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shorter strip scar?


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  • Regular Member

Hi, All

Just thinking about any future procedure I may need and was wondering if its possible to get a shorter donor scar, having it stop in the back and not going as far as the sides. The reason I ask is that the hair on the back of my head is much more dense and can hide the scar much better then my sides can.

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  • Regular Member

Hi, All

Just thinking about any future procedure I may need and was wondering if its possible to get a shorter donor scar, having it stop in the back and not going as far as the sides. The reason I ask is that the hair on the back of my head is much more dense and can hide the scar much better then my sides can.

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  • Senior Member

That is an excellent point and is a valid strategy. It is much easier to hide the scar in the back. The problem is that you would have to go with smaller sessions.

____________

2700 Total Grafts w/ Keene 9/28/05

663 one's = 663

1116 two's = 2232

721 three's = 2163

200 four's = 800

Hair Count = 5858

 

1000 Total Grafts w/Keene 2/08/07

Mostly combined FU's for 2600+ hairs

 

My Photo Album

 

See me at Dr. Keene's Gallery

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  • Senior Member

Creepingback,

 

Good question indeed but there are pros and cons to each approach.

 

If you have aggressive hair loss that would require, for argument's sake, 4500 grafts, you could have three sessions of 1500 in order to keep the donor scar as short as possible. This plan would have several downfalls. It would take roughly three years to get to the point where all the hair has sprouted to maturity. You would also have more scarring in the donor area so while the donor scar may be shorter it may wider. It also may cost significantly more. I know of a few clinics at least that have a sliding scale fee plan where you are charged one fee up to a set number of grafts then a lesser fee for additional grafts over that first set number. The more you come back the more you spend above and beyond what you could have spent (less) had all of it been done in one session. Then there is the additional recovery issues with each procedure as well.

 

 

The upside is being in the OR fewer times, faster time to final results, less recovery, less cost, and less scarring.

Having all of your work done in one session, where possible, makes more sense however if your donor hair on the sides is significantly less dense than the hair in the back then you may not be able to have this area touched to begin with. This will be up to you and your doctor obviously but hopefully I've helped out with some of the issues with smaller, multiple sessions.

The Truth is in The Results

 

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

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  • Senior Member

You've gotten some great responses.

 

To me, it's pretty simple. Yes, you can get a shorter scar but you won't get as many grafts and if you plan on more surgeries to keep the scar short it'll be more expensive for you.

Hairbank

 

1st HT 1-18-05 - 1200 FUT's

2nd HT 2-15-06 - 3886 FUT's Dr. Wong

3rd HT 4-24-08 - 2415 FUT's Dr. Wong

 

GRAND TOTAL: 7501 GRAFTS

 

current regimen: 1.25mg finasteride every other day

 

My Hair Loss Weblog

 

Disclaimer: I'm not a Doctor (and have never played one on TV ;) ) and have no medical training. Any information I share here is in an effort to help those who don't like hair loss.

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  • Regular Member

Thanks for your responses. I kinda knew it would be less grafts however the extra cost didn't come to mind, that's a consideration. If I need to go in again Ill need to think about that..If you have seen my pics you can see why it's a concern.

Thanks again!

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  • Senior Member

No one has mentioned that the longer and wider the strip taken, the higher the risk of scar stretching.

 

There is a minimal risk when doing smaller sessions, however, the downside of this is more cost and longer down time to achieve final results.

 

There is a fine line to be walked here.

 

Make sure you can achieve your goals in a timely manner, but at the same time, take it down a notch to be a bit safer.

 

For example, if you go to a clinic and they say, let's take a 30cm strip that is 2.5cm wide to get 6000+ grafts.

 

Sounds great, sounds exciting right?

 

However, what about backing down a bit to 1.75 wide and 30cm long for 4000+ grafts?

 

I understand the want for more hair at one time, but I think a bit of conservatism in these matters is OK, no problem whatsoever.

 

I just believe there are very few cases of "one and done" so instead of doing 6000 grafts at one time, and then 2000 to finish the session off, lets back it down to 2-- 4000 graft sessions, etc...

 

Just my point of view, and I understand the costs involved, but I think sessions of 3-4 thousand are great and if a guy is going to have 2 sessions, being a bit more careful should not concern anyone.

 

Take Care,

J

Go Cubs!

 

6721 transplanted grafts

13,906 hairs

Performed by Dr. Ron Shapiro

 

Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

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  • Senior Member

Bspot,

 

"No one has mentioned that the longer and wider the strip taken, the higher the risk of scar stretching."

 

Actually the length of the scar has no relation to stretch back. Stretch back occurs when the donor strip is too wide relative to what the patient's donor area can handle.

 

"There is a fine line to be walked here."

 

I get it...fine lineicon_smile.gif

 

"However, what about backing down a bit to 1.75 wide and 30cm long for 4000+ grafts?

 

I understand the want for more hair at one time, but I think a bit of conservatism in these matters is OK, no problem whatsoever."

 

4000 is conservative? I think conservative would be more along the lines of a 1.25 x 20 donor strip yielding roughly 2000 grafts (using 80 per cm2 as an assumption for the donor density). I don't know of a lot of clinics performing 4000 grafts so the 2 x 2000 would be more common.

