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Old 07-29-2012, 07:52 PM
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Default If you get a second FUT, should you ask the doctor to cut out the entire first scar?

If you get a second FUT, should you ask the doctor to cut out the entire first scar? I understand this means fewer grafts, but can't you always just have a third FUT to get more grafts?
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Old 07-29-2012, 08:05 PM
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Removing a scar from a previous procedure does cause some degree of limitation on the number of grafts that can be obtained in a procedure done at a later time. However, most patients that I see would much prefer one scar versus two scars. I would certainly discuss this with your physician.
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Old 07-30-2012, 11:33 AM
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If the scar is in the "usual and correct location", meaning not crissy crossing your entire back of the head...which I do see from time to time... then its all a mathematical equation of how much hair you need/want, how lax is your scalp, and can you get enough hair from the strip AND excise your old scar at the same time. That is what an inperson preop consultation is all about. Bring it up with your doctor before the morning of surgery so you can think about it. I always discuss it, tell the patient what I'd suggest, and then have them tell me BEFORE taking the valium on the morning of surgery.

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Old 08-01-2012, 04:39 PM
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I agree with all of the comments made by Drs. Charles and Lindsey. I would add that I do try to excise the entire scalp if it is pretty clear to both me and the patient that this is his LAST transplant procedure. It saves him another trip and surgery, but this is only a good idea, as Dr. Lindsey said, if there is enough laxity and if the plan to remove the scar does not limit the surgeon from being able to harvest the amount of hair the patient is requesting. If you attempt too much and the closure is under tension, then the effort to reduce the scar backfires, and you get a "rubber band effect" of an even wider scar than when you started, despite the fact you excised the entire scar. If it is a somewhat wide scar and the patient wants as large of a session as you can achieve, then it is clearly better to put off the scar excision for a year, until when the scalp becomes lax once again and it can be done without undue tension. Even in this situation, it is still important in my opinion to end up with only ONE scar and to take the new strip from exactly above the old scar, so that there are not two scars.
If the patient needs a third session in addition at some future date, then I think it is better to NOT excise the old scar, but to leave it, which will minimize the tension on the closure after the present donor harvest and the later closure also. Dr. Charles made this point also.
Dr. Lindsey hit the nail on the head in noting that a personal exam and consultation with the surgeon before surgery is the best way to plan and make the right decision. No two patient situations are exactly the same.
Mike Beehner, M.D.
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Old 08-01-2012, 07:15 PM
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Not that my opinion means crap after 3 M.D.'s have posted, but yep, they are all right.

Nothing can replace the exam of the doc who will be doing your surgery. Assuming you pick a good one.
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Old 08-01-2012, 10:50 PM
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I actually asked Dr. Paul if he could remove my older scar with my most recent procedure. He told me he could but I would receive a substantially lower amount of grafts. He recommended taking another strip out directly above the older scar so as to get the highest possible number of grafts for my procedure. My scar(s) is wider than most but I am happy I went with his suggestion. My scars are not noticeable unless I pull my hair up to showcase them. I will be addressing the doubled scars in the near future with a scar revision. You can't always get everything you want with every procedure. There's going to be some give and take.
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Old 08-03-2012, 06:57 AM
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You have this issue firmly in hand and appear to be making the correct choice. I usually push more hair, rather than scar excision, if people wear their hair long enough to cover their scars anyway.

Good luck to you.

Dr. Lindsey McLean VA
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