Scar City

[Dr. Alan Feller]

Much of the hair transplant industry has been cleaned up since the advent of forums and websites like HTN. However, there are still areas of HT that remain largely unaddressed.

 

Another thread on this forum:

http://www.hairrestorationnetwork.com/eve/showthread.php?t=144474

Referred to a UK clinic who consistently produce poor and/or disfiguring scarring within the donor area.

 

While Bill' intention was to discuss the relative appearence of donor scar with respect to camera and head angulation, it struck me that a much more important point was being ignored, namely the proper "absolute" position of donor incisions.

 

This is why I scanned and posted THE textbook definition as to how a proper donor incision should be planned and executed. I doubt any doctor will publicly contradict the text, and they shouldn't since it is one of the few things in medicine that is objectively and demonstrably correct.

 

Allan, the topic starter in the other thread, had a procedure in the UK that clearly ignored the basics of "Hair Transplant 101" by harvesting a donor strip that was obviously too low and led to a needlessly greater chance of large scar formation. Was this just an isolated "once in a while" incident, or was this "less than optimal" approach to donor harvesting a more pervasive problem?

 

I think it is not only a prevelant problem, but epidemic.

 

By coinicidence I had a UK patient in my office only a few days before Allan posted his results from a UK hair transplant doctor. What I found in the donor area was appauling. It demonstrated an utter and complete lack of understanding of basic scalp physiology and an almost purposeful desire to disfigure.

 

Most of the time, these awful results come from the "hit and run" HT docs who may perform one hair transplant per month. To them, the donor area is not a part of the body to be respected-and it shows in their results.

 

 

In the photos you can see an upper scar and a lower scar. The first UK doctor produced the lower scar. It is located BELOW the occipital bump and predictably looks worse than it otherwise might have. The second UK doctor went way high in the donor area (in an effor to avoid the first scar no doubt), but because this scar is located well above the occipital bump the size of the scar is much smaller.

 

The problem with both scars is that both UK surgeons totally missed the very prime donor real estate. I was thankful for this because it made my job that much easier, but one must wonder why such amateur mistakes were made by HT docs who have not only been in practice for years, but CLAIM publicly to be "experts" and "leaders" in the field.

 

Here are a couple of other goofy scar results produced by self proclaimed "experts" in the field of hair transplantation

 

 

In the bottom photo the doctor had excised the donor strip well below the occipital bump, and that scar is smaller than one would normally expect for such an inappropriately low scar. We can only imagine how good his donor scar would have looked had it been excised on or above the occipital bump.

 

In any surgery the outcome is never 100% guaranteed, but the odds can be slanted in favor of the surgeon and patient by simply understanding some basics and applying them every single day. Why this has not been done is beyond me. Thankfully, such results can be reported on the internet for the world to see.

[Dr. Alan Feller]

Much of the hair transplant industry has been cleaned up since the advent of forums and websites like HTN. However, there are still areas of HT that remain largely unaddressed.

 

Another thread on this forum:

http://www.hairrestorationnetwork.com/eve/showthread.php?t=144474

Referred to a UK clinic who consistently produce poor and/or disfiguring scarring within the donor area.

 

While Bill' intention was to discuss the relative appearence of donor scar with respect to camera and head angulation, it struck me that a much more important point was being ignored, namely the proper "absolute" position of donor incisions.

 

This is why I scanned and posted THE textbook definition as to how a proper donor incision should be planned and executed. I doubt any doctor will publicly contradict the text, and they shouldn't since it is one of the few things in medicine that is objectively and demonstrably correct.

 

Allan, the topic starter in the other thread, had a procedure in the UK that clearly ignored the basics of "Hair Transplant 101" by harvesting a donor strip that was obviously too low and led to a needlessly greater chance of large scar formation. Was this just an isolated "once in a while" incident, or was this "less than optimal" approach to donor harvesting a more pervasive problem?

 

I think it is not only a prevelant problem, but epidemic.

 

By coinicidence I had a UK patient in my office only a few days before Allan posted his results from a UK hair transplant doctor. What I found in the donor area was appauling. It demonstrated an utter and complete lack of understanding of basic scalp physiology and an almost purposeful desire to disfigure.

 

Most of the time, these awful results come from the "hit and run" HT docs who may perform one hair transplant per month. To them, the donor area is not a part of the body to be respected-and it shows in their results.

