FUE vs scar revision

[HairTransplantOops]

I am 32 and made the mistake of having a hair transplant when I simply do not have a enough hair on my head to fill my frontal or crown. Not enough supply for the demand. I should have paid more attention in economics class before undergoing the procedure. So, now I am stuck with the typical ear to ear FUT scar with a balding top of my head. I think I can maintain this for at least 10 years and look simply like a thin 30 something old. My question is should I attempt an excision/revision or simply put FUE into my scar in attempt to trim it down to a respectable level all around (hoping for 1/4 inch or less with slight scar showing only)? My scar is 2-3 mm wide all around. I know there are plenty of you out there that have had this decision to make and it either bit you or you were successful. Maybe it is not worth the risk for the possibility of a 50% improvement?

Let me know what you guys think?

[doinmyheadin]

I am interested in this as well. Similar situation, 2-3mm scar which I think is very common. Personally I think if I had a scar revison it would not get much better. There are a few results online (but not a many of them) of fue into scar.

With fue into a scar the width mentioned would you be able to cut the sides and back down to a number 2 or 3mm clipper without seeing the scar line? Outside in bright natural light of course. I dont want to shave to zero or anything and dont want to do the SMP thing every few years.

[doinmyheadin]

Are there any Veterans out there who can recommend or have been through this?

[doinmyheadin]

Bump anyone?

[HairTransplantOops]

I am somewhat skeptical about your 1 mm or less scenario. From what I can gather, revisions are somewhat like playing with fire and can be unpredictable. To believe that you can completely make a scar "disappear" does not sound realistic. By no means, do I not think that it is possible but the fact of the matter is that there are risks with revisions. I have been advised by a couple of the top docs (3 MD with combined experience of over 60 years) in the U.S. that my scar is not worth the risk, but it does keep going through my mind to try a revision and simply see what happens (hoping for the best with fingers crossed). If there were a guarantee that it would be smaller by all means I would say slice me up.

[doinmyheadin]

HairTransplantOops I tend to agree with you. I have had two tranplanst one with a Australian doctor who used staples ( he was previously a plastic sugeon) and another with probably the most popular doctor around who uses satures, both did the trico closure. The second doctor cut out one side of the scar and extended it further up the side of my head. The scar from both operations eventually healed at about 2-3mm which I think is a lot more common than the 1mm scar FUT doctors promote.

Surely there are some veterans who can give some advice on the topic.

[GNX]

no offense Doc but I strongly disagree! there have numerous cases of patients having stip surgery buy great doctors and have been left with the typical ear to ear scar that had widened. the 1mm or less visible scar is just not accurate.

if I took the time I cud posts countless patients who have presented POOR strip surgery results that have a much larger scar then 1mm and the doctors were not no-name doctors either.

bottom line is you just don't how a patent is gonna heal and to say its most likely due to a poor surgical procedure is absolute nonsense!

With todays refined techniques and knowledge on how wounds heal favourably, a strip scar should be 1mm or less in width.

Having said that, unfortunately the most frequent cause for a bad strip scar is poor surgical technique. Unfavourable healing characteristics of the patient is a rare cause.

When a patient enquires with a bad strip scar the first thing I do is to ask who did the procedure. If the surgeon isn't someone that I know with an excellent surgical technique I will assume the cause is poor technique. In this case the most effective surgical treatment is a scar revision that involves a direct excision of the scar and closure with the best possible technique.

FUE grafting and SMP have limited efficiency in these situations as they do nothing to remove the existing scar. They only camouflage the scar to some extent. I will consider these methods only when I know the previous procedure was done by an expert and I suspect that the patient has unfavourable tissue healing characteristics, or when a proper scar revision is done with success and I still want to improve the camouflage.

In my experience, there hasn't been a single case when I did a scar revision and the scar didn't improve. The results ranged between complete disappearance of the scar to a significant improvement. There were a couple of cases where the scar improved but with less effect than I expected. I diagnosed that these patients had unfavourable tissue healing characteristics. I had an interesting case where both a body hair transplant and SMP on the scar done by reputable surgeons were not effective and a scar revision done by myself that removed all of these with the scar led to a significant improvement. The previous interventions had actually increased scarring and made it more difficult to do the repair.

[HairTransplantOops]

doinmyheadin, from the research i have done on scar width following fut surgery we are still on the low end of width and it could be far worse.

[jamesst11]

With todays refined techniques and knowledge on how wounds heal favourably, a strip scar should be 1mm or less in width.

Having said that, unfortunately the most frequent cause for a bad strip scar is poor surgical technique. Unfavourable healing characteristics of the patient is a rare cause.

When a patient enquires with a bad strip scar the first thing I do is to ask who did the procedure. If the surgeon isn't someone that I know with an excellent surgical technique I will assume the cause is poor technique. In this case the most effective surgical treatment is a scar revision that involves a direct excision of the scar and closure with the best possible technique.

FUE grafting and SMP have limited efficiency in these situations as they do nothing to remove the existing scar. They only camouflage the scar to some extent. I will consider these methods only when I know the previous procedure was done by an expert and I suspect that the patient has unfavourable tissue healing characteristics, or when a proper scar revision is done with success and I still want to improve the camouflage.

In my experience, there hasn't been a single case when I did a scar revision and the scar didn't improve. The results ranged between complete disappearance of the scar to a significant improvement. There were a couple of cases where the scar improved but with less effect than I expected. I diagnosed that these patients had unfavourable tissue healing characteristics. I had an interesting case where both a body hair transplant and SMP on the scar done by reputable surgeons were not effective and a scar revision done by myself that removed all of these with the scar led to a significant improvement. The previous interventions had actually increased scarring and made it more difficult to do the repair.

Very well put. I must ask, however, in which of the repair cases you performed, did the scar completely disappear?? how is this even possible? Did hair actually grow through the scar tissue? Thank you.

[amadeus]

Here’s what I think and I have been on these forums for 13 years, originally researching my hair transplant options on another forum that I still have an account on but much prefer the atmosphere of this forum.

Surgeons will only post their best results and unhappy patients show and complain about the bad results. I have seem too many hair transplant pictures and videos to count and as popular as this forum is, only a very small percentage of hair transplant results can be found on this and other forums compared to the thousands of hair transplants performed every year. No one who just reads these forums or who has had a couple of bad hair transplants has the knowledge of people who are actually doing the surgery. There are good doctors, bad doctors and doctors who have been so hyped on these forums that everyone just believes they are great, even when they might just be mediocre at best.

Dr. Karadeniz responded to the OP’s question and everyone else’s replies based on his personal experience. He can just as easily fill in scars with FUE grafts as do a scar revision, but if a doctor with far more experience performing surgery than any typical poster on this forum, believes that in his hands this might be the best approach, depending on the case, then personally I would trust his advice over any of yours.

Joe Tillman is also in a much better position to give advice than most people on these forums. As someone who enjoys posting his opinion on this forum also, I can understand that we all have our biases, but anyone who cannot voice their opinion in a civil, logical manner is someone who should just be ignored. The lack of common courtesy and disrespect displayed on some of these forums is disgusting and only interferes with the ability for people to do real research.

If I were the OP I would be grateful that Dr. Karadeniz took the time to give such an in-depth response. As for the people who spend so much time trying to act like experts or be nasty on these forums, they should just be ignored and seen as the trolls that they are.

I also have to say that I am disappointed that a representative of a doctor would post such a dogmatic response like “Don’t attempt to have a typical ‘revision’ because this will only likely result in ‘stretch back’ and make matters worsen.” without even seeing pictures of the scar. Perhaps Dr. Mwamba himself should post his opinion once he has the chance to actually see what this person is working with?