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  1. #1
    IAHRS Recommended Hair Transplant Surgeon Dr. Lindsey's Avatar
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    Default Dr. Lindsey complex scar revision with 3 layer closure, McLean VA

    This fellow has had a few hair procedures elsewhere in our area. He presented seeking improvement in his right lateral scarline which was fairly wide. I expect to get a 50% improvement with today’s procedure and he may want to return at a year and have a few grafts FUE’d into the scar. Given his curly hair, and skin color, even a few of his hairs give pretty decent coverage.
    We excised his old scar, and although he’d been doing scalp exercises, he was quite tight. Shown in the intraop pics is my assistant’s finger for size reference. Note how wide the wound retracts. Then note the improvement with a very deep layer closure. Next a subcutaneous closure takes the tension off of the skin edges, and the skin sutures simply align the skin level. Sutures are out at day 7 and he’s to followup in 30 days and use vitamin E twice a day, and to refrain from any activity which stretches my scar. While there is never a guarantee with these cases, I’m hopeful that after a year, we’ll show significant progress. We got about 40 grafts out of his scar and these were placed up front at no charge.

    Dr. Lindsey McLean VA
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    William Lindsey, MD
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  2. #2
    IAHRS Recommended Hair Transplant Surgeon Dr. Lindsey's Avatar
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    Default

    Here are 1 month scar check pics. Looks fantastic. While not a guarantee he won't have a noticable scar, if it looks this good today, its likely to turn out ok.



    Dr. Lindsey McLean VA
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    William Lindsey, MD
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  3. #3
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    Default

    That's healing very nicely. Quite favourable physiology it seems. Good stuff.

  4. #4
    IAHRS Recommended Hair Transplant Surgeon Dr. Lindsey's Avatar
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    Default

    FDR, its tough to actually know if his physiology is good or not....

    The best predictor of a good or bad scar is how a person did with a previous scar. Well, this guy did poorly. Was it the result of bad physiology, bad surgery, or some of both? Only time will tell. Hopefully he'll check in with me this summer so we can all have an idea of which is was, but I agree, at least at this visit, he looks to have healed as well as anyone.

    Dr. Lindsey McLean VA
    William Lindsey, MD
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  5. #5
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    I say favourable physiology because at 1 month it looks like it's healing extremely well. It's really interesting how some people scar. I've had many cuts and stitches as a young man but I can't help but notice how much better my eyebrow healed than some of my friends who have had similar sports related cuts (ridiculous how common split eyebrows are in soccer from elbows when players are competing in the air for the ball). Scar healing does seem quite variable from one person to the next.

  6. #6
    IAHRS Recommended Hair Transplant Surgeon Dr. Lindsey's Avatar
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    Like alot of things in medicine... I think there are 3 components to the result.

    1. Skill of the doctor
    2. Physiology of the patient
    3. Some degree of random chance or luck or lack thereof.

    To address each:

    1. I think I sew better than most, but I don't always get great scars and just last week I saw a perfect scar in a patient who had had surgery from a fellow I know who may not always get great scars.

    2. This is key and hard to predict. 10 years ago I did a facelift on 2 twin sisters. Both turned out fine. However, one sister extruded every single suture I put in her and we dealt with this hassle for 3 months. I'd rate her scars as a "B". The other twin extruded none....and I'd rate her scars as a "A". There is some physiologic difference between them.

    3. Sometimes you get lucky.

    Dr. Lindsey McLean VA
    William Lindsey, MD
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