Not A 'Pencil Thin Scar'

[northeastguy]

Teg...... so sorry your dealing with this. Make sure you follow up with Dr Rahal and like you said do nothing for 1 year... let that scar fully heal and any hair that may still be in shock, return. Be patient. Then address it. you have options. Lots of good threads on this forum regarding FUE repair and scar grafting. Find and talk to the docs who have lots of success grafting scars.... there's a small handful of them.

I hope others leaning toward FUT get a read of your post. Once your cut, your cut. It won't be long before FUE becomes the gold standard and all Physicians will be forced to learn and improve their FUE skills. Just as micro and mini's advanced to FUT, FUT will also be fazed out. More advanced methods of FUE i'm sure will surface and newer techniques will improve outcomes. To do FUT in this day and age is just to risky I feel.

Thank you so much for sharing.....

[teg_101]

Thanks for the input 'northeastguy'. Yes i plan to wait till the 1 yr mark and assess things at that time. Im planning on contacting the clinic to provide an update. I'll be sure to mention my concerns regarding the scar. Not sure what they can do about it other than a revision, which is completly out of the question! Im a little pissed to say the least since i was 'convinced' to undergo another FUT procedue, because i had already been cut open from past surgeries.. I was told the scar could be improved because of the 'tighter' closure method that the clinic uses, (staples vs sutures), but clearly that was not the case.

While FUT still produces some stellar results, the surgery is far too invasive, and leaves the possibility of some bad scarring, as is with my case. I see that you have undergone some revision work as well, and things are looking good for you at this point.

[ejj]

Hello Teg,

I am sorry you are in this position; scar revision, in my opinion, is a gamble.

I actually do not think that your scar is that bad going off the photographs provided. I agree that it is best to wait a full year and after that formulate a plan.

I would go with FUE into the scar over two procedures. I would go with small sessions to increase the vascularity in the scar tissue and optimise the yield.

I know this is hard but in the scar repair department, slow and steady with minimum risk is the best way, in my opinion.

Best Wishes and keep us updated.

ejj

[teg_101]

Hi 'ejj' I don't plan to going in for a revision, as that was my intent as a part of my 3rd OP, one to revise the scar, and two, gain additional density. The scar itself isn't horrific, but its something that I'd like to improve, as I'd like to be able to have the option to wear my hair short (grade 2-3) I'm planning to wait till the full year mark to see if I will see any dormant hairs grow through the scar, but at this point it doesn't look too promising.

Now that I look back, I'd say my scar from my first OP was pretty darn thin... (see below) It was the base of the scar that had stretched, as shown in my pic at the beginning of the thread, which I was concerned about. I was hoping to have that addressed, but didn't imagine that it would have stretched out the rest of the scar at the side of my head. Well, whats done, is done, can't go back now. Thanks for your input. I'm will look into the possibility of undergoing two sessions, if required.

[Granastasis]

I agree with teg_101..SMP is the best option for you. Try to search on the web for more information. Wish you luck

[northeastguy]

Fue in the scar followed by micorpigmentation is a great option. I have had 6 transplants and have done the above to help. I wear my hair very short. For all these reasons, I always encourage young patients to consider FUE. You can move about 3,000 grafts in one session without the scar. Yes it is more expensive but in the end you have one less thing to worry about... a big long scar.

Well said Doc...

[ITNEVERRAINS]

And us old guys who did strip before FUE was an option can get rid of those scars as well. I'm honestly more excited about my scar revision next year than my 4 HT

[drybone]

Fue in the scar followed by micorpigmentation is a great option. I have had 6 transplants and have done the above to help. I wear my hair very short. For all these reasons, I always encourage young patients to consider FUE. You can move about 3,000 grafts in one session without the scar. Yes it is more expensive but in the end you have one less thing to worry about... a big long scar.

You have had 6 operations? You look pretty good doc.

[Ryth]

My question at this point is, would stitches/sutures produce a better scar in my case, or is it simply a case of patient's physiology, where my scar will end up the same way? Also, based on the picture, would is this scar 2+ cm wide? Should I look into other repair methods, FUE etc? A scar such as this is simply not acceptable by any standard in this day and age. Any thoughts/comments.suggestions are appreciated. Thank you.

Stitches produce horrible scars due to them having to wrap around the whole wound while they are in. They also have to be out in 7-10 days and that isn't enough time for a scar to properly heal. So do not go to a place that does a scar repair with stitches. Your scar will stretch out. Trust me.

I suggest someone like Dr. Shapiro. He uses staples and Acell. He did mine and I had a bad scar. I'm going back for 1 final revision on areas that we haven't gotten to yet.

Another thing that doctors do unfortunately in scar repairs is that they aren't aggressive enough and only go 'near' the edges of the scar on both sides. If you want to get rid of a scar, you actually have to go into the hair around it and then close those 2 areas and draw together 2 hair bearing edges. Most don't go to the hair bearing edge, they go right to the edge of the scar and even leave a tad bit of it and then close it..which really is just leaving about 1 mm of scar already which will definitely stretch.

