leg was involved in an accident and therefore i have a gigantic scar from the underside till over my knee. This scar cannot be repaired cause the tissue is thick and hard.

Thats why iam absolutely against flap reduction and FUT and also why iam personally afraid of operations. If they would have taken my leg more seriously then today i wouldnt have a nice leg which really looks bad.

For this reason Acell i am really setting my hopes to this. And also ejj has a chance to revision his scar, i know its additional trauma but there is also a chance by using Acell and plucked hairs to get this fixed.

And therefore i quote ejj here, i would only go for FUE these days but insist of using Acell and small test sides with plucked hairs.

You know its maybe in my world simple but, my scar at my leg cant be fixed in life time. But even if you have scars at your head, at least we can give it a shot with plucked hairs and Acell.

The more it is used the more we can se the "magic" behind it or grasp it.

And which doc is offering him the free revision? Dr Cooley or the greece one. Thats the question.

Oh and before it comes down to this, scars today have even this stigmata around it. Believe me, when you went to a smim class with my leg you know exactly what to expect.

@topcat : Is this what HairRobinHood is doing right now, Confidence or not? I think to insult other people has nothing to do with confidence

Richard you make a good point. Would anyone here return to a back surgeon that left him partially paralyzed, or a brain surgeon that left him blind for more work to try and correct the situation? I would hardly believe it, but somehow HT is different and many seem to be okay with it. Chances are they would research who they thought the best in the world was in this area and would go to them sparing no expense.

I think that scar is too large and although revision might reduce it somewhat it probably not worth any unintended consequences. FUE into the area if donor is available might be a better option. If this option is taken I suggest a small session at first.

Dr. Cooley at the very least should offer him a partial refund and let him decide what he thinks it best for himself.

I like to post what I think is a logical answer to the situation but in the end it’s up to the patient. I also know some forums and posters don’t like to hear logical answers one of the reasons I was banned from HTN and why the site in my view has so little credibility. This is the problem with this industry, people think they have to lie, cheat and steal to make a buck. You can do the right thing and still do very well.

@topcat : Your points are valid. I gave the advise for the free revision to use it because i never had the chance to with my knee and also because there is a chance for Acell to work.

But of course he had to speak to Dr Cooley at first. The good thing is, that his beard donor area didnt get damaged during this process.

With the small session i absolutely agree. The problem in his case is, that the greece clinic had done a bad job.

As i said i only said i was pro revision because of the higher chances here to get this done. But yes Dr Cooley should give him a refund and let him deceide whats best.

But in ejj´s situation i can understand why he asks for an advise here. I would do the same to hear different opinions with their pros and cons.

The reason why people still get back to their ht docs is the believing " This time he will get it right"

Richard, we agree, if I lost one eye in an operation I want to be given enough respect to choose a different doctor to work on the other eye. I don't want to be forced to go back to the original doctor because of financial considerations. I expect the doctor to have the common decency to mitigate my expenses.

The only way I believe a revision might work is to do what Balloonman did if anyone here remembers him from about 8-9 years ago. But inserting a balloon under the skin is a long and painful process which can also have servere consequences if anything goes wrong.

Iam familiar with tissue expansin but not with Balloonmans case because i wasnt around here at this time.

So the common sense here, before we all give away advises here, that ejj should talk with Dr Cooley.

I think he should do this as soon as possible to get this nightmare fixed finally

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This posting leaves out some important information. I was consulted by this patient to 1) improve the old donor scars from numerous procedures and 2) add hair to the front which was very thin despite all the work he’d had done. It was my understanding that these were equally important. I suggested FUT to fill in the front and described the new plucking procedure. Because it was so new and we did not have a clear idea of the success rate, there was no charge for the plucked grafts or use of ACell. The only fee was for 2,000 FUT grafts. This was not planned as a ‘one and done’ and there was discussion that multiple procedures would be necessary to fully correct his old donor scarring. No results were promised or guaranteed but I certainly did give him an optimistic assessment based on the early results I was seeing in other patients.

Looking at the results:

1) Plucked beard grafts in old donor scars: The patient’s scalp had extensive wide donor scarring from old procedures. We performed about 600 plucked beard grafts throughout this area. I have not seen the patient in person but from the photographs it appears that virtually none of them grew. We have since learned that plucked grafts do not grow well in scars and that the wider and denser the scar tissue, the lower the success. I understand the disappointment and upset by the patient as I too am extremely disappointed by the failure of the plucked grafts to grow in scar tissue. Looking at the photographs, there appears to be an improvement in the texture of the old scars from the multiple recipient sites made and implantation of ACell coated grafts. I believe this will make the area even more receptive to FUE grafts in the future (see below).
2) New donor scars: The patient had minimal donor reserves and minimal scalp laxity. Yet he desperately needed some density in the front central region of his scalp. Despite all the work he’d had done, there was a lack of density which was the primary factor contributing to his balding look. I identified 3 areas which I thought we could harvest from. We were able to obtain over 2,000 FUs which we used to transplant the frontal core. Because all the good, safe areas of his donor area had already been harvested, I had to go to areas that I would normally avoid. I wrongly assumed that ACell would ensure scarless healing of these donor strip sites. Two of the three sites stretched due to their location and are now creating a cosmetic problem. I have since learned that ACell doesn’t prevent donor scars, but it does eliminate the thick, dense scar tissue that would normally result. These did not stretch because of ACell. The texture of these new “hairless gaps” is softer and feels like normal skin, according to the patient. I believe that these areas will be very receptive to FUE grafts. I take full responsibility for creating this result and have offered to fix it (see below).
3) FUT results: It seems unfair to judge this case without looking at the results of the grafting to the frontal scalp. The patient had already been committed to longer hair to cover all his old donor scars, yet this made the lack of hair in his frontal scalp even more apparent. From what I understand, the 2,000 FUs have grown in well, yet no before and afters are presented. Also, on top of everything, the patient had an unfortunate incident in the post op healing phase where a relative accidentally slammed the car trunk down on his grafted area, creating a full thickness laceration. I have offered to fix this as well. It’s easy to second guess in retrospect and question whether the patient should have had strip FUT. Yet, he desperately needed more hair in the front and it seemed like the best option at the time.

Moving forward:

1) I believe that a combination of beard and scalp FUE will correct the two donor ‘scars’ I created. Another option is re-excision but there are no guarantees the results will be better.
2) Beard and scalp FUE will be even more effective in the old donor scars as a result of the area being ‘rejuvenated’ by wounding and ACell.
3) Plucked grafting should work well in his frontal scalp and to fix the area where he had the accident and to add some more density overall.

I have been in communication with the patient for two months now and have repeatedly offered all this at no charge. I sincerely hope the patient takes me up on it. I am as anxious as he is to see this turn out well.

Dr Cooley

Would it be that when you pluck the hairs, perhaps you are just 'reactivating' the stem cells, in line with the recent research by Cotsarelis, and that is why plucked hairs won't grow in scars.. because there isnt anything there.

So I don't think the plucked hair is growing a 'new' follicle at all.

Quote:

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Originally Posted by Bakez

Would it be that when you pluck the hairs, perhaps you are just 'reactivating' the stem cells, in line with the recent research by Cotsarelis, and that is why plucked hairs won't grow in scars.. because there isnt anything there.

So I don't think the plucked hair is growing a 'new' follicle at all.

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Perhaps. What I think is happening is that native stem cells from surrounding follicles contribute to the rebuilding of a new follicle around the plucked graft. But these are just theories and require more study.