+ Reply to Thread
Results 1 to 2 of 2
  1. #1
    Junior Member
    Join Date
    Jan 2021
    Posts
    1

    Default Can’t find consistent information on keloid risk

    Hello,
    Thank you very much for reading my thread.

    I have come to this forum after failing to find the information I am looking for anywhere else online. It is impressive that such a wealth of knowledge and experience is concentrated within this forum, and that everyone is so willing to share information and help one another. It is quite inspiring.

    I am a 33 year old caucasian male who recently completed an initial consult with a hair transplant surgeon in Southern California. I have relatively mild hair loss in the temple areas as well as frontal scalp (bangs) area and the doctor recommended 1,500 to 2,000 grafts depending on whether I wanted to lower my hairline slightly by a half inch or not.

    I thankfully do not have a history of pervasive hair loss in my family, my father is 74 and his hair looks about the same as mine, just some mild hair loss in the temples/front, except his hair is gray now.

    As a precaution I started finasteride four months ago to (hopefully) get the DHT permanently under control. So far I can’t tell if it has done anything or not, probably due to my slow rate of hair loss. I certainly have not seen any regrowth from the finasteride, and don’t really expect to for whatever reason.

    Where things get complicated is I am a keloid former. I have six (!!!) keloids on my body in areas where they commonly form: Two in my sternum (mid chest) area, one on each of my shoulders and two on my back/shoulder blades.

    I understand that the working theory is that keloids tend to form in areas of high muscle tension, which could possibly explain the variance in the rate of occurrence across different areas of the body, for example the shoulders vs scalp, although this theory nothing more than that, a theory. Keloids are still an endlessly confounding topic in modern medicine, and there are many examples that run counter to muscle tension theory.

    I went into the hair transplant consultation presenting my keloid history as my overwhelming primary concern, arguably more important than the success of the transplant itself, and explained I would only want to move forward with a transplant after undergoing a small 10-50 test graft session, waiting nine months to observe scar formation patterns, and then making a decision based on those results.

    The doctor agreed that was the best course of action, concurred the test graft session is paramount and *if* successful after nine months he recommended FUT strip harvesting due to both my relatively younger age (for donor hair preservation if needed in the future for a second procedure) and the benefit of having a smaller, linear scar in the donor area. He explained the scarring from FUE takes up a surface area roughly 12 times that of the FUT strip scar, due to the fact that the FUE punch hole scars can not be “closed” and reduced in size the way the strip incision is closed. He said “If things were to go south, you would rather have a single long keloid back there which you could grow hair over than to have the entire donor area turn into a field of miniature keloids.” I think I agree with that assessment.

    I have come to this forum seeking a deeper dive into the statistics of keloid formation in hair transplant surgery. Most information online pertaining to this topic is discussed on the promotional websites of doctors in their FAQ section and its always some variation of:

    1) “Keloids are very rare in hair transplants. We can do a test graft and see what happens”

    2) “Contraindication for hair transplant is a history of keloid formation” (meaning just don’t even try it)

    I guess what I’m looking for are actual statistics. Sure maybe they only form in 1% of hair transplant patients, but what percentage of those people actually have a history of keloids in the first place?

    A more useful statistic would be the rate of keloid occurrence in hair transplant patients *who have a documented history of keloid formation* - for example “X percent of patients with a history of keloid formation go on to form keloids on their scalp post hair transplant surgery.”

    I understand very well that given the mysterious nature of keloid formation it is inherently difficult to predict their occurrence in any single individual. Given the unique complexity of every person’s genetic profile, I’m sure even among fellow keloid formers there is a great deal of variation in occurrence, both in terms of the severity and location of the lesions.

    But even taking into account all of that mystery and lack of certainty in terms of outcome, I am surprised there has not been some sort of large meta-analysis done, either in the United States or Europe, to at least *try* and quantify the keloid occurrence rate among hair transplant patients with a history of keloid formation.