The Truth is in The Results

 

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

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  • Senior Member

Here guys.... I think Joe is always WRONG!!!!!!!

 

I also think he is a poor speller.

 

He also never buys his own cigarettes and bums them off everyone else.

 

Happy Now?

Go Cubs!

 

6721 transplanted grafts

13,906 hairs

Performed by Dr. Ron Shapiro

 

Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

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  • Senior Member

Making the strip long and narrow rather than short and wide should take tension off the wound, giving the best chance of a great closure and faint scar.

 

Creeping Back,

 

I would agree with Jotronic that keeping the strip *very* short can be problematic, particularly if this commits you to multiple surgeries.

 

I would ask you to keep in mind that most top physicians in the field will carefully examine the hair in the area they are surgically excising. If you have notably poor density or poor hair quality on each side above the ear, I suspect your physician would shorten the strip slightly for a couple reasons. 1) It is inefficient to surgerically remove thinly haired scalp. 2) As you expressed, there may be a problem with the concealablity of the scar in that area.

 

Although I have never examined your scalp, I suspect that the strip dimesions could be altered *slighty* to avoid creating an issue while still removing a reasonable number of grafts.

Notice: I am an employee of Dr. Paul Rose who is recommended on this community. I am not a doctor. My opinions are not necessarily those of Dr. Rose. My advice is not medical advice.

 

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

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  • Senior Member

That is all good info, but let's keep in mind the second part of his concern - it is easier to hide the scar in the back. It's much more difficult on the sides. People are concerned about these things.

____________

2700 Total Grafts w/ Keene 9/28/05

663 one's = 663

1116 two's = 2232

721 three's = 2163

200 four's = 800

Hair Count = 5858

 

1000 Total Grafts w/Keene 2/08/07

Mostly combined FU's for 2600+ hairs

 

My Photo Album

 

See me at Dr. Keene's Gallery

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  • Senior Member

Also the longer scar. The higher the probability of nerve, neuro-venous and vascular damage/ complications.

B- spot don't cave in. Befriending is part of the game.

You are /have been stroked my man.Sad to see it..

A hair on the head is worth two on the brush.

I don't work for commision.. I bust e'm for free. Thank me later.

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  • Senior Member

Aq, I don't get "stroked" ok?

 

I also don't stroke others, here or anywhere else.

 

Joe and I talked on the phone, hashed out where we stood on my post in response to his post, and moved on.

 

That is all.

 

Feel free to continue to disagree with Joe, as I am sure he and I will in future.

 

Take Care,

J

Go Cubs!

 

6721 transplanted grafts

13,906 hairs

Performed by Dr. Ron Shapiro

 

Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

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  • Senior Member

I guess he doesn't have to answer that Joironic.

I don't think your cute.

B- you don't stroke. That is why I am miffed by your backdown.

Now Joironic is making intentional typos ?

So when are you picking up the ZR1 for grandma.

A hair on the head is worth two on the brush.

I don't work for commision.. I bust e'm for free. Thank me later.

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  • Senior Member

We are talking recent post op strip scar coverage here. 6 months post op, you will generally have no problem covering the scar and it will be virtually undetectable (assuming you go to a quality doc).

 

As in CreepingBack's case, most of us tend to have hair that is both more dense and coarser in the back of our heads. It is therefore easier to cover a strip scar with it. On the sides of our head, we have somewhat less dense hair so the chances of the scar showing through are greater. Add to that the fact that on many people the hair on the sides of the head tends to stand out a little more (as opposed to laying down flat) and you have a somewhat more difficult time. Add a cowlick or donar area shockloss caused by the strip and it exacerbates the problem.

 

One last factor is that the scar tends to go upward as you go around the sides of the head. This places it at the transition point between the top of the head and the curvature downward. At this point the hair sticks out in a more horizontal direction, increasing the see-through effect. In the back of the head, the scar is at its lowest point and the hair back there is virtually laying flat vertically.

____________

2700 Total Grafts w/ Keene 9/28/05

663 one's = 663

1116 two's = 2232

721 three's = 2163

200 four's = 800

Hair Count = 5858

 

1000 Total Grafts w/Keene 2/08/07

Mostly combined FU's for 2600+ hairs

 

My Photo Album

 

See me at Dr. Keene's Gallery

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  • Senior Member

WoW! that was quick. Must have doen some magic over the phone.

Originally posted by the B spot:

Editing my post to say that I am not feeling well today and I reread my post and I did not like how I responded to Joe's post.

 

Had a great conversation with him today and we are on the same page here.

 

Take Care,

J

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  • Regular Member

I am suddenly wondering why are we so paranoid about the donor scar? I mean, I have seen people walking around with scars on other parts of their bodies like arms and legs where there are (usually) no hair to cover, some of them pretty long and hideous, like a burn scar, yet they don't seem that concerned about exposing the scar to the public.

 

Take myself for example, I had several surgeries on my fingers and wrists to remove various ganglia, and the scars are very visible with no hair to cover at all. But I am not a bit concerned about other people seeing them. Yet when it comes to the donor scar from my HT, I absolutely don't want it to show. Is it because our mind works differently based on the location of the scar? Any thoughts?

