Scalp Exercises and Previous Scar

[Plum]

I am likely going in for a second procedure and was told about scalp exercises. One thing I had not heard before was that depending on how deep the scar runs from the first surgery, these exercises may not be of much benefit. Anyone have any insight about that?

On a related topic, how long should one ideally be doing scalp exercises before surgery? Would a month be sufficient to derive any benefit?

[CIT]

Strip scars

Hi Plum,

Strip incisions will run at about 1 cm. deep. I am not quite sure about why you need to worry about scalp exercises. If you are tight in the back, experience a great amount of pain, or complications with the scar. Does your scar bother you in any way?

[gillenator]

Plum,

Some will advise strating them as long as one year before your procedure. It really comes down to the indivudual patient and how much laxity there is to work with. Past HT patientss in theory and many times true lose a certain level of scalp laxity from a previous procedure. Scalp laxity does for the most part come back just from time. These proposed scalp streching excersiss before surgery can and will loosen up the epidermis to produce more "play" in the scalp. When the next strip is excised and the area is closed, there can be far less tension from the pull on the sutures. That will minimize any stretching of the strip scar. Some docs tend to want to use staples to close the patient should the area be tight after the strip is taken. Each case is different. Have you had your scalp physically evaluated for laxity?

[Plum]

Thanks for the responses from you both CIT and gillenator.

In response to whether my scar bothers me, the answer is no. I don't even notice it's there. I am contemplating a second surgery and would like to maximize the number of grafts as well as ease the discomfort post-op. I had quite a bit of tightness after my first procedure for several months so if scalp exercises could help with that, then I'm all for them!

Gillenator, yes I did have my scalp evaluated for laxity at a consultation with a hair transplant physician recently. He indicated that he may only be able to get roughly 1100 grafts because of my existing scar (which ranges from 2-3 mm wide) and because of a fairly tight scalp. He suggested doing scalp exercises but because he hadn't done my first procedure to see how the donor area was closed, he couldn't say whether the exercises would be all that effective.

[Jotronic]

The goal of scalp exercises is not to stretch the epidermis. The goal is to stretch the fibrous connecting tissue between the galea and periosteum. The whole point of scalp exercises is to...

A. Increase donor laxity for a larger harvest (if necessary)
B. Decrease post-operative tension for less potential for discomfort and less potential for excess scar formation.

Patients do not "have" to perform scalp exercises but as the first clinic to recommend them and the only clinic to have made a video showing the proper technique we think they are very effective for those patients that are recommended to perform them.

[CIT]

Multiple strip scars

Hi Plum,

It is unfortunate that some individuals don’t have enough laxity to undergo multiple strip sessions. If you are going with strip, you should do as many grafts as possible. If you are going to give up more scalp laxity, the general rule is that you should minimize the number of strip surgeries to as few as possible. It doesn’t make much sense to harvest a total of 2200 grafts by excising four separate strips. 2200 strip grafts should be harvested in one sitting/session/day. If you are really concerned about the associated pain from strip, you may want to start looking at procedures that don’t compromise any laxity in the donor area.

There are other methods that can significantly reduce recovery time and involve less associated pain than follicular unit transplant (strip) technique. These techniques allow the surgeon to selectively choose each donor follicular unit from the donor area (back of head) one at a time. This way you maximize the number of hairs per graft. From experience, the human scalp can have up to 7 hairs per graft, but these methods do have potential draw-backs that can result in very small (0.3mm) hypo-pigmented wounds in the donor area. Patients should understand that not only should they have the fewest number of strips possible, but there is also an increased chance that additional stretch-back will occur in the donor area. The stretch-back may be visible after multiple FUT/strip sessions, but scars eventually reform the donor area and change donor area characteristics. So with multiple strips, always consider the possibility of having an even wider scar in the donor area. Luckily, there are alternative solutions available that can effectively treat wide strip scars.

Hopefully this info has shed some light on deciding how to move forward with your next step.

CIT













My advice is not medical