Does scalp laxity return back to normal? Does further procedure pull hairline back?

[akuma]

With the strip procedure, say about 2000-3000 grafts taken out, open skin is then sutured together and skin is tighter from the top and bottom of the scar.

 

That means the skin below and above the scar is pulled together. Which means the frontal hairline would be pulled back to a certain amount. So if one takes on another procedure in the future (say another 2000 grafts), it will further pull the frontal hairline back (more tightness at the scar area due to another procedure), which means new hairline will have to be created (if one wants to lower it back to normal).

 

This is my guess on what happens. Is it true?

 

Or does scalp tightness return back to normal after a few months and frontal hairline is "not" pulled back by the scar area?

 

Would be helpful if patients that had around 2 or more procedures could comment on this.

 

I am not sure if this has been covered before.

 

Thanks guys

[TakingThePlunge]

akuma,

 

I've had two hair transplants but I believe I had a little higher than average laxity. After my first procedure I felt my scalp probably had the tightness of a "normal" scalp and after the second, it felt a little snug for awhile.

 

Many hair transplants physicians recommend scalp stretching exercises for mega-sessions or subsequent procedures. I haven't needed those yet. If I have a third hair transplant, I imagine I will have to do stretching exercises to loosen my scalp a bit.

 

As fart as I understand it, the scalp is very stretchy and, with the hairline being essentially on the opposite side from the donor strip, it is not affected by the closure. I did however get a very nice neck lift as an added bonus.

 

Perhaps someone else has had a different experience.

[Dr. Glenn Charles]

Most of the pull and stretch comed from the back of the neck area and not the forehead. Unfortunetly, you will not get a face lift in addition to the hair transplant. Some patients in time can almost return to normal laxity. However, in many cases after a patient has had several procedures there is a decrease in laxity of the donor area. Scalp stretching exercises can be used in tighter scalps to improve scalp laxity in the donor area prior to having hair transplantation surgery.

[akuma]

 

As fart as I understand it, the scalp is very stretchy and, with the hairline being essentially on the opposite side from the donor strip, it is not affected by the closure. I did however get a very nice neck lift as an added bonus.

 

 

 

Most of the pull and stretch comed from the back of the neck area and not the forehead.

 

I kindly disagree with the above. Yes most of the pull comes from the back of the neck and not forehead. But I do believe there is some pull at the forehead. Hence the hairline is pulled back JUST a little. To some extent.

 

How do i know this? This is how...

 

Before the hair transplant, I could put my palms on top of my head, press on my scalp, and be able to move the skin forward (towards hairline) and back (towards crown). And I had good movement BOTH ways. Everytime i did those movements, it looked like the kinda of movement when someone is wearing a wig (hair line moving back and forth JUST a little). I remember the movements clearly.

 

Now after the transplant, I try the same thing and this what happens.

 

I do the same thing. Put my palms on top of my head and move palms backwards towards crown. I no longer have the AMOUNT of movement I used to have before transplant (meaning the donor area is already pulling at the forehead/top scalp). The movement I have now is barely anything. This means the top scalp is more taut now.

 

I try and move the palms towards the hairline, again barely any movement, and I can then DEFINITELY feel a tension in the donor area.

 

The donor scar pulls the top scalp skin as well as the neck area. So for me I know it did pull the hairline back a little. Before I thought i was seeing things but I know for sure it has been pulled back a little. My forehead does look a little bigger than before.

 

I think this would happen for people like me who had high laxity on top of the scalp. I think the issue is not common with people that have low laxity on top of the scalp.

 

I think people should be aware of this before they get transplant. For some people the hairline can get pulled back a little.

 

I guess the question i have now is when can I start scalp exercises to increase scalp laxity at the donor area? Which I know would bring back my top scalp laxity back to normal.

 

PS my transplant area and donor area is not swollen.

 

Thanks

Edited March 31, 2011 by akuma

[akuma]

Looking at alot of before and after HT pictures of patients showed that it happens to others as well.

 

Am I the only one who noticed this? No one else came across this?

[Dr. William Lindsey]

I think that Dr. Charles is correct and respectfully disagree with the subsequent poster. As I have not met him, I can't argue that he didn't have the change that he describes, but that would not be expected.

 

As a hair doctor who also does browlifts, (see thread on tricho closures updated today), I can tell you the usual problem with browlifting is that the forehead doesn't "stay up" where you want it. And the usual culprit is pulling the skin and galea (tissue under the skin) without freeing up the forehead muscles from the eyebrow area bone, or upper eye socket. You can pull on that forehead skin alot, whether all the way in the back of the head for a strip, or even right at the hairline, and if you don't free up that orbicularis muscle from the bone...the resultant brow elevation will be short lived. I know, as I've had to redo a few browlifts years ago when I was too timid to really free it up.

 

Dr. Lindsey McLean VA

[akuma]

I think that Dr. Charles is correct and respectfully disagree with the subsequent poster. As I have not met him, I can't argue that he didn't have the change that he describes, but that would not be expected.

 

As a hair doctor who also does browlifts, (see thread on tricho closures updated today), I can tell you the usual problem with browlifting is that the forehead doesn't "stay up" where you want it. And the usual culprit is pulling the skin and galea (tissue under the skin) without freeing up the forehead muscles from the eyebrow area bone, or upper eye socket. You can pull on that forehead skin alot, whether all the way in the back of the head for a strip, or even right at the hairline, and if you don't free up that orbicularis muscle from the bone...the resultant brow elevation will be short lived. I know, as I've had to redo a few browlifts years ago when I was too timid to really free it up.

 

Dr. Lindsey McLean VA

 

I didn't quite get what you meant doctor. In my post i wasn't referring to brow lift. I was referring to the top scalp being pulled back a little if it has high laxity. Just a little. It was more noticeable to me because I do have alot of native hair, and i remember where my hairline used to be on my forehead bone. Now the native hair is a little behind the spot it used to be, due to donor tension.

Edited March 31, 2011 by akuma