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Old 08-14-2012, 08:38 AM
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Default Dr. Lindsey excision of 50 cent sized congenital bald spot on 10 year old boy, McLean

This little boy was referred by a dermatologist a couple of years ago for a 50 cent piece size bald spot. Mom and I talked about options including excision of the area, FUE into the area, or a combination of both. They returned this summer as other kids have started making this little boy self-conscious about the spot. Given how dense his surrounding hair is, I frankly thought that just FUE-ing the area would not be dense enough particularly with a short haircut. So we agreed to excise the area and next summer we’ll re-assess and see if any additional work needs to be done.
I told them that I’d expect that we’ll decrease his bald spot 50% or more with this procedure, but from the looks of the picture, I’d say we likely got 90%....assuming it doesn’t stretch back much.
Note the size of the bald spot before excision. Then I excised about 3/4 of it so that I knew that I could get the area closed with minimal tension. Once it felt like it would close well, I then excised another sliver of it.
On the white surgical drape, you’ll see the size of the original specimen (where the pink color is) and how quickly the lesion contracted down to a much smaller size. This is because people lose collagen-the springy connective tissue that holds your skin tight-at 1%/year of age. So he’s only lost 10% of his collagen and his skin contracts quickly. If you did this on a 70 year old, the specimen would barely shrink.
Then a deep layer closure taking all of the tension off the skin edges was done, and then skin sutures were placed. He went swimming the next day and sutures were removed at day 9. I’ve recommended vitamin E applied twice daily and expect to do a scar check in a month. If it doesn’t stretch…we may be done, but I think we’ll likely need a small FUE case next summer.
The little boy was easy to work with and was a real trooper. Hopefully his mom will come on and describe their experience.

Dr. Lindsey McLean VA
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Last edited by TakingThePlunge; 08-16-2012 at 11:54 PM.
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Old 08-14-2012, 08:39 AM
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The software of this forum switched the number 3/4 to a ? in the description above.

Dr. Lindsey
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Old 08-14-2012, 09:57 AM
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Thumbs up My son's procedure was easy and it looks great!

My 10 year old son was born with a shiny bald spot. I knew he would never have hair grow from that area. At first, it wasn't an issue but as he got older he became more self-conscious about it. He said he was ready to get it fixed and so we headed to Dr. Lindsey. Procedure was simple and painless.
My son is happy with the results so far! We will have to wait and see if FUE is needed. If so, we will do it.
Thanks Dr. Lindsey - You Rock!!
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Old 08-14-2012, 05:32 PM
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Dr. Lindsey definitely rocks! He is the best all around surgeon I've seen on this site. I love the interesting cases he presents week after week.
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Old 08-15-2012, 11:29 AM
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Hi Dr. Lindsey,

My friends son has a similar sized bald patch in the crown area, it had something to do with him being an IVF baby. He has had it cut out 3 times but there is still a patch about 3 times the size of this.

I advised my friend not to get any more revisions done to his son, and that I had heard of this procedure called fue (he knows nothing about my hair!)
He does have some hair growing in it but not much, do you think this was a good call considering the fact that he has all ready had 3 ops on it? I would of thought 4-500 fue will fill it in.
One issue is he is only 7 years old, so I was wondering what would be the best age for this to be done?

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Old 08-16-2012, 11:55 PM
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Dr. Lindsey,

I fixed the fraction in your original post.
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Old 08-16-2012, 11:59 PM
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Dr. Lindsey,

Thank you for sharing yet another inspirational story. It's heartwarming when a doctor can put his surgical skills to such good use. Fixing this small defect will no doubt have an enormous effect on this youngsters life.

Good work!
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Old 08-21-2012, 09:37 AM
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Sparky

If they are able, have them come see me. I'd wait until the child can cooperate for the procedure awake whether that is age 7 or 15. IF its 3 times the size of this...almost certainly I'd push to do serial excisions and then FUE whatever is left. It might take 3 operations to get to that point though.

Thanks.

Dr. L
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Old 09-18-2012, 08:13 AM
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Its been 5 weeks. Mom sent in these pics. Looks like we're making progress. First the redness is normal...particularly in a child. It will take what seems like forever for that redness to fade and the younger the longer it takes. Next he has a little shock loss on the edges even though I didn't use cautery. That should come back by next summer. ( I did the same cut on my son to take off a dime sized mole and it took 8 months to start growing back ) Lastly, it doesn't look like the scar is stretching.

I'd have like to have seen him in the office but the patient had a math test and that took priority. Hopefully one day soon school will be a holiday day and they can stop by.

Dr. Lindsey McLean VA
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Old 10-03-2012, 02:26 AM
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I work in a school and know kids can be bloody mean. Kudos Dr. Lindsey I hope you get the boy fixed up!
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