Scar Grafting with Dr Cole

[northeastguy]

Stick with scalp hair. If you're curious have him do about 10 beard grafts in the scar to see how well it takes. I did not have success with beard hair in the scar. We did test beard hair on the scalp and I think I had some success. I had 10 placed on the scalp and we will count out what took on Thursday. The other issue I had with beard grafting was ingrown hair's and it left bumps in the area where the extractions we're done. Right now, unless you are completely depleted with scalp hAir, I would stay away from beard grafting. Again, it's OK to test and see how well it takes in your scar. You're already having a procedure so why not test. If you make your goal a 2 guard, you're setting yourself up for likely success. That is an extremely reasonable goal. Again, be patient and do "multiple" passes. Then, by adding the temporary pigmentation you Will likely achieve your goal. Honestly, if you have success with the grafting and stick with a two guard, you may not even need pigmentation. Cross that road in a couple of years. Good luck.

[wylie]

You know, I have had about 10 strip surgeries from the early 1990's to 2000, and while the surgeries themselves cost me around $50,000 to repair, using beard hair and scalp hair (mainly beard hair), at least the butcher doctor left me with nice thin strip scars.

But the problem was I had all that bald space where the strip scars were and I had to grow my hair long in the back to cover them up. I had Dr. Cole add about 500 beard hair to my scars, which grew well, but I needed much more work. That's where Dr. Umar came in, because about the only thing I would trust Cole with is working on a scar. His history in repairing patients hair who have been disfigured is an ugly one, and I'm not going into detail, other than to say I have first hand experience and realized he is not proficient in repairing your hair. I had that part done by Dr. Umar, who also dropped close to 2000 beard hair grafts into all the scars (over multiple sessions) and the results were amazing. But you are still dealing with less hair in the scars than the surrounding area, so what one needs to do is camouflage the area with SMP. I had Nicole at Shapiro add this to my scars and it gave the confidence to shave my hair to a #1 in back, and I have 100% confidence in my appearance, at least regarding my 10 strip scars.

This is the reason I'm commenting on this thread: Shaving my hair in back to a #1 guard has actually proved to be better than leaving it long in back. If I had it long in back I would not only have the wiry beard hairs sticking out but it would be noticeably thinner in spots. With it cut very close like I have it, the beard hair helps fill in the gaps but the SMP makes it look like there is hair in the scars and fills in the areas without beard hair. So my advice to anyone wanting to fix their scars is:

First step: Add beard hair to the scars. There is no substitute for actual growing hair when it comes to concealment. Beard hair works great, it is thicker than scalp hair and gives more coverage. The problem with this is there is only one doctor that I know of in the U.S. I trust with this, and that is Dr. Umar. I'm fairly sure there are plenty more doctors in the U.S. who have gained experience since I completed my repair (2014) but I don't know who they are. If you go with someone without the requisite experience you waste valuable resources: $$ and beard hair, and one (maybe both) are finite resources. You dont want to waste either.

Second step: Now you need camouflage to the scars to fill in the gaps left by the beard hair addition. I personally would never recommend permanent SMP. That can easily create new, and permanent, problems. The risks far outweigh the gains. Temporary SMP works great, and touchups cost $400. They say you can go for a year between sessions but I go for two, and I'm going to go three on this one.

It's fairly simple: Add hair and camouflage. And when both are added, you might be surprised to find out cutting your hair shorter provides better concealment to your scars than having long hair that is noticeably thinner in some areas. It did for me.

Also, northeastguy, you started this thread 5 years ago and you are still working on this? What is preventing you from finishing up your scar repair? I wish you the best and hope you come to a conclusion soon. I never thought that I would cut my hair to a #1 guard, but then again I never thought I would go out in public without wearing my hat. Without beard hair, I would be doing neither. I barely had enough scalp hair to repair my hairline, and the rest was all beard, over 5000 grafts. Not to sound dramatic here, but the truth is, beard hair saved my life. I didn't know how much longer I could keep wearing a hat after 20 years of doing so.

[southeastguy]

I want to thank both of you (Northeast and Wiley) for sharing your story. There is at least hope out there for guys with strips that wan't to cut their hair short.

