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  1. #1
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    Default Donar Scar Repair from 13 year old grafts...

    Hello- I read about Donor scar repair all the time, but never about the type of scarring I have. I currently shave at a 2 and show a little of the open donor/harvesting look that is shown in the link below. I would love to shave it all off, get the scars lasered off if possible but can't really find much info on this. Just thought I would ask to see what you thought. My goal is to be bald with minimal scarring if possible. The procedure I had done was 13 years ago. Thanks for you time.



    Thanks for your time..

    Stokes

    http://www.bernsteinmedical.com/hair.../fixing-scars/

  2. #2
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    Your case is definitely a bit trickier than a typical scar repair or revision. I don't know much about laser scar removal and how effective it would be, or whether it would damage the existing hair.

    If you still have a sufficient supply of donor hair, a FUE surgeon could redistribute it in hopes of camouflaging the existing scarring. This is basically the opposite of a normal FUE procedure, in which the surgeon thins out the donor region to improve frontal or vertex density.

    If your donor hair is already depleted from your previous surgery, one option may be donor recharging in which you can achieve partial donor replacement. In this method, body hair is extracted and used to fill in gaps where your scalp hair has been over-harvested. This is a good use for body hair as it works quite well as a 'filler' and it could add back some of the pigment lost from previous harvesting.

  3. #3
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    CIT Girl- have you seen a case like mine and do you have any photos that I could look at? Thanks...

  4. #4
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    Stokes,

    I spoke with Dr. Cole and he confirmed that we have seen a number of cases like this. I am trying to find out who the patients were and whether they were photo-released to try and get some pictures to share with you.

    Dr. Cole had some input on the various options of scar repair you could go with:

    "One way to treat them is to excise them and then suture the defect closed. This takes several sessions and is successful sometimes, but no so successful other times. One thing is for certain: you cannot excise more than one row of them at a time. This is why it takes so long to resolve them using this method. Even after reducing them, you still often need to add some hair by way of FUE.

    Another way to treat them is to add hair to them by way of FUE. This too often takes several sessions of grafting, but is faster than excising one row at a time.

    Still another way to reduce the number of open donor scars is to excise a few rows of them in a strip procedure. This will eliminate the open donor scars, but it will result in a linear strip scar."

  5. #5
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    Quote Originally Posted by Paul McAndrews, MD View Post
    Stokes,
    The type of scarring you have is what we call “buck-shot” scars, which was created by 3-5 mm punches that were left to granulate in (i.e.- heal without closing with a stitch). No laser will make these scars go away. The problem is that the surrounding scalp has hair creating a 5:00 shadow, no matter how close you shave it, while there are many 3-5 mm white scars that breaks up this 5:00 shadow and the scars stand out.
    Considering your goal of being bald with as minimal scarring as possible, the best possible solution is to take hair and put it into this scar tissue to hide it. The best technique would be FUE (Follicular Unit Extractions), which will create a scar but these scars are minimal (0.8mm) with less break up of the existing scalp’s 5:00 shadow.
    If we were able to put hair into the scar tissue how would it look if I wanted to shave it all the way down? Basically the crown of my head has stopped producing hair and I am just hoping to find a comfortable shaving level to as close to the scalp as possible.

    Also what about using body hair?

    Thanks...

  6. #6
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    Quote Originally Posted by Stokes View Post
    Hello- I read about Donor scar repair all the time, but never about the type of scarring I have. I currently shave at a 2 and show a little of the open donor/harvesting look that is shown in the link below. I would love to shave it all off, get the scars lasered off if possible but can't really find much info on this. Just thought I would ask to see what you thought. My goal is to be bald with minimal scarring if possible. The procedure I had done was 13 years ago. Thanks for you time.



    Thanks for your time..

    Stokes

    http://www.bernsteinmedical.com/hair.../fixing-scars/
    Without viewing any photographs of your donor scar area, I can give you some general information about scars and scar revisions.
    First of all, it is most important to determine what are your objections with the scar. Is it that the scar is widened? Is the scar raised? Is the scar narrow and is noticeable because of a color mismatch with the surrounding tissue. In hair transplantation scarring, the problem usually is that there is no hair growing within the scar, and so a straight line is detectable. Of course FUE removes the straight line scar, but this does not mean there is no scar, it is just much harder to detect. I agree with the patient advisor who told you that FUE would be one way to improve the scar, but I would need to see how wide of an area you need to cover, to tell you how likely it is that FUE would provide you with a good solution. Often in patients who have open donor area scarring, it is difficult to obtain enough scalp hair via the FUE technique to make a big difference, but you can use body hair to minimize the scarring. Laser's do not remove scars, they make them more inconspicuous. Laser's target certain aspects of the scar for improvement, such as color, or contour, and help to minimize the scar by affecting either color or contour. It is very unlikely that laser alone would provide a tremendous improvement, unless the scar was raised or red, in which case the laser cut flatten the scar, and make it less red. Lasers cannot put hair back into an area of scarring, nor can it erase the scar completely.
    I hope this gives you some useful information.
    Dr. Ken Siporin, Los Aneles, CA

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