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  • Senior Member

Bill,

 

It's the issue of vanity. We all want people to believe that we are strong, confident individuals with no weaknesses. The last thing we want is for those around us to percieve us as weak and that we are not comfortable with the way we look.

 

I don't get it though. There is the obvious double standard. Women can get the most blatant boob job and the vast majority look in awe and amazement. A guy walks down the street with a bad HT or nondiscreet rug and people snicker behind his back.--What gives??

 

I for one have made the decision that if my next Ht has me looking like I hope, I will tell people that I had the procedure. Not that I will wear a flashing t-shirt, but I hope to eliminate the stigma of HT's. If I am in a room and the conversation comes up about HT's or whatever, I will point mine out and see what the response is. Personally if I have the results that I expect, I will be kind of proud to display for the shock factor.

 

So many of us have our insecurities and are afraid to talk about them, but for the most part people are understanding and want to discuss their own issues but might not have the proper setting or are nervous to be open with others.

 

Once again just my opinion as I ramble.

 

NN

NN

 

Dr.Cole,1989. ??graftcount

Dr. Ron Shapiro. Aug., 2007

Total graft count 2862

Total hairs 5495

1hairs--916

2hairs--1349

3hairs--507

4hairs--90

 

 

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  • Senior Member

First off the guy on the street is not responding to a thread on a public forum, he is probably just walking....as for scar length most people come to forums seeking help and support so it is only natural to have a post like such...hence your example -the guy walking down the street with burns confidently does not carrier over. On to the meat and potatoes....if one wants to optimize styling options and keeping short hair on the sides is pivotal or ultra important cosmetically speaking, then they should look into shorter strips it's really that simple. HT are give and take arrangement you got to get to give it...more grafts you need the more you got to get (longer strip). The key is to find a balance that you are comfortable with personally (like your burn patient example he was comfortable in his own skin so it didn't matter to him).

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Some people are more concerned than others about the scar. This has to do mostly with what we expect and value as important. Clearly those considering an HT are trying to improve their appearance. Whereas some focus so much on the fact that they have new hair, they don't care about the scar, there are others who look at the scar as the deal breaker.

 

It's a matter of what we value and find important.

 

Personally I don't think a shorter strip scar verses a longer one really matters as long as the existing hair conceals a thin scar that lies underneath (regardless of length). Personally, I'm more concerned about the width (or really the height) of the scar.

 

Just my thoughts...

 

Bill

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  • Senior Member
Originally posted by Bill:

 

Personally I don't think a shorter strip scar verses a longer one really matters as long as the existing hair conceals a thin scar that lies underneath (regardless of length). Personally, I'm more concerned about the width (or really the height) of the scar.

 

Just my thoughts...

 

Bill

 

Exactly, Bill.

 

With tricho closure and a Doc who knows how to close, a thin scar with hair growing through it should be able to be covered by 1/2" of hair. That's pretty short. How many of us have gotten an HT and have the desire to wear our hair that short? I sure don't.

 

BTB made a good point about scar-phobia. How many of your average Joes (no offense, Jotronic) really know much about HT's?? Even most balding guys probably still think of the plug days. Face it, we hair geeks (I say that respectfully as I'm one icon_cool.gif) are much more educated about HT's.....tons......than the average person.

 

The only time I believe the scar issue is more prevalent is for a NW 6/7 with thinning or poor donor area who wants to "try" a HT...........and maybe he shouldn't be trying. However, they may want the ability to clip down if it doesn' work. To me, if it's that much of a gamble I just wouldnt' go there.

 

I did an accidental experiment this morning which relates to this. I've cut my own hair for years, noticed I thought I needed to trim my bangs...........pulled some hair up with a comb........ran the clippers across it.........looked in the mirror and OH SH!T!!!, I clipped it way to short. So, I gave myself and early morning haircut..........cut the top down to 1" using a guard............cut the upper part of the sides to 1/2" and the lower part feathered into it at 1/4". IF I bend my head down looking "up" into the back of my head I can faintly see the scar..........looking at it straight from the sides or back you can't.

 

I've been wanting to start clipping down anyway for HT #3 so this was just the first step and actually forced me into it. Now.......I have decent donor hair with average to above average density which may be in my favor. One negative is the the hair on the sides is really gray so when I clip that close it's even that much more see-through but the scar was still a non-issue.

 

At the end of the day I suppose it's just personal choice but I'd rather have a plentiful harvest knowing I can grow my hair long enough to cover the scar verus multiple HT's with a shorter one.

Hairbank

 

1st HT 1-18-05 - 1200 FUT's

2nd HT 2-15-06 - 3886 FUT's Dr. Wong

3rd HT 4-24-08 - 2415 FUT's Dr. Wong

 

GRAND TOTAL: 7501 GRAFTS

 

current regimen: 1.25mg finasteride every other day

 

My Hair Loss Weblog

 

Disclaimer: I'm not a Doctor (and have never played one on TV ;) ) and have no medical training. Any information I share here is in an effort to help those who don't like hair loss.

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