Trichophytic closure-Is this ideal???

[Capelli11]

Hey All,

 

In my extensive journey to research the heck out of a HT...I have and still continue to be on the fence about FUT vs. FUE and which procedure would be ideal for my situation (anyone wanting to see my pics please see my previous postings). The thing about FUT has always been the scar but upon recently consulting with a doctor that is on this site, it has shed some new light on the topic.

 

My constant beef about the scar is not the scar so much itself (i.e. the thin white line) but how it visibly looks when say a patient has their hair on a 3 or 4 guard. I have seen many pics and a few in person while waiting for a consultation in that for some reason, you can see the infamous smiley face as the donor hair somehow almost pushes the scar appearance to the forefront (meaning the hair in the donor area for some reason seems to create a smiley face effect where you see the dark donor hair "smiling" at you but never really seeing the white scar line. Upon consulting with this doctor I mentioned above, I was kind of shocked when I was told that he doesn't use the Trichophytic closure and utilizes mainly the standard closure. I was intrigued as to why he uses this and he seems to indicate it is an overall better suture and he hasn't seen that "smiley face" appearance with it. I mean it seems to make sense that if there are no hairs growing through the scar the above hairs can cover it in their normal pattern instead of the newly growing scar hairs which can be distorted (see below)

 

I began to do some more research on Tricho scars to try to get to the bottom of why this smiley face occurs as it really is detering me from getting FUT and what the cause really could be. I researched Tricho and noted that there is a subtle but definite change in the direction the hair that grows through the scar making the scar line stand out from the surrounding scalp. Also that the hair angle distortion associated with strip harvesting is not negated with tricophytic closure. In fact this may be amplified with the misaligned hairs growing through the scar tissue. With that said, can anyone comment on this? It appears that hairs that grow through the scar appear to grow as outliers thus perhaps creating that "smiley face" push through appearance in the donor area.

 

I hope I got my point across as to how this occurs...the smiley face can also be noted as the look you get when you wear a baseball hat for too long...like that ring around your head. Any feedback will be greatly appreciated in that how you feel about your HT and scar if this smiley face happens to your head. Thanks!!!

[aaron1234]

You'll get the smiley face scar with strip no matter type of closure the doctors use. Tricho is not necessarily the best type of closure. Each doctor has his own preference and it also depends a lot of what the patient's physiology brings to the table. That said, most good doctors will give you a scar that won't be recognizable with a #4 guard - maybe even a #3. Dr. Shapiro was not very pleased with how my scar turned out from my first procedure with him but I still could barely see it with a #4 guard.

[scar5]

You didn't mention that the 'ditch' a kind of recessed valley that occurs along the scar line (unpredictable) is something that makes strip scars look worse than they really are because they add a shadow-effect so that the fall of the hair is altered along the strip line, accentuating the scarring.

 

In general, people are waking up the idea that trichophytic closures are not the big deal they are made out to be. That was not always the case, when the 'T' word became the catch-word for the strip industry for a time when it was under assault from the first wave of FUE in the states. And it worked. People believed that with Tricho, they would be good. At the same time, the first FUE clinics started to produce patients with large diameter 'dots' and with marketing, strip maintained its supremacy on the basis of - unbelievable at is seemed - because of scarring (not yield). We had people like Dr. Feller warning us that FUE scars MORE than strip, and Jotronic posting pictures of terrible dot scars (with disclaimer, that they were 'bad cases')

 

Scarring is unpredictable. My best scar, which is one of the best I have seen, and my worst scar, which was a disaster, come from the same HT doctor! Both non-tricho.

 

Then I have had tricho too, and whilst 60% of the scar is pretty good, the remainder has stretched. And even in the good bit there is a definite 'gully' or along the line. The skin, up to 1cm above the line is raised then gradually sinks as it reaches the gully. At certain angles, the scar would not be visible, but the valley draws attention to the scar itself. Even tattooing can do nothing to hide this. It requires injection of a gel under the scar to flatten it out. This is required every few years if I want to buzz my head.

[zo1279]

Wow...thanks for shedding more light on this topic! Sorry to hear about ur scarring...that is the one thing kind of holding me back...that infamous shadow that forms creating that smiley face.

 

Anyone else have this issue????

[ParraPhil]

I'm still yet to be convinced that slicing one's head open is a good thing ...

[orlhair1]

I almost did not get my HT because of concerns about my scar. I did have the option to do FUE, but decided against it after several consults, even though i thimk it is a great procedure also. I can tell you that yesterday (4.5 months post op) I tried to find my scar and it was difficult to locate. I have had a couple of pretty short haircuts without it being visible. I believe that is typical today with the top clinics, but any of the top surgeons will tell you that there is some risk for issues with the scar, some of which can be assessed based on risk factors inherent with the patient.

[RodG]

Hi,

 

I personally don't see the point in getting a really short haircut after a HT but that is your prerogative. If you definitely want a 3 or 4 cut then FUT may not be the way forward for you.

 

You haven't told us the amount of grafts that you require to obtain the result that you want. You also should have done research and understand that FUE will have a little lower yield and will leave some scarring. It is my understanding the FUE costs about double the price of FUT?

 

Good luck with whatever you decide.

 

Regards Rod