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Old 01-17-2010, 06:04 AM
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I haven't posted much since my HT Oct. 12th last year.

I had mentioned that I had done the scalp exercises an average of one hour per day instead of the recommended 30 minutes. Some days I even did as much as two hours. The benefit from my extended sessions resulted in my laxity going from tight to very loose.

However, looking back I wonder if doing more than the recommended amount is wise. One thing that occured is a loosening of the skin enough to where I actually developed a turkey neck! I had originally attributed this to getting older and that I just hadn't noticed before. But after I stopped the excercises and had the operation, my turkey neck has mostly disappeared.

The second drawback is that I believe it likely stretched the old HT scar I had. Granted, it was very short in length since only 400 grafts were removed back in 1996. However, I notice now that the old scar is the one hurting. The new HT scar healed up very nicely and I have no pain there at all. But anytime my head rests on the back of a chair or I have a tighter hat on, the old scar starts giving me trouble.

This just gave me pause for thinking that it might be better to stick to the recommended 30 minutes per day instead of trying to overdo it for the additional laxity.
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Old 01-17-2010, 07:54 AM
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Thats a good point raised!
Could excessive scalp exercise result assist in the raise in probability of a stretched scar?
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Old 01-17-2010, 01:41 PM
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I only recommend scalp exercises on patients who have tight scalps or patients who have had prior hair transplant surgery and I am planning on removing the previous HT scar. As you witnessed yourself these exercises can loosen up the scalp tissue allowing the doctor to remove more donor tissue and hopefully be able to close the wound under minimal tension.
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Old 01-17-2010, 01:50 PM
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Quote:
I only recommend scalp exercises on patients who have tight scalps or patients who have had prior hair transplant surgery and I am planning on removing the previous HT scar.
Hello Dr. Charles,

In the patients you have recommend this to, have you noticed stretching of the original scar as a direct result of the scalp exercises?

If so, to what extent? Also, if the the scar had stretched, ultimately you would have to remove more tissue - how does this reflect in the final result, taking into account the scar stretching and resulting extra tissue removal?
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Old 01-18-2010, 02:58 AM
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Severn

Was there a reason for not removing the old scar tissue when excising the new strip, placement/not problematic?

I too have a painful section of scarring that I believe is from an attempted tattooing procedure??¦maybe I'm wrong?
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Old 01-18-2010, 06:00 AM
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Quote:
Originally posted by JJ09:
Severn

Was there a reason for not removing the old scar tissue when excising the new strip, placement/not problematic?

I too have a painful section of scarring that I believe is from an attempted tattooing procedure??¦maybe I'm wrong?
He supposedly took a little bit of it off but I'm not sure where. The old scar is probably only 3-4 inches tops. The new incission is roughly 1.5 inches lower. Even though I believe he planned on taking the new strip lower, he did offer to remove the old scar too. I kind of brushed it off saying that it really didn't bother me. And for the last 14 years it hasn't. It also didn't occur to me at that time that the old scar had probably stretched. But after all the scalp exercises it's the only part that is hurting. The area where the new incision was removed has no pain at all.
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Old 01-18-2010, 09:25 PM
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Thanks for clarifying that??¦the only thing I have tried to alleviate the pain is cortisone injections??¦to no avail. If you ever discover any treatment that helps in this regard??¦please post, I will do the same of course!
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Old 01-19-2010, 06:06 AM
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We suggest scalp exercises in most patients starting a few weeks preop, and consist of fairly firm squeezing of the strip site with both hands, one minute before every meal. That seems to work for us. People remember to do it, but don't make a career out of fiddling with their scalps.

Dr. Lindsey McLean VA
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Old 01-20-2010, 05:04 PM
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Dr. Lindsey,

In the patients you have examined pre-op and advised scalp exercises to, have you noticed much of a difference come the surgery date (given the fact they have only been performing them for a number of weeks and for 1 minute at a time)?
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Old 01-21-2010, 05:02 AM
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Maxxy,

The instructions we give seem to do a good job in loosening up the scalp for closure. As I have blogged before, I have no idea how these exercises work. There are 2 described skin stretching phenomena: stress relaxation and skin creep. I won't bore you, and you can google each to learn more, but a little stretching a couple of times a day "ought" not to do much....but I can tell you that I think it makes a huge difference in tight scalp'ed folks.

Dr. Lindsey McLean VA
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