Scar Repair

[sp8rky]

Was thinking today that it might be a nice idea to have a thread to talk about our strip scars, big and small and what we want to do about them.

So far all of our discussions regarding this has been piggybacked onto other peoples repair threads, so in this thread we can talk about our own problems with scars without hijacking other peoples threads.

We can talk about FUT scars and FUE scars, and if you have scars from accidents that you want fixed as well.

All treatments can be talked about, whatever you can think of that will make your scars less visible, throw it out there and talk about it.

Please add pictures to your posts if you can, as it will help other people to know what you are talking about.

Regards


Sparky

[Spex]

Sparky,

You are a sound veteran and your help and guidance is always appreciated to many readers and you are defo one of the level headed good guys on the boards.

There are a variety of successful options for repairing scars now days - patience is key though as you well know!

I had FUE into my old Bosley scar (4x strip sessions) with great success in the areas worked on and its been documented online over the years. I have have multiple small FUE sessions into my old Bosley scar. The yield was high and it helped break up the appearance. It allowed me to have some greater flexibility but i wanted more ( dont we all.. ) i didnt want to waste or throw more FUE into my scar or use BHT as i'm not a fan of it, so i recently attempted temporary SMP ( scalp micro pigmentation) into the scar area and in weak areas along the scar and areas of the scar that had continued to stretch and caused me concern on a shorter grade, which so far has really helped. I have documented this also.

FUE and BHT are both good ways to get hair growing in scars again. It is important that patients understand that scars generally only can get diluted down and camouflaged however, not removed. Some do have delusions of grandure initially when it comes to scar repair, i have seen this over the years and these patients reside on somewhat wishful thinking and hope - This often boils down to their desperate and vulnerable state. Often these patients feel they have been violated and often they have - Its all understandable and patients want to attempt to back out the one way tunnel! Its important to stay grounded when entering into scar repair especially, and keep expectations in check at all times and be very patient. Nothing wrong with a positive attitude, but be realistic is all i'm trying to say, otherwise you might well be disappointed.

Scar repair and yield into scars is unpredictable whether via revision, FUE or BHT as you well know Sparky and its impossible to say how successful a revision will be or growth will be into scars until 12-18 months post op minimum. Growth is generally slower in scars and yield generally lower. I tried to explain this recently that in some cases yield can be very low ( generally speaking) as all depends on the individuals scar, blood supply etc. If the scar is small then chances are % yield will be high and the outcome more visually successful. My statement was a general one regarding grafting into scars generally - as its a fact, yield can and is lower into scars than say a virgin scalp. be prepared for every eventuality.


See write up on BHR site. I clinic well known for helping repair scars with FUE and BHT.

To add grafts into the scar can be a good option depending on the size of scar and how well it has healed. It is considered that the yield will be lower when placing in a scar line and it is prudent to place a lower density initially and measure the yield before using too many precious grafts that might not subsequently grow.
Body Hair FUE (BHFUE) uses the same principles of extraction as FUE, but the hair is extracted from various parts of the body and not from the scalp. BHFUE is recommended in cases where there is insufficient scalp donor hair.To add grafts into the scar can be a good option depending on the size of scar and how well it has healed. It is considered that the yield will be lower when placing in a scar line and it is prudent to place a lower density initially and measure the yield before using too many precious grafts that might not subsequently grow.BHFUE is a relatively new form of hair replacement; it is important to appreciate that because of genetic variants, hair characteristics and growth rate, BH will behave differently to scalp hair and the yield can be much slower and lower. BHFUE in certain special instances may be the answer to repair or restore hair but only after an extensive consultation period. A patch test would also be undertaken.



Its important that patients understand yield can be lower into scars so always go with a test patch FIRST , based on the outcome you can then determine the best way to proceed with YOUR scar. ALL scars are unique!

FUE into the scar is a good first port of call if the scar can not be revised. If the scar is wide and long then revision might be the better option as minimising the scars surface area will make it easier to camouflage with fewer alternative session whether via FUE or BHT or even SMP.

My recommendation depending on the individuals goal is FUE into it first then possibly try BHT after that. These are permanent options and realistic options and ones i personally recommend especially FUE. Be realistic and keep expectations in check however. The smaller the scar the easier it will be to repair via FUE /BHT with fewer sessions required for a permanent solution. I mentioned and recommended an individual do FUE initially into his scar recently given his goal and advised this was defo the best way to go initially for HIM given the size of the scar ( very small ) . I mentioned yield can be low in scars and tried to help him understand the general risks however.

