Hair Transplant Scar Stretchback?

[toyman]

I have seen the term "scar stretchback" being used in relation to hair transplants. What the heck is that? It doesn't sound good. How does it affect the outcome of the surgery????

[SpencerKobren]

I have seen the term "scar stretchback" being used in relation to hair transplants. What the heck is that? It doesn't sound good. How does it affect the outcome of the surgery????

Hi Toyman,

Welcome to the forum!

This is a great question. Check out IAHRS Member Dr. Victor Hasson's response to a similar question that was published on the IAHRS Info Center. http://hairloss.iahrs.org/hair-trans...ir-transplant/

Hope this helps!

[gillenator]

The link Spencer provided is good reading. I especially appreciated Dr. Hasson's comments about sub-dermal scarring which many prospective FUE patients are unaware of. Why? Because that layer of tissue is not visible to the naked eye like the epidermis. Many are of the opinion that if you cannot see it, it does not exist, BUT IT DOES EXIST, and further, can affect future FUE extractions within in the same location.

Scar stretchback only applies to Strip and often is attributable to two scenarios. First, there is a lack of adequate scalp laxity and second, the patient has issues with healing. Thank goodness there are competent HT surgeons who actually check the laxity throughout the occipital zone because IT CAN VARY. Adjusting the width as the strip specimen is harvested is admirable and consequential. Many docs advocate the use of scalp exercises well ahead of the procedure to improve the level of laxity. Some multi-procedure strip patients lose laxity to the point where it cannot be regained. FUE is their only option at that point. I have heard from patients who had several past strip procedures only to have their third or fourth strip procedure leave them with a wider scar than expected. YOU WOULD BE AMAZED AT HOW MANY OF THEM TELL ME THAT THEIR LAXITY WAS NEVER RE-CHECKED for subsequent procedures simply because they never stretched before! If your doc does not evaluate your laxity for a Strip BEFOREHAND, you better run for your life!

I was somewhat surprised that other methods of closure such as the double-closure method, etc were not mentioned. This can greatly reduce the potential of scar stretchback. Other closure methods will employ a variance in the tension of the sutures along the opening when closing.

Some patients just heal with widened scars or what is referred to as a "raised scar", the latter having nothing to do with laxity. Raised scarring can be more prevalent in certain ethinical groups however it can occur to any race. THAT'S WHY IT IS SO CRITICAL to have these issues addressed in the patient's mecial history BEFORE any decisions to move forward with surgery are made. Every patient needs to be screened and evaluted for past scarring and how well they healed. Patients who have dire healing issues or other health circumstances that can potentially have a negative impact in the healing process, should be ruled out for Strip which is my honest opinion.

Hope this has been of some help and best wished to you.