Steroid injection into strip scar?

[LondonHTseeker]

Hi peeps

 

It's been a while since I posted here. A couple of weeks ago I got my third strip surgery with Dr Feller in New York, around 700 grafts into the hairline. It went smoothly and now I'm just waiting out the result.

 

Thing is I can tell that my body's screwing up the donor scar again, because since I took the staples out at 14 days the scar has been thickening up and is probably in the process of stretching. I'm due to get steroid injections into the donor scar on Thursday from a plastic surgeon on Harley Street here in London. I know this surgeon and he's trustworthy.

 

Does anyone know of the effectiveness of steroid injections for this issue? I haven't asked Dr Feller yet; I figured I'd just come straight here and ask.

 

Thanks.

[Shampoo]

I haven't asked Dr Feller yet; I figured I'd just come straight here and ask.

 

 

why would you make an appointment with another doctor about a problem with your hair transplant surgery before talking with the doctor that just recently performed your surgery? (Dr. Feller)

[LondonHTseeker]

Because I know about steroid injections from experience and I think they can help here.

[Shampoo]

Setting up an appointment with a different doctor to work on a problem from a very recent hair tranplant without even discussing the problem with your hair transplant doctor, especially one as highly regarded as Dr. Feller seems rather reckless. In my mind a call to Dr. Feller would have been first, not posting on here for medical advice and going to a different doctor without consulting with Dr. Feller. Good luck dude.

[LondonHTseeker]

Thanks for the information there Dr Feller. I understand it's physiology and my scalp's propensity to form keloids, that's what I thought (I knew it was no fault in the scar closure). I'll give the steroid injections a shot, can't do any harm as I've had a lot from this surgeon before in a different scar elsewhere on me and it gave some good results.

 

Thanks for the figger wagging there Shampoo mate, but in my opinion a few careful steroid injections from a quality plastic surgeon is hardly 'reckless'.

[LondonHTseeker]

P.S. Hope the hurricane hasn't been too damaging for you Dr Feller...

[Shampoo]

Thanks for the figger wagging there Shampoo mate, but in my opinion a few careful steroid injections from a quality plastic surgeon is hardly 'reckless'.

 

London I hope it works out for you. I just find it very odd that patients sometimes seek medical help elsewhere and on message boards BEFORE consulting with the doctor that actually did the recent surgery.

 

I guess now via a message board question you have your answer from Dr. Feller: "giving steroid injections post operatively is not normal operating procedure".

 

At the very least I would wait a few days and speak with Dr. Feller directly and get his full thoughts on what you are about to do which is "not normal post-op procedure". No matter what you decide...good luck.

[Dr. Glenn Charles]

How long has it been since your procedure? I recommend waiting for quite a while before considering any steroid injection into any scar.

[Shampoo]

How long has it been since your procedure?

 

Dr. Charles he stated "couple of weeks ago I got my third strip surgery with Dr Feller in New York, around 700 grafts into the hairline".

 

And he says he has an appointment to get injections from a different doctor into the scar day after tomorrow.

[LondonHTseeker]

Hi Dr Charles, the operation with Dr Feller was three weeks ago tomorrow. Why do you recommend waiting please? I was thinking it would be good to catch the scar early before it thickens up and stretches too much but then I'm not a doctor so I may be wrong.

[bonkerstonker]

I don't see how a steroid injection would help stop your scar stretching it would help with a infection but thats about it imo.

[LondonHTseeker]

They can sometimes dissolve scar tissue, which might stop the scar from becoming thick and stretching.

[Mickey85]

FUT for 700 graft??

[LondonHTseeker]

OK, so tomorrow I'm going to see the surgeon for steroid injections - if he agrees that they are appropriate. I hear Dr Feller's advice that they are unlikely to do much at all, but I figure it's worth trying just in case.

 

I'm a little concerned by Dr Charles' suggestion that it's too early for the injections, but I've googled it and haven't seen anything advising against steroid injections into a scar at 3 weeks. If anyone knows of a reason why I shouldn't do it I'd be grateful to hear it.

[LondonHTseeker]

Yep, Mickey, well it was a scar revision of a previous FUT donor scar as well, so definitely worth the FUT method.

[Mickey85]

Did Feller do all your strip procedures? So sorry to hear about the scar stretching man. My scar stretched too so I can totally empathize...

[LondonHTseeker]

Well I don't think the scar has actually stretched yet. So far it's looking much better than previous scars and I'm hopeful it's going to stay thin. But there is some lumpiness starting to form and I'm trying to nip any potential stretching in the bud with the steroid injections. Yes, Dr Feller has done them all and the results are very good because I have very fine hair which requires a lot of grafts to achieve density; and the recipient area has always healed extremely well.

[Mickey85]

Dr. Wesley used cortizone injections to fix a patients really big scar with good success, although it had to be administered regularly after the procedure. Not too sure about the details of it though.

[Janna]

Hi LondonHTseeker,

 

You really do not want to inject your scar line with steriod at this time. 3 weeks post op is way too soon like Dr. Charles advised. Your scar is still healing. It will contintue to heal on the inside for 6-8 months. You could do more harm now by injecting steriod than good. What you may be experiencing now is shock loss of native hairs around the scar line. Those hairs generally come back in 2-3 months.

[LondonHTseeker]

Thanks for the information, Janna. So now I'm thinking I should cancel the appointment. But I find it a bit confusing because I know surgeons often inject post-rhinoplasty noses with steroids only a few weeks after the operation, to good effect. I'm not concerned about shock loss, it's the lumpy scar tissue reforming around the incision line that worries me. I guess I should give it a while longer though. Yeah, I'll cancel for now.

[Janna]

The steroid injection won't prevent your scar from stretching or make it heal better. It's really for minimizing thick scar tissue. Did you check with Dr. Feller on what you should do? I highly doubt he would want you to have the scar injected while it's still healing.

[Dr. Glenn Charles]

I have never heard of steriods used to prevent scar formation. It is used in some cases after the scar has fully formed. It takes much longer than three weeks to determine what kind iof scar you will end up with. I would also be concerned with avoiding excessive flexion of the neck to minimize widening of the scar.

[LondonHTseeker]

Thanks for the advice, I cancelled. I agree the scar could be made worse by injecting it so early after the operation.

[bonkerstonker]

Why don't you try a steroid cream i have some at home from when i had a bit of psorisis might put it on the small section of my scar thats slightly stretched to see if it calms the redness a bit.

[Dr. Carlos Wesley]

The advice you've received from Janna and Dr. Charles has been very sound: contact your surgeon, Dr. Feller, first before taking additional steps.

 

That said, you're right, LondonHTseeker, about the benefit of steroid injections as an adjunct to scar reduction to camouflage facial scars. You mentioned noses. I know of a couple plastic surgeons who published on the benefit of steroid (triamcinolone acetonide) injection used along with surgical scar reduction and have attached their before/after pic.

 

Because corticosteroids reduce the main culprits in scar formation (fibroblasts and collagen), a number of surgeons use steroid injections to treat hypertrophic (thick) scars either alone or along with surgical scar reduction. It's important to reassess the scar every 4-6 weeks if you're doing this until the scar tissue stabilizes. In our office, we do occasionally incorporate intralesional injection of steroids with surgical donor scar reduction. Our patients are asked to return to the office about 5 weeks postoperatively to determine if any steroid injections are merited.

 

Good topic!