 

 

In the photos you can see an upper scar and a lower scar. The first UK doctor produced the lower scar. It is located BELOW the occipital bump and predictably looks worse than it otherwise might have. The second UK doctor went way high in the donor area (in an effor to avoid the first scar no doubt), but because this scar is located well above the occipital bump the size of the scar is much smaller.

 

The problem with both scars is that both UK surgeons totally missed the very prime donor real estate. I was thankful for this because it made my job that much easier, but one must wonder why such amateur mistakes were made by HT docs who have not only been in practice for years, but CLAIM publicly to be "experts" and "leaders" in the field.

 

Here are a couple of other goofy scar results produced by self proclaimed "experts" in the field of hair transplantation

 

 

In the bottom photo the doctor had excised the donor strip well below the occipital bump, and that scar is smaller than one would normally expect for such an inappropriately low scar. We can only imagine how good his donor scar would have looked had it been excised on or above the occipital bump.

 

In any surgery the outcome is never 100% guaranteed, but the odds can be slanted in favor of the surgeon and patient by simply understanding some basics and applying them every single day. Why this has not been done is beyond me. Thankfully, such results can be reported on the internet for the world to see.

[bullitnut]

hi its just superb reading your posts you make everything easy to understand by fantastic detailed descriptions its blatently obvious that you are one of the minority of excellent ht doctors, and with every post its plain to see that you are passionate about you job and that you geniunely want to help people which is why you will be my first port of call when i have the funds to get my head sorted at the back end of the year, can i just say on behalf of all ht patients especially uk ones THANKS FOR BEING ONE OF THE GOODGUYS this might sound like im arse kissing to some people but im not its just heartwarming to see a doc who demonstrates time and time again that he cares cheers!!ps. excuse the spelling english was never my strong point haha

[Bill - Seemiller]

Dr. Feller,

 

Thanks for posting this. Clearly there is a more appropriate place to remove tissue in order to minimize the risk of scar stretching. It appears that cases can be made to go higher on occasion without increasing these risks, but the lower the scar below the occipital bump, the greater the increase of stretching.

 

Thanks,

 

Bill

[Guest Baldie3000]

This is some quality stuff doc! If I get surgery, how can I be sure that doctor will take the strip from the right area?

 

~Baldie3000

[PLEASE GROW PLEASE]

How can you be sure ? Just go to Feller

[PLEASE GROW PLEASE]

Bullitnut That not ass kissing its the truth. Dr Feller is one of the most sought after doctors in the world yet he still somehow finds time to try and educate people with his busy schedule.

He could very well just leave Spex to answer all questions yet he not only posts tons of pics he types detailed posts all the time.

Theres only a small handful of doctors I would trust with my head and he is one of them.

Shapiro would be number one though

[Dr. Alan Feller]

Bull, Bald, and PGP:

Thank you very much for the kind words, they are greatly appreciated.

 

Bill,

My pleasure, thanks.

 

I hope the many doctors who read this site, but rarely participate, take the time to understand the physiology I've presented. It will make a world of difference to their results, their reputations, and their patients.

 

Dr. F

[richie48]

hey Doc

 

Another top post , thankyou for taking time from your busy schedule to clarify thing further from the origional post and answer my questions .

 

I am happy that your attitude to the HT industry is one of education , compassion and integrity , these attributes only com firm my choice in you as my own surgeon .

 

Thank god I found you hahahaha

 

richie

[MrJobi]

Good post

 

I do see a couple docs on here who do push the limit regarding how high the donor strip is taken.. This has always been a topic for discussion

[richie48]

Bill

 

Is there any chance this origional post from Dr Feller could be posted in the stickies at the top of the experience page , it's a really serious topic and is a must for any newbies doing research .

 

Just a thought as you were recently asking for new topic headings , and I think this is well worth keeping .

 

thanks

richie

[Bill - Seemiller]

Richie,

 

One thing I haven't gotten in the habit of is taking individual posts and turning them sticky threads. If we did this, it would be difficult for members to jump into the discussion since they will have to do some scrolling to find it.

 

However, I agree that this and several other topics are important. Perhaps we could create a new sticky thread with frequently asked questions and important considerations and then link to a number of important threads rather than post each one separately. Compiling a list of these will take some time, but perhaps we can work on this in the near future.

 

Thank you for your suggestion.

 

Bill

[richie48]

hey Bill

 

Thanks for the answer , I see how that could get in the way of a discussion ,good idear about a list though , is there any other way to keep info given freely be the docs to stay at the top of the page ?

 

Info like this is priceless and when doctors post it , it's accurate and credible .