To all the guys who have had their strip scars repaired (Northeast and Wiley) I was wondering how many grafts/cm2 do you guys have in your scar to get to where you are today. Native hair is 80/100 grafts cm2. I am just wondering how close you need to get to that figure for the hair to blend nicely at a #1-#2. Also, how many passes did it take for you to get there. I am assuming I will need at least 2 passes of maybe 30 grafts/cm2 each. That would get me to around 60 grafts/cm2 if they all grew. Do you think that is enough to get the job done if I supplement with Trichopigmentation?

[Therealdeal23]

I am so glad that you responded to this thread I was afraid you stopped checking. Every SMP place I have called has said that it looks best shaved down or at a 0 guard so that the SMP most closely matches the stubble. They said keeping your hair at a 1 or 2 guard would deem it noticeable. These are the opinions of Matt Lullo from scalp micro USA and Jae Pak from NewHair (some of the best known and most successful SMP providers in the entire business and their results speak for themselves). I've also spoke to another clinic and they told me the same thing. While they say it will still be noticeable if one is examing and scrutinizing the scalp, about 90% camo is achieved and it will go fairly unnoticed by just about any casual observer. I asked if I were to pack the scar with hair would it look okay grown out at different lengths and they said yes while it may help, grown out at a 1 or 2 guard would still be more noticeable than 0 guard and probably not achieve the camo you would want and def draw more attention. That is why I am so intrigued with you actually having gone through it saying a 1 or 2 is better than a 0 (assuming you have hair in it). Northeast guy is there any way I would be able to speak over phone or email? You've been a complete inspiration to many patients like myself I just needed some insight and help from someone who has been trough the journey. I've gotten many different opinions from many different people and just need some clarity. Please let me know.

[Therealdeal23]

Pictures like this make me skeptical of Dr. Cole's work. The description says 447 grafts were added + 3 sessions of SMP. That strip scar is compleltey unnnoticeable and just seems to good to be true. Is that photoshop perhaps? I would LOVE for it not to be but man..what do you guys think? Dr. Cole has many cases of FUE into scar where the coverage is outstanding..I can recall two other cases also where the scar seems to be tremendously camoflauged and just about gone. How can such a result be possible? Pictures like this give me hope and I pray these are the actual results Dr. Cole has produced and not some form of editing because that would be downright wrong.

[southeastguy]

@Therealdeal23...

I did temporary smp so I can speak to that part of this. If you are planning on shaving every single day then temporary smp is a good option by itself and grafts may not help all that much. However, if you plan on having any length of hair at all, you will need to graft into the scar and supplement with temporary smp. Do the temporary smp first. Its quick and easy and will give you some immediate relief.

We notice scars because of the contrast of hair, then a bald spot, and then more hair. I am soon to go in for my first FUE into scar and I am strongly convinced that I will have tremendous success at a #2 and hopefully a #1 if the grafts grow. Speak to Eric at Aheadink. He will explain wll of this to you and his results were incredible.

[Therealdeal23]

So technically speaking, it is possible to 0 guard (or shave whatever looks best with SMP) and then let the hair grow to a 1 and 2 with little problem if you have SMP and a scar pretty densely packed with hair? So you would be able to for example go to a barber and get a 0 and then let it grow and not maintain a 0 every couple of days assuming you have hair in it and it would look good? I mean, ultimately that is the dream because that would be like almost being back to normal.

Personally, knowing what I now know, I would never reccomend FUT to anyone but that is just my personal opinion. FUE or no transplant at all.

[southeastguy]

Its really up to your level of comfort. I personally think you are going to be safer with getting a number 1 and letting that grow out for a week or two. I feel that a 0 will be more obvious than a 1 or 2. I agree that you should do FUE or nothing. The only guys who should be getting strips are guys over 50 years old who know with 100% certainty they will never want to go below a #4. To get good scar coverage you will probably need 2 or 3 smaller sessions of no more than 25 grafts/cm2 on the first session. Make sure you find the right Doctor for the FUE into scar. I am happy to share my results with you in the coming months.

[Therealdeal23]

I completey agree. My hair loss wasn't hereditary or due to male pattern baldness. I suffered from traction alopecia as a result of the way I tied my hair under my turban (I'm Sikh very common in Sikh males) and it took my hair loss to a Norwood 3 with my temples also losing some hair. There is no extreme hair loss in my family either so FUE literally was designed for something like my case but I let a surgeon sell me on FUT and he left a wide scar (3-5mm) too low on my head under the occipital bump. I completely agree with you...if you're of older age and advanced hair loss and have gone 40-50 years without ever really wearing your hair short..then by all means go for it. In just about any other case, I wouldn't recommend it to my worst enemy.

