My scalp is incredibly tight at the very back from the base of the neck to just below a point in line with the top of the ears, above this (still the rear of the scalp) to the sides of this and on top, I seem to have standard laxity. How will this affect me given that most diagrams of the donor area I see pass through this tight section? By tight I mean it barely moves vertically, though horizontally it is fine.

Good thread,

Unless there is some major catastrophe, scars are best revised at a year, 6 months is acceptable in certain cases. This is due to the timeframe required to "get" the final scar result before committing to a new procedure. Collagen deposition falls off at 6 months and the scar is essentially done, although I have seen significant changes in some scars out to a year.

With a 2 layer closure like we do here, I tell guys they can exercise the day the sutures come off. Now I tell them not to TRY to stretch their scalps...don't ask for trouble; but it is ok to do sit ups/crunches if your hands don't pull on the scalp.

As to scalp stretching exercises, I would wait 6 months.

Trinfos, you would need an exam for me to tell you what your scalp's deal is. One person's claim of really tight, might be another person's description of normal. Hard to tell without a look.

Dr. Lindsey McLean VA

__________________
William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

Dr Lindsay, do you agree that scalp exercises wont make a 6 year old scar worse? My scalp already seems to have good laxity, but if I want a revision, which I do it seems a bit more laxity wouldnt hurt. Ive compared my scalp to my wifes and I seem to have more laxity.

__________________
My Hair Loss Website

Sparky,

Your six year old scar will not get bigger because of scalp exercises. You should be safe at this point. If you wish for simple scar revision you do not need as much laxity as if you wanted more grafts.

Stimpson,

To give you an idea of what scalp exercises can do, I'll use my best friend as an example. Back in late 2003 when I went home for Christmas my best friend, who also had bad surgery at the same clinic I did in Knoxville, wanted to know if he was a candidate for surgery with Dr. Wong. I told him after examination that I'd be surprised if Dr. Wong could get more than 2000 to 2200 grafts out of his donor area. He had two wide scars and more than average tension. I told him to start these scalp exercises that we had come up with to get it loose. After five months, when he came in for his procedure, his scalp was loose enough so that Dr. Wong was able to pull 4100 grafts AND his old scarring. I am NEVER EVER off by this much so the exercises made a big difference for him.

Trinfos,

Horizontal movement in the donor is not really a good indicator of what can be done. It is the vertical movement that is the concern. In your case, even though the back is tight, you should start the exercises to increase your laxity as much as possible. Even a small improvement can make a healthy difference. The nape of the neck however shouldn't matter because it does not relate strongly to the laxity in the donor region.

__________________
I am employed by Hasson & Wong as a patient educator. My opinions are my own and might not be that of Dr. Hasson & Dr. Wong.

Hasson & Wong-The More You Look The Better We Look.

Dr. Hasson and Dr. Wong are members of the Coalition of Independent Hair Restoration Physicians