Scar Revision Question to Physicians or Members of this forum

[jro]

Hi Everyone,

 

When having a scar revision from ear to ear done,is it best to do the whole scar or is it best to do half the scar, then 6 weeks later do the other half.

 

Ive been seen by a few physicians and they all say different things. To get the best possible scar, some say it does not matter you can do the whole scar. Having it done in 2 sessions will not make a difference. The others say you need to do it in 2 sessions for the best possible scar.

 

Does it matter?

 

Thanks

Edited December 1, 2012 by jro

[jro]

Hi Again everyone,

 

Does anyone know what is the best way to do a scar revision? Can a HT Physician give me some advice on this subject. I have a scar 7mm from ear to ear. Been told different ways to approach the scar but there should be just one answer to this.

 

Does it matter?

 

Thanks so much for your advice?

[ej]

hi , i think it depends on your scalp laxity , my opinion is that there is a higher risk of stretching again , if you revise it in one go , theory is if its stretched once highly likely to stretch again ,

i have heard some Drs prefer to excise the strip scar in two, or more procedures, to be on the safe side and reduce the possibilty of stretching again

 

I would take your time and get your laxity assessed with a few Drs , my experience was that my scalp was too tight for revision , so i opted for beard fue into it that has worked quite well

 

hope this helps

 

ej

[Blake Bloxham]

Who said to do it in 2 sessions? I feel like taking care of it in one session would be better. Additionally, are you undergoing additional FUT with the procedure?

[jro]

Thanks ej, it has stretched again but do you think a different method of closure could make a difference?

 

 

Hi Future HT Doc

 

I went to two cosmetic physicians in my local area( not recommended here) and they both said that i needed to divide the closure in two sessions to get a good result. it would not put tension across the whole back and sides.

 

I went to a HT Physician recommended on this forum and he said it would not make a difference. He said moving your head ( chin down) only effects the back not the sides.

 

also, here in the forum under scar repair search. Janna with the shapiro medical group said with scar repair they did the sides first then 6 months later they did the back in one case.

 

Before it was just a regular tricho closure with no deep sutures but i been told they would close it with deep sutures. Could that make a difference?

 

I need some hair but i think im going for the scar repair only. You can't have hair and get a approved scar. Im want a better scar. . Im not a expert on scar repair but i would think that everyone should be on the same page with repairing a scar. (the whole scar or divide it in two sessions).

 

Thanks guys, i appreciate your advice.

 

 

 

Jro

[Dr. Ricardo Mejia]

Stretch scars can happen irregardless of the type of closure. My technique for minimizing this problem is to reduce the tension as much as possible. This involves a layered closure technique not just in the subcutaneous layer, but also the galeal layer to hold more of the tension, a 2-0 vicryl stitch will hold the tension longer than a 4-0 vicryl stitch, so the type o f sutures can also make a difference. Focus on minimizing the tension by removing small amounts at a time whether it is by width or dividing the scar in parts. Even after all the above techniques are used, the risk of a stretch back scar is possible. However, I have good success with the above. I typically prefer to do as little as possible which is contrary to what patients want which is to get it all done at once and do more hair transplants at the same time. Focus on just the scar revision. A lot of physicians do not use deep sutures noting that the results are good enough. As a dermatologic surgeon, in all my plastics closures, I prefer a two layered closure which adds more value and results in my closures. Many plastic surgeons doing hair sometimes do not use deep sutures as noted above, the results are good enough. However, they would never do a facelift without a two layered closure or deep sutures. It all comes down to providing support in the deeper layers to minimize tension on the epidermis. Hence this I my philosophy in the donor area and it works well in my practice.