 

I think some way of keeping some info at the top is a good idear and certainly needs thinking about .

 

thanks Bill

richie

[Bill - Seemiller]

Richie,

 

Brainstorm with me over the next couple days and perhaps we can discuss our findings privately about how we can come up with a frequently asked question post that contains some of the best answers from patients and physicians alike.

 

Physician blogs can also be found on each doctor profile on the Hair Transplant Network which will soon include the one above.

 

Thanks for your interest,

 

Bill

[Hairnutter123]

Sorry guys. Just put this edit thing in as I think I have posted this in the wrong place. Have copied it into my own "need advice" thread.. maybe it could be removed. New to this.

 

Hello

 

There is so much information on this forum that it could take an age to read.

 

Scars are one of my major issues. My UK HT has left me with a terrible result on my recipient area but the scar from my donor is ok, sort of, and I can hide it as long as I do not cut my hair shorter than a grade 5.

 

It seems so important to choose a Doctor that cares about the donor area also. I know I have not yet posted any pics.. will do very soon.

 

My main concern is that any further work may help with the top of my head but the donor taken from the wrong area or leaving a bad scar will just change the problem I have from the top of my head to the back.

 

Interesting reading.

[richie48]

hey hairnutter

 

I've replied on your other thread bud

 

good luck

richie

[16inchscar]

these photos are so depressing. im scared to death to cut my hair short..wish i could have just been happy with the way god made me..now i have to deal with the horrible scars and also the future hairloss thats gonna make my transplants look like a deformity. but dont worry docs the butchers that caused my depression are all at bosley atlanta

[richie48]

hi 16inchscar

 

So Sorry to hear of your awful predicament , some of these surgeons have no fucking morals , its as simple as that , wankers deserve to be shot !

 

Between sharing your story and sites like this doing there best to educate we can try hard to out these below par clinics , and try to stop any newbies making the smae grave mistakes .

 

You mention you're worried about further loss showing your transplant , perhaps you should try meds to keep what excisting native hair you have to disguise the damage as best you you can .

 

Thanks for sharing your story and I hope my suggestion helped a little .

 

richie

[louierah]

I have decided to give up the hair replacement fight and just be happy I am healthy and alive. I have however put aside some funds to try and help the appearance of the donor scar.

[Bill - Seemiller]

lou,

 

There are a number of people in the world who are bald and happy. And if you can be, then I agree that surgery is not for you.

 

It's hard to tell by the picture, but the donor scar looks ok. Using some mederma for the next few months a few times a day might help minimize its appearance.

 

Best wishes,

 

Bill

[louierah]

I think the donor scar is pretty normal and your right I think if you plan on spendin $30k or so you can get good results but when I went for my 1500 for $6k I was not told to put aside another $24k to really achieve the look I would be happy with. If I were I probably would have just shaved it then. I am using Mederma and I am actually going tomorrow to a doc to see if lasering may help.

[bverotti]

dr. Feller, I like your new avatar, quite funny.

 

But seriously, we are seeing a tremendous number of bad bad strip scarring by European docs, as if nothing changed over the last 10 years.

Maybe you have an opinion to why this is ?

[Bill - Seemiller]

Dear forum members,

 

Dr. Bessam Farjo posted a compelling argument for the occasional harvesting the donor strip under the occipital bump.

 

You can read his detailed argument with pictures on this thread.

 

Best wishes,

 

Bill

[PLEASE GROW PLEASE]

Actually your scar looks prety good. A couple rounds of fue and youll be all good

[nucklhead]

Originally posted by louierah:

I think the donor scar is pretty normal and your right I think if you plan on spendin $30k or so you can get good results but when I went for my 1500 for $6k I was not told to put aside another $24k to really achieve the look I would be happy with. If I were I probably would have just shaved it then. I am using Mederma and I am actually going tomorrow to a doc to see if lasering may help.

 

I would just like to tell you that your scar looks like nothing more than a scratch! and Im not gay and dont mean to sound that way but you have a very nice shaped or nice looking head! if i was you I would just stay bald and learn to live and be happy with it! Lot of girls now adays dig that too and it is not weird or unatractive like it was many, many years ago, in fact its a trend now.

 

Trust me i have seen Keloid scars from HT, Otoplasty rinoplasty that is really really sad to see and imagine being in that persons' shoes! what you have, that mingor scratch of a scar that you have is really NOTHING compared to what most people have had to live with after a bad surgery experience! go ahead and live your life the way you should and be happy with it!