Scar revision and FUE on UK Patient - Dr Lindsey

[Spex]

This patient had recieved multiple strip surgeries from previous clinics and desperately wanted to minimise the scars. He travelled over to see Dr Lindsey after seeing Dr Lindseys unique ability with scars. Dr Lindsey removed the vast majority of the top scar with some remarkable wizardry and also placed i

23.5 cm of top scar excision.

59 grafts extracted

134 FUE's placed in bottom scar.

[Dr. Lindsey]

Thanks for helping with his posting Spex. Yes, he was a really nice fellow. He called thursday, as his wife was having a little trouble removing the stitches, but he emailed Friday that all were out and he was doing well. His biggest trouble is going to be not re-stretching my scar with his INTENSE exercise.

Dr. Lindsey McLean VA

[northeastguy]

Dr Lindsey,

Any updated photo's on this scar revision? Do you find it benificial to do scar revisions in sections to limit stretchback?

[Dr. Lindsey]

No I don't have any pictures. Almost everyone swears they'll send pics and correspond monthly like I ask, but rarely do people do so. Perhaps Spex has seen some or even the patient himself.

I generally excise all of a scar and close it in 2 or even 3 layers and "typically" that can get a 50% improvement although sometimes its a lot more and sometimes not much improvement. Unfortunately the best predictor of scar outcome is how a person scarred before. And since I wasn't there the first time, its hard to tell if poor technique or patient physiology or both are responsible.

Good question.

Dr. Lindsey McLean VA

[Spex]

I will chase the patient up.

[Follicle Death Row]

I've heard of double layer closures before in the context of split foreheads and brows. With FUT does it spread the tension between the layers so that there is less tension on the skin or epidermis so to speak? I imagine if you could get more tension carried on the inner layer you might get a finer scar?

Completely off topic but just how tough are the USMLEs doc? Scores look terrifyingly high for plastics and orthopedics?

[northeastguy]

Thanks Spex, I'll keep an eye open.

I currently have 2 strip scars. I am planning to have FUE done in the lower scar early summer. In addition, I will be looking to add some density to the top sides. Depending on how well the fue's take in the lower scar, I will then address the top one....hopefully with FUE. Should those results not work out, I'll look into doing a revision.

[Dr. Lindsey]

sounds good northeast guy. post your case for us when it grows in.

Dr. Lindsey

[Dr. Lindsey]

FDR yes, it takes the tension OFF of the skin edges and puts it on the deeper tissues, so that the epidermis stays together without widening into a wide scar. At least that is what is supposed to happen. There is a physiologic component and conceivably a luck component too.

Not sure what the exams you reference are. Sorry.

Dr. Lindsey McLean VA

[Follicle Death Row]

USMLE - United States Medical Licensing Examination. I'm considering my career options and may decide to train in the US for a few years. Not quite sure what area of medicine I want to go into yet but I definitely have an interest in orthopedics and I might be best served training abroad.

From what I've heard it's a tough exam with regards to matching for your desired career path. Apparently a lot people go in to sit the exam and if they think they're not going to get the score they want they tank the exam on purpose because once you pass it that's your score forever. i.e. If you pass you get your score for your career. It seems a bit wrong that you can fail the exam on purpose if you're not going to get 90% or whatever the corresponding score is. Scores only count if you actually pass. I suppose you have to play the game.

[Dr. Lindsey]

Oh, well good luck to you on your US training.

As to the exams...I don't know. I took parts 1 and 2 of the national boards in med school and studied and did ok I guess. Part 3 we all took about halfway through internship, where there is no chance to study, and after taking call the night before. I passed. My buddy, who is now a vice chairman of a major academic dept sat down, filled out all the answers as "c" and was done in 3 minutes. I guess he passed, and again now is a vice chairman of a surgery dept here in the US, so I'm guessing part 3 is not to challenging!

Specialty board certification exams on the other hand are pretty thorough. In my specialty of Otolaryngology, you take a written exam in the fall, and if you pass you take an all day oral exam in the spring. But its on stuff you actually need to know in order to practice...so its a good test and if you are prepared, you pass.

Good luck to you.

Dr. Lindsey McLean VA