Dear All,
Again, thank you for the replies and expressions of concern. This experience has been difficult, to say the least. Before I attempt to provide more details to address some of your questions, let me just say that the donor site scar has improved significantly in just the past several days since posting. I've been reading a lot about the healing process and, quite simply, the body is amazing. Most of the scar is now slight pinkish and smooth, with the exception of what I refer to the problematic area on my left temple, which is still a bit raw (granulation tissue) but visibly getting better everyday. I'll try to post more pics.
To address some of your questions:
When I walked out of my HT, the entire donor site was sutured. I received the full complement of written post-op instructions about washing the recipient and donor sites, refraining from exercising, sleeping at a 45 degree angle, etc. The first several days, the HT clinic washed my head and applied ointment to my donor wound. Something I did not mention in my original post, but that my HT surgeon reminded me of, was on Day 2, when he checked on the donor site and asked how I felt, I told him I felt pain and tightness on the left site of my donor site. He felt the donor site on the left side, said some of the sutures were loose, but there was one on my left temple that felt tight, and he proceeded to cut it. At the time, I thought, "There must be a ton of sutures back there, so cutting one just helps to relieve some of the tension." And, I have to admit, it did feel better at the time. However, as I mentioned in my original post, it wasn't until around Day 5 that I learned that my HT surgeon, even though he sutured the entire donor area, and despite the suture he had cut on Day 2, left the sutures on the left side of my donor areas "loose." By loose, I mean that there was more slack than what normally sees in the closing of donor site.
I have to admit, when I saw the pictures I had posted of my donor site, I reacted like much of you. I expressed my extreme concern to my HR surgeon at the same time. He contacted me the next morning, Christmas morning in fact, and offered to meet with me today.
According to my HT surgeon, despite the large number of graphs, there was nothing pre-op or during the donor excision that had given him any indication that he would not be able to close the donor site normally. This was my first HT (virgin scalp and good donor site density). However, when he was attempting to close the donor wound, particularly on the left side, he noted quite a bit of tension -- he mentioned something about connective tissue. He said he could have closed it with more tension, but in his opinion, doing so risked cutting-off the blood supply to that part of the scalp, which could have resulted in necrosis. So, he elected to keep the sutures "loose," understanding that the donor wound would be wider than normal, but opting for safety instead. Now - and this is important - my HT surgeon told me that he had told me that this was what he had to do during the surgery, while he was suturing. I have no recollection of him telling me this, but I do recall when he was suturing my donor site him saying, "it's really tight on this side." I was heavily medicated during the surgery, so it's possible he told me about keeping the sutures loose on the left side and I just don't remember.
Now, I know many of you have asked for his name, and I apologize again but I cannot bring myself to do it, for several reasons:
1) I have worked in the surgical/medical field for all of my adult life. When I used to live in San Francisco, I worked for a prominent plastic surgeon. In LA, I worked for an internationally reknowned pediatric cardiothoracic surgeon. Even with the best pre-op plan, during surgery, sometimes surgeons are thrown a curve. The good surgeons have the experience to make the best, but sometimes difficult decisions when things don't go as planned. I believe this is what happened in my case.
2) I do not wish to engage my HT surgeon via this forum, nor do I believe he needs to justify his decisions to anyone but me. He has done so. While of course I am not happy with the current result, I would have been much less happy had I developed necrosis. He has offered to revise the scar for free; however, as some one mentioned, the scar needs time to heal. And, yes, I will getting second opinions on the revision, when it comes time. He has offered to meet and view my healing process as often as I feel necessary, weekly even (although that would be hard, given the travel). BTW, I'm not naive, it's in his best interest to provide me with the best outcome possible. He knows it, and I know it.
3) Now, to those who say, "Think of your fellow man," I totally understand. Looking at the pictures I posted, I'd be scared, too. But, I would also remind folks that, a HT transplant is not without any risks, and not all transplants have excellent results. As bad as those pictures were, I feel my ultimate result will be okay, with the exception of a 1.25cm wide x 5cm long scar on my left temple that I will hide when my hair grows-out, and that will will ultimately be surgically revised.
For those of you considering a HT, I would not let my experience dissuade you. I'm pretty sure the top of my scalp is going to look amazing, and the way I normally wear my hair, you won't be able to see the scars once my hair grows. However, if you are considering a strip procedure, I would suggest asking any HT surgeon you speak with, "Have you had situations when you either couldn't close a donor site completely, or there was a lot of tension when you attempted to do so? What did you do in those situations? What were the outcomes? What would happen, if that happened to me?" I did not ask these questions.
Again, thank you for your replies and I'm sorry again to those who will not be satisfied by my response.