I want this guy to know whilst i'm here i actually only ever wanted to educate him and was not trying to down play FUE into scars in anyway shape or form. I'm pro FUE into scar - as i personally like this option better over all other options, including temp SMP. SMP is an option but not permanent. FUE is the way to go initially especially with small scars for a permanent solution. SMP has its place, and a small one at that. Its very early days too for it and hopefully it will become a good option for certain people and also give them hope and realistic options. We are doing our best to provide info on this and time will only help.

Depending on the individual and their goal SMP is now a potential option into scars, however, as i told the same guy previously mentioned, explore more proven methods/ options first and be patient and lets wait to see more scar sessions documented online. Every scar is different and some scars are not even conductive for SMP ( This is why a small test patch is advisable also a minimum of 10 days prior to any large session) as the scar might not be able to carry the ink, the ink can disperse as the scar tissue can not hold it.

Fortunately my scar took it very well and it has completely camouflaged my scar, however its a temp solution, one which will only last a couple of years. The temporary ink SMP has and is becoming more appealing over the permant ink tattooing we have all seen previously as if the temp ink temp doesnt suit or work, it fades over the course of 2 years approx. There is a back out option so to speak.


Scar revision is a viable option for many too, especially with larger scars from poor surgery or previous multiple surgeries if the scalp has laxity. Many cases of scar revisions online too. However there are NO guarantees with scar revision. Every time you cut the skin it will leave a scar. Laxity and physiology play a vital role in scar revision. Research this in great depth and always get examined by a recommend Doc in person to assess all your revision variables. You have more than you think


Be aware that scar repair is a time consuming matter regardless of size and regardless of age of scar. Every patients goal and scars are different and there are options out there for repairing scars, just be aware that there are limitations and impossible to completely reverse the strip scar process. It can be camouflaged and diluted down but it will always be there!

Be REALISTIC and PATIENT despite what a Doctor thinks he can do to improve ones scar the proof is only ever going to be in the pudding despite all best intensions and ability.


Would you agree Sparky ?



Best Regards,

Spencer (Spex)

[sp8rky]

Spex

I think as you say there are several options available.

From personal experience my FUE into scar has made a great difference for me, my hairdresser sees a massive difference in it and has trouble finding the scar. That's one of the things I wanted to get out of it, I don't have to give any hairdresser special instructions anymore.
The scar will always be there, whether it's treated with BHT, FUE or SMP.
My scar is still there, it just has hair growing out of it now.
A good thing appears to be the FUE work primes the scar and brings more blood and vascular activity so the person may then go back for more if needed, think that's why they go with lower density on the first pass.

I think that both scalp FUE and beard seem to grow well, beard seem well suited for planting into scar tissue but again if I am right there are different ways of planting and it is very specialist with regard to density, angles, site incisions etc.
One thing about using body hair is looking at the quality of it and if the patient is on Finasteride as although great for scalp hair they can effect body hair, although beard even less.

BHR from what you pasted appear to be wise in that they do not have a full speed approach but flag up as they did with my own case the necessary cautions and go from there.

I think it is exiting that options are out there and hopefully the patient will benefit from a multitude of options. SMP looks exciting and certainly hope it will be a safe and effective option for people.
Like beard hair usage, it will not be without problems and interesting to see how the skin is after 2 years, does the SMP effect further FUE into the scar? how is the skin if the process is repeated every two years for example and of course the respective health issues with regard to the absorption and discard of the chemicals used as the SMP fades.

I would hope in the future, such scars become less and less common, on that I think we can all agree.

[northeastguy]

Well said sparky.......

I'm hoping to get the same Results with FUE.... Very early and a long way to go for me. 3 month mark on sept 18.

[sp8rky]

Cheers.

I'm sure you will get the result you are after!

Keep us updated. It's really nice to see scars getting fixed and people being able to leave their mistakes in the past.

[sp8rky]

Took this the other day, fue into scar, long hair atm as I am waiting for some fue donor areas to grow out, but should be able to go to 3-5mm now.

[Stevie R]

Looks great man, happy for ya, but why don't you think you will be able to take it down to a 0 grade?

[sp8rky]

Only because of the stitch marks, I don't understand how fraxel will remove them. I think there maybe 1 or 2 grafts lost per stitch mark.

[Stevie R]

Well IDK why it does but many think it does such as IWANTMYHEADSHAVEDBACK if you read his thread somewhere in the Hairloss Help repair section as well as many others that say it eliminates the stitches. All I am saying man is look it up, the fraxel lady told me it can reduce the scar 25-35 percent in width put the most common effect is the skin gets closer to native skin. So I think that since stitches are small to begin with and fraxel does reduce it then perhaps that is why they say it has disappeared from their head, if this makes since to ya.

[sp8rky]

I have seen his thread, dunno about tattooing your whole head though!