I would love for you to keep us updated with your repair. If you don't mind, would you be able to email me some pics of your SMP and how it looked? I will be starting my repair journey soon and hope to keep you all updated also.

[Therealdeal23]

I've narrowed my FUE into scar down to Dr. Umar, Dr. Cole, and maybe Tejinder Bhatti in India (price of $1.5 a graft and proven results/ISHRS recommended and best surgeon in India in my opinion.). Price, to me, is the last thing on my mind but if you can get a bargain and great results no harm. I'm leaning Umar because of his extensive work and proven documented results. Even Dr. Cole seems to be a great option but his pictures seem TOO good to be true and I'm just not sure..would you care to comment on that northeastguy? Do you think all the cases he posts himself are legit and not edited? It is VERY easy to edit pictures..I can edit anyone's strip scar to disappear in about 2 minutes in photoshop.

[southeastguy]

Im not sure how to send photos in the forum. Just make sure for SMP you go to someone who uses temporary SMP and is using "Beauty Medical" Products from Milenna Lardi. You can look that up on the internet who uses her products.

[Therealdeal23]

Southeastguy, have you thought of getting a scar revision first? Much easier to graft into and SMP a thin scar. I read in your profile that it is .5cm (same as mine). Have you ever considered going to a top doctor who's really good in closures like Dr. Wong, Dr. Lindsey, etc and see if they can reduce it? I'm planning a scar revision first only problem is it's a bit low on my head and it may not improve. If your scar is at/above the occipital bump, the best doctors are usually VERY confident they can improve it. They told me of laxity is good and it is not too low on the head, very rarely do they not get an improvement. But yes, there is always risk and some guys just don't even wanna go through the process of getting cut open again but in my opinion if the doctor is confident they can get an improvement it is worth it to try.

[southeastguy]

I wouldn't touch a scar revision with a 10-foot pole. I have spoken to nearly a dozen doctors (including Lindsey) and not one could give me a guarantee that a scar revision would make it better. If I had a 1cm+ scar in width I would consider it out of a lack of other options. But with a .5cm width the idea should be immediately thrown out. After all, what made the scar go to .5cm in the first place.

My suggestion to you is:

1. Get temporary SMP into scar immediately (2-3 sessions - cheap, painless, immediate results)
2. Find an FUE into scar doctor that has proven success. I am getting my FUE with Shapiro Medical Group in MN. They said 80% of the grafts grow in the scar. I visited them in person and think that they run a very honest, competent practice. You should check them out. *I have not had the procedure done so I can't speak for my results at this time.
3. Assuming the grafts grow, go back for a 2nd session 12 months later.

[Therealdeal23]

I'm going to graft the scar and wait for the SMP afterwards but I completely understand doing SMP first as it does give you results right away. Technically speaking, isn't it possible to keep packing the scar with grafts to achieve a higher density? I understand for most average wife scars about .5cm you might need 600-700 grafts in total to give you a solid result..but what if you continued to pack it with say, 900-1000+ (assuming donor isn't an issue). What if you wanted to even pack it with 1200? This is all hypothetical and I'm not saying someone should use all that donor for a scar but technically speaking if someone wanted to, woould it give an even better result or is it not really going to make a noticeable difference? Imaging packing a scar with 1000 grafts and SMPing it...would anyone really be able to notice there was a strip scar there??

[southeastguy]

From what I have learned, you probably want to get to around 50-60 grafts/cm2 and then SMP should make up the difference. Native hair is 80-100 grafts/cm2. It depends on how long your scar is. My scar is 25cm long X .5cm which is 12.5 grafts/cm2. If you do the math I am probably looking at 500-600 grafts over two sessions. My guess is that at some point you will get diminishing marginal returns and it just won't make sense to keep grafting, not to mention each graft is another tiny scar. The scar will always be there, but the idea is that you are making it tough for the average person to notice it in a social situation. I am not trying to trick a hair transplant doctor that I don't have a strip scar....I am trying to trick the average person who sits behind me at a concert or walks past me at the mall.