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  1. #1
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    Apr 2019
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    Unhappy Large FUT Scar Repair - Exploring Available Options

    Background:
    • Date of Procedure: 9-18-2020
    • Procedure: FUT
    • Grafts: 2,500
    • Doctor: Dr. Arocha, Houston, Texas
    • Age: 35
    • Current Preventative Measures: Propecia, Minoxidil, Laser Cap, and Micro Needling

    First, I want to say that my goal here is not to bash the doctor. He has been receptive to my concerns and presented some possible solutions. My hope here is to tap into the community for guidance.


    Issue:

    Unfortunately, the procedure left me with a very wide FUT scar. The scar is largest above the ears, but it is fairly prominent throughout. Prior to surgery, the doctor notified me that scars can be unpredictable, but I was also told that a reasonable expectation is to be able to be able to cut your hair with a guard 3 without the scar showing. Currently, if I cut my hair with anything less than a guard 7, the scar is very visible. Even with longer hair, multiple people have commented on seeing the scar when my hair falls to the side, and this has been a source of frustration and embarrassment.

    Objective:

    Repair the scar to the extent possible, while also leaving open the door for future procedures. I am planning on getting another procedure (FUT or FUE to further fill in the frontal hairline, temples, and crown). Combining both the scar correction and this second procedure is ideal. The next procedure will likely be 2,000 to 2,500 grafts.


    Conversation with the Doctor & Proposed Solutions:

    The doctor suggested that my wide scar may be due to the high elasticity of my skin. He also suggested that merely sleeping wrong can result in a widened scar. Further, he pointed out that, though I do not have keloids (thankfully) the scar is slightly thickened.

    The doctor proposed the following solutions:

    FUE Procedure to fill in the scar area, which would require about 300 grafts.
    Another FUT procedure in hopes of cutting out the scar and using additional staples to help minimize stretching.
    Combination of an FUT and FUE. The FUT would be near my neck, which has the least amount of stretching and the FUT would be used to fill in the point most prone to stretching, which is above the ear.

    Option 1: FUE Procedure


    My concern here is the loss of grafts for future procedures, as well as the fact that so many grafts will be spent just to conceal the scar (300+). I will likely need a third procedure as my hair continues to thin, and so I would like to maximize my available donor area to the extent possible.

    Option 2: FUT

    If the procedure successfully cuts out the scar and can result in a smaller linier scar, then that would be ideal (especially considering that 80 grafts would be enough to conceal a small scar). The doctor suggested a special tempur pedic pillow that may help reduce head movement (and thus the chance of scar stretching). The issue is that I have evidence that my skin stretches, and I am also fearful of a keloid (though I do not have a history of this).
    In regard to my prior FUT, I was studying for a major exam for a few months after the surgery. My head was tilted downward while reading, which may have contributed to the scar? This is just a thought regarding one factor that won't come into play on my second procedure.

    Option 3: FUT + FUE

    Here, the number of FUE grafts in the wide areas around the ears would be around 100, while the remainder of the scar (near the neck area) would just be excised via FUT and more closely monitored. I am open to this option, but the optimist in me wants me to go with the second option (a complete FUT with scar revision) in hopes of attempting to excise the scar and remain extra vigilant.


    What do you think?

    Your thoughts are appreciated.

    In your experience, how bad is the scar? Was there something that I or the doctor could have done to avoid this issue?

    Is there an option that I am missing? Should I consider another doctor for the procedure? Note: I live in Houston, which makes Dr. Arocha especially appealing (particularly in regard to follow-up visits). I have heard fantastic things about Hasson & Wong, but the distance is a concern.


    This has been a source of stress, and any guidance the community can offer is really appreciated. Thank you, everyone.



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