I would suggest leaving your staples in 14 days for half and then taking out the others at 21 days minimum.

When I had my scar repaired in two stages due to length, I left them in for 21 days for half and then 30 days to make sure there was no tension. Now my scar is pencil thin where it was done. If I didn't have some old plugs scars above each line (which I'm having punched out and then X stitched closed) my hair would cover just fine and i'd have great coverage.

I also suggest having your scar done in small parts...2-3 inches in length cut out, then a 2-3 inch space that isn't cut, then another 2-3 inches in length cut out, etc...removes tension on the scar.

so you want to do something like this in stages (= is scar)(-- is repaired)

So if this was your scar

============================================

You'd want to do something like this where you cut a small section out, then skip then cut another section out.


Stage 1

{ cut out } ======== { cut out } ========{ cut out }


Stage2

---------- { cut out } ---------- { cut out } ----------

[drac0nyx]

nicely illustrated advice!

[teg_101]

Update

Hi all,

First off, thank you to everyone on this forum for their opinions and suggestions.

I just to provide an update on the state of my scar. Its been approximately 20 months since my last surgery. At this point, I'm done with any further surgeries, other than addressing the scar. I wanted to give my scar ample time to settle down and to assess it after the 1.5 year mark. As you can see from my pictures, there was a great deal of hair which grew back after the shock loss occurred from the last surgery. Still formed some cysts within the scar, which don't seem to heal :-/

I have been looking at the various options that are available to me to address the scar, but am still quite uncertain which route I want to take. I can confirm that I DO NOT want to be cut up again, or even attempt a excision at this point, its just way too risky. If I could go back, I would have taken the FUE route for my last surgery, and left the scar (which was alot better) as is, and not gone for a revision. Well, can't cry over split milk I suppose..

Earlier this year, I looked into SMP from H&W. I went in for a test patch, but didn't pursue the treatment further because unfortunately it looks like the ink did not settle well on my scar, so that is out of the question. At this point, it looks like I'm in line for multiple FUE sessions to fix this mess. Now its a matter of determining who I should be consulting for this..

Any questions, comments, concerns are welcome. Thanks for reading.

[reversethree]

Hi all,

First off, thank you to everyone on this forum for their opinions and suggestions.

I just to provide an update on the state of my scar. Its been approximately 20 months since my last surgery. At this point, I'm done with any further surgeries, other than addressing the scar. I wanted to give my scar ample time to settle down and to assess it after the 1.5 year mark. As you can see from my pictures, there was a great deal of hair which grew back after the shock loss occurred from the last surgery. Still formed some cysts within the scar, which don't seem to heal :-/

I have been looking at the various options that are available to me to address the scar, but am still quite uncertain which route I want to take. I can confirm that I DO NOT want to be cut up again, or even attempt a excision at this point, its just way too risky. If I could go back, I would have taken the FUE route for my last surgery, and left the scar (which was alot better) as is, and not gone for a revision. Well, can't cry over split milk I suppose..

Earlier this year, I looked into SMP from H&W. I went in for a test patch, but didn't pursue the treatment further because unfortunately it looks like the ink did not settle well on my scar, so that is out of the question. At this point, it looks like I'm in line for multiple FUE sessions to fix this mess. Now its a matter of determining who I should be consulting for this..

Any questions, comments, concerns are welcome. Thanks for reading.

hey teg

also have issue with scar stretch after 2nd FUT

thanks for your post

what did Rahal say about the scar post op?

don't know what to do myself.....

[UnBald]

with the greatest respect matt , i would have to disagree with you , a further revision is high risk , more so when the patient has already stretched on a second strip , the reason i believe we dont see more of these poor revisions on the forums is due to the Drs offering the revision ` free of charge ` and then silencing the patient with legal disclaimers and ` pay offs` again just my opinion

The second point i would address is i have had excellent growth with fue into my huge scars from my former drs , so much so im back in the chair for the third time week on wednesday , low density grafting to start with and establish blood supply , small procedures , small manual punch , excellent Dr with excellent surgical plan has been hugely beneficial to me

regards

ejj

hi, Who did you go with for fue into your scar?

[ejj]

Hi Unbald,

I had FUE into my scars with Dr Bisanga at BHR.

All the best

ejj

[35YrsAfter]

Still formed some cysts within the scar, which don't seem to heal :-/

I have been looking at the various options that are available to me to address the scar, but am still quite uncertain which route I want to take. I can confirm that I DO NOT want to be cut up again, or even attempt a excision at this point, its just way too risky.

Any questions, comments, concerns are welcome. Thanks for reading.

Our recent patient had a wide strip scar with ingrown hair from another hair transplant clinic. Dr. Cole did a scar revision that addressed the ingrown hair issue. The scar widened back slightly as they commonly do but the area is now level and FUE grafts should provide additional cosmetic improvement. Fortunately our patient has good thick hair and wears it relatively long.



35YrsAfter also posts as CITNews and works at Dr. Cole's office - forhair.com - Cole Hair Transplant, 1045 Powers Place, Alpharetta, Georgia 30009 - Phone 678-566-1011 - email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
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