trichophytic closures

[hairgirl08]

does every doctor who knows the trichophytic closure use this?

if not, why not?

[hairgirl08]

does anyone know anything about this?

[Dr. Glenn Charles]

There are several different ways to suture the donor wound in a hair transplantation procedure. Some doctors have tried and it did not get as good of a result as their previous technique. It is the kind of technique that if not done properly may lead to more problems later on. Others feel that if a patient is likely to need several procedures that the trichophytic closure should only used on the final surgery. There are some two layer closures being used today that leave a donor scar that is very difficult to find.

[NEWHAIRPLEASE]

The two layer closures I've seen have been virtually impossible to find?

[aaron1234]

I did have trich done for my 2nd procedure and it didn't turn out so great. However, I just had a double-layer closure done with my recent surgery and my scar is doing much better already. It also depends on patient physiology. For some, trich is the way.. for others, it is not.

[hairgirl08]

when you say it didnt turn out so great, do you mean you still got a scar? and the hairs didnt grow?

what kind of problems can happen if its not done properly?

do doctors do double-layer closure if they dont use the trichophytic closures?

[Blake Bloxham]

Thank you for the input Dr. Charles!

[NEWHAIRPLEASE]

Hairgirl, when there is a cut on your body, there is ALAWAYS gonna be a scar! It may be less noticeable with trycho or double layer closure, but there will always be a scar.

[NorwoodBalding]

Just a side note, it's really refreshing to see doctors like Dr Charles visiting forums like these, it just demonstrates to me that they have client satisfaction in mind. And also, it really separates them from all the corporate entities out there who have love only for capital.

 

Thanks greatly Dr Charles for reassuring troubled sufferers like myself.

[NEWHAIRPLEASE]

Yes, thanks to all the doctors for their input on this forum.

[aaron1234]

Yes, trich or no trich you will have a scar. I have a tendency for larger scars and my skin is sensitive. The benefit of trich is having hairs grow through the scar to diminish its detectability. Hairs grew through my scar but not enough to make a difference. Plus, having hair grow through my donor wound caused some skin irritation. My scar wasn't bad, just having the trich didn't achieve it's purpose with me.

[Cam Simmons MD ABHRS]

...do doctors do double-layer closure if they dont use the trichophytic closures?

 

hairgirl08

 

A trichophytic closure is ANY closure that results in hair growing through the scar. It literally translates to "hair-loving" closure. It can be done with staples or sutures and can have one-layer or two-layers. The tips of the hairs and the surface of the skin can be removed from the upper edge, the lower edge or both and there are many ways to remove that narrow, superficial ledge.

 

If I had to choose between having a narrow scar with no hair or a wide scar with hair growing through it, I would choose the narrow one. Fortunately we can usually create narrow scars with hair growing through them.

 

Some patients have medical conditions that predispose them to make wide scars so doctors ask about that possibility before planning any surgery.

 

To prevent wide scars in otherwise healthy people, it is most important for the closure not to be tight and to avoid taking too wide a strip of skin away with respect to a given patient's scalp flexibility. If a doctor takes a narrow strip then pulls the sutures too tight he or she can still make a wide scar. Other techniques that are used to minimize tension on the surface are to either undermine the edges or to use a layer of sutures to hold the deeper layers together so the outside sutures (or staples) have less tension on them. Different doctors find different techniques work best for them. I have tried many techniques but find that in my hands a 2-layer sutured closure produces narrow scars most consistently. I do a 2-layer closure for all of my patients.

 

After the deep layer, I test how easily the edges come together. If they can overlap, I remove a 1 mm ledge from the bottom edge so that the trimmed hairs will grow through the scar. I then suture the surface layer without tension. If the skin edges ever just come together, I recommend against taking more skin away to get a trichophtyic closure so we can avoid tension and keep the scar narrow. I do a trichophytic 2-layer closure for almost all of my patients. Sometimes when we are trying to get as much hair as safely possible we start out hoping to be able to do a trichophytic closure but change to a non-trichophytic closure if needed. It is always an option to revise a narrow non-trichophytic scar and turn it into a narrow trichophytic scar later.

 

In summary, you don't have to choose between a trichophytic closure and a double-layer closure. You can have both at the same time.

[NEWHAIRPLEASE]

Good explanation Dr Simmons.