    It is frankly a bit odd that given the 30+ year history of hair transplant procedures, the topic of keloid scarring is still tantamount to a medical rumor mill, a collection of anecdotal reports from doctors and patients who have seen keloids happen, or maybe they haven’t, it’s just all so incredibly opaque and non-scientific.

    So I’m curious if anyone here knows more than I do on this subject. That would be quite easy, since I know almost nothing except what I’ve stated above.

    Lastly I would state I can’t seem to find any information on the prevalence of keloid occurrence at the *transplant site* as opposed to the donor area. There are innumerable discussions about scarring in the donor/graft excision area on the back of the head, but almost no discussions (at least that I can find) about the risk for keloid formation where the hairs would ultimately be transplanted into, for example in my case the temple and frontal scalp (bangs) area. I guess I’m wondering how invasive the graft insertion process is compared to the excision process. Obviously in the case of strip harvesting the excision will be an order of magnitude more traumatic than the insertion process, due to the literal excision of a piece of the scalp, but I still don’t understand how invasive the insertion process is. Is a scalpel used to insert the grafts into the temple/forehead regions? Are there any newer, less invasive methods for graft insertion?

    I know ultimately for me, like everyone else it will just come down to my own biology and how the test graft heals after nine months, and all of this “research” of mine probably amounts to nothing more than a coping mechanism in a situation where I lack control.

    However I thought it would be useful to at least try and create this thread to see if any experienced hair transplant surgeons who have done thousands of cases involving patients **with a documented history of keloid formation** could weigh in with their experiences. Again, the rate of occurrence in patients without a documented history of keloid formation is essentially meaningless for the purpose of this discussion, so while I’m happy that there are thousands of patents out there with positive (non) scarring outcomes, unless they have had a documented history of keloid formation its not really useful information in this context.

    Thank you very much for reading this far.

  2. #2
    Junior Member
    Join Date
    May 2022
    Posts
    1

    Default

    Hi, thanks for making this post! Like you, I have a history of keloid and it's a big concern for me in researching a HT. Did you end up going forward with treatment? How did it work out?

Similar Threads

  1. FUE with Keloid scarring
    By GregoryJames1991 in forum Men's Hair Loss: Start Your Own Topic
    Replies: 0
    Last Post: 05-31-2020, 08:13 AM
  2. ARTAS FUE - Will This Finally Help To Create A Globally Consistent Standard Of Care?
    By tbtadmin in forum Hair Transplant Results By IAHRS Recommended Surgeons
    Replies: 1
    Last Post: 07-29-2016, 02:06 PM
  3. VIDEO GRAPHIC Dr. Lindsey Keloid scar excision and 3 layer closure McLean VA
    By Dr. Lindsey in forum Hair Transplant Videos, Patient Interviews and Surgeon Q & A
    Replies: 1
    Last Post: 06-08-2016, 10:34 AM
  4. Consistent shedding since minox 5%
    By 2suun in forum Men's Hair Loss: Start Your Own Topic
    Replies: 0
    Last Post: 11-08-2015, 03:41 PM
  5. How important is it too be consistent with the hours between minox applications?
    By iH8d0ugh in forum Men's Hair Loss: Start Your Own Topic
    Replies: 4
    Last Post: 07-21-2013, 08:21 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

» IAHRS

hair transplant surgeons

» The Bald Truth

» Recent Threads

1800 graft repair case results by Dr. Lindsey
Yesterday 08:38 AM
Last Post By Dr. Lindsey
Yesterday 08:38 AM
Navigating the German Job Market as a Kenyan Citizen
11-04-2023 06:31 AM
Last Post By Keegan212
Yesterday 03:51 AM
DR HAKAN DOGANAY/ 4500 GRAFTS / Implanter Pen+FUE
03-26-2024 04:15 PM
Last Post By Hakan Doganay, MD
03-26-2024 04:15 PM
The Mane Event for Thursday, June 15th, 2023
06-15-2023 02:59 PM
Last Post By gisecit34
03-26-2024 08:05 AM