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I’ve recently had an onslaught of scar repair cases and lots of discussion about trichophytic closure. While I’ve posted a number of threads on my closures and I’m pretty open about our results, this thread should serve as a complement to those posts by me and my recent youtube video on the topic. You can find it elsewhere on this forum and on youtube at: https://www.youtube.com/watch?v=a8-I1P1m5Lk
For the past 6 or 7 years, I’ve done about 120 strip cases. With rare exception, most folks have, or can get, reasonable scalp laxity with exercises starting a month preop. And while I don’t get to see everyone’s scars postop, as a lot of people live out of the area or even the country, each year I do see among my patients: 8 or so perfect scars, that I’d grade an “A”, 4 or so poor scars, done by me as best as I can, that I’d give a grade of a “C”, and gobs of scars that I think are in the “B” range. While I may be biased, Wendy and I almost never see a “D” result in our patients without some other factor playing a role….undisclosed scar history, Neosporin use, hygiene issues due to travel…for example.
So here are 4 cases done by me. I would say 2 are “A”, 1 is a “B” and one is a “C”.
Case 1 is a 47 year old indian, first timer, who had a 3000 graft case. Shown are his sutures, 1 week of very little cleaning, and 1 month scar check. Note he has hair growing all throughout his scar line. This one is FANTASTIC. “A”.
Case 2 is a 50 year old mixed race, predominantly black guy who had a previous case by me 3 or 4 years ago and now is getting his crown done. He also did no cleaning, looked pretty good at 1 month, and shown is his shaved donor region with the old scar visible at 3.5 years. My scar is the top edge of his new strip. NOTE, HE HAS AN OBLIQUE SCAR ON THE LEFT FROM A CYST REMOVAL ELSEWHERE…NOT BY ME. But his old strip scar looks decent and would certainly never be seen with ½ inch long hair over it. Would some semblance of cleaning postop or some scar care have made a difference??? Who knows, but this time I’m pushing him to do a better job and we’ll see. GOOD. “B”.
Case 3 is a 50 year old white guy who had 2700 by me and shown are his sutures, 1 week, and 2 sets of 12 month pictures. One is a close up of the other. His old scar is right in the middle of his new donor strip. I almost always put it at the edge but that scar is so good I didn’t want it at the edge and forcing me to get fewer hairs on his second case. FANTASTIC SCAR. “A”.
Case 4 is a 40 year old indian medical professional who did no cleaning or scar care. Although his hair grew very fast…and he was all grown in by 7 months or so, his scar was mildly hypertrophic and he said he didn’t care to do anything to minimize it. Even so, its not a bad scar but not one I’d put up on the poster out on main street….”C”.
So I hope this helps folks understand the range of outcomes possible by good trichophytic closure. I do believe proper surgical technique is a good portion of the result but postop care and genes play a role as well. I’m always a little reluctant to put up anything but “A” results, but even our “C” results are better than many people would expect…certainly hidden with only a ½ inch hair cut in almost all patients.
Dr. Lindsey McLean VA
For the past 6 or 7 years, I’ve done about 120 strip cases. With rare exception, most folks have, or can get, reasonable scalp laxity with exercises starting a month preop. And while I don’t get to see everyone’s scars postop, as a lot of people live out of the area or even the country, each year I do see among my patients: 8 or so perfect scars, that I’d grade an “A”, 4 or so poor scars, done by me as best as I can, that I’d give a grade of a “C”, and gobs of scars that I think are in the “B” range. While I may be biased, Wendy and I almost never see a “D” result in our patients without some other factor playing a role….undisclosed scar history, Neosporin use, hygiene issues due to travel…for example.
So here are 4 cases done by me. I would say 2 are “A”, 1 is a “B” and one is a “C”.
Case 1 is a 47 year old indian, first timer, who had a 3000 graft case. Shown are his sutures, 1 week of very little cleaning, and 1 month scar check. Note he has hair growing all throughout his scar line. This one is FANTASTIC. “A”.
Case 2 is a 50 year old mixed race, predominantly black guy who had a previous case by me 3 or 4 years ago and now is getting his crown done. He also did no cleaning, looked pretty good at 1 month, and shown is his shaved donor region with the old scar visible at 3.5 years. My scar is the top edge of his new strip. NOTE, HE HAS AN OBLIQUE SCAR ON THE LEFT FROM A CYST REMOVAL ELSEWHERE…NOT BY ME. But his old strip scar looks decent and would certainly never be seen with ½ inch long hair over it. Would some semblance of cleaning postop or some scar care have made a difference??? Who knows, but this time I’m pushing him to do a better job and we’ll see. GOOD. “B”.
Case 3 is a 50 year old white guy who had 2700 by me and shown are his sutures, 1 week, and 2 sets of 12 month pictures. One is a close up of the other. His old scar is right in the middle of his new donor strip. I almost always put it at the edge but that scar is so good I didn’t want it at the edge and forcing me to get fewer hairs on his second case. FANTASTIC SCAR. “A”.
Case 4 is a 40 year old indian medical professional who did no cleaning or scar care. Although his hair grew very fast…and he was all grown in by 7 months or so, his scar was mildly hypertrophic and he said he didn’t care to do anything to minimize it. Even so, its not a bad scar but not one I’d put up on the poster out on main street….”C”.
So I hope this helps folks understand the range of outcomes possible by good trichophytic closure. I do believe proper surgical technique is a good portion of the result but postop care and genes play a role as well. I’m always a little reluctant to put up anything but “A” results, but even our “C” results are better than many people would expect…certainly hidden with only a ½ inch hair cut in almost all patients.
Dr. Lindsey McLean VA
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