In "FUT regardless the number of procedures the patient is left with only 1 scar" ?!

[Lotsofhair]

Hello everybody,

 

According to Bernstein Medical "with FUT, the first scar is completely removed in the next procedure. Even though the scar may be longer in the next session, with FUT, regardless of the number of procedures, the patient is left with only one scar"

 

I cannot make sense of that. How is that even possible? I'm confused.

 

I thought that 2 FUT = 2 scars (one on top of the other), 3 FUT = 3 scars, and so forth. Makes sense?

 

Ok, I possibly get the "the scar may be longer in the next session" but what if the 1st session was already a mega session and the longest possible scar was already produced. Then what? The argument just confuses me. I'm interested what the doctor means exactly and how he would make such a goal possible on a purely physical basis.

 

I've seen pictures of patients with exactly that : 2 or 3 scars in the back of their head and I assume that each scar is the product of a single HT.

 

Please somebody help and shed some light on the issue. Thx so much!

 

 

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full post :

 

"With each subsequent session, the scarring in FUE is additive

• For example, if the first FUE session is 2,000 grafts, there will be 2,000 tiny round scars. With a second session of 2,000 grafts, there will be a total of 4,000 scars

• In contrast, with FUT, the first scar is completely removed in the next procedure. Even though the scar may be longer in the next session, with FUT, regardless of the number of procedures, the patient is left with only one scar"

 

Source : FUE vs. FUT Pros and Cons of FUE Hair Transplant vs Strip Harvesting | Bernstein Medical - Center for Hair Restoration

[StaggerLee123]

If done correctly the patient will have one scar after consecutive procedures. Once the initial donor is taken and sewn/stapled up the result is a single scar. During the next procedure the surgeon takes the donor from either side of the scar basically removing the old scar and then the wound is closed pulling the skin together and forming a new scar where the old one was previously.

 

The pictures you see of patients with two or more different scars are usually from botched operations where the first incision may have been too high or low on the head (out of the "safe zone") and the second procedure was taken slightly lower or higher on the head and they weren't able to combine the two.

 

Also in the "bad old days" of hair transplantation some surgeons used a multibladed scalpel that would leave two scars that ran parallel to each other.

 

Comprende?

[Lotsofhair]

Oh! I think I get it! Thank you StaggerLee123!

 

I take it that when you say "the surgeon takes the donor from either side of the scar" you mean either slightly on top or bottom ; not left or right, making it longer. The scar actually gets larger (ie. 1 cm -> 2 cm)...

 

Obviously this would lead to a more noticeable scare. But still only 1 which I suppose is better than 2! Very interesting.

 

Here's an article on the subject :

 

"There’s no doubt that one scar is the best for multiple hair transplants. However, subsequent sessions make the single scar wider depending on the width of the strip that is excised. A 1cm width strip will leave a minimal or invisible scar on average, whereas a wider strip will leave a bigger scar. The outcome of a single scar after two follicular unit transplant (FUT) procedures usually results in a donor scar that is wider than the original since the total width is doubled, more or less. Excising the scar from the first hair transplant is not easy since the hair follicles within the scar are not aligned in the same direction as normal hair follicles since they are embedded in scar tissue. Even with trichophytic closure, the hair follicles within the scar are in danger of transection. Careful dissection is very important to avoid damage to these follicles even though I use my open technique with the aid of skin hooks. I still have a hard time in some cases to try to dissect the follicles that are within the scar to avoid transection, since the hair direction of the follicle is distorted due to fibrosis. If we excise the strip and the scar is included at the center it would be much easier, in the same manner as if we avoided dissecting inside the scar. However, slivering a strip inside the scar is more difficult. When you encounter the scar, there is the potential for follicular transection.

In my opinion, if the scar is invisible, why bother to incise the same scar causing more potential for follicular transection. If we make a second scar, we do not encounter the old scar and there will be less potential for transection. If the patient needs further sessions, the two scars can be incorporated into one.

If the scar from the first hair transplant session is a little bit wider, I will use a single scar by excising the first scar and incorporating the scar inside the strip to prevent an even wider scar when it heals.

I always discuss with my patients prior to surgery whether they would want a single scar or two scars. Whether to do one or two-scar strip is still a debate. However, the majority of hair restoration surgeons as well as patients will select a single scar, if possible. The majority of my patients still have a single scar after subsequent sessions.

Dr. Damkerng Pathomvanich"

Will a Second Hair Transplant Result in Two Donor Scars? | Hair Loss Q & A

[Dr. Ricardo Mejia]

We typically plan the surgery with the intent to leave only one line. It is imperative when Starting with your first transplant that it is done correctly to assure future success of subsequent trichophytic incisions to leave a proper result. The line from the first surgery is removed with the second surgery.

 

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Assume the line above b is the initial surgery line. When we take a strip we take a rectangle shape from line A above to A below. The line scar from the original surgery is removed as part of the strip. This is a crude example but hope it helps to illustrate the point.

[MTL30]

if it's one scar or 2 scars who cares, FUT leaves a nasty cut that nobody wants to look at.

[Dr. Ricardo Mejia]

You are correct. Fortunately these days we have options for patients and advanced our procedures to have FUT one linear cut producing between 6000 to 8000 grafts which in most cases is hidden by the hair or you can have FUE with 6000 to 8000 punch cuts scattered through out the back which is also hidden by the hair. The advantage of fut is the hairs come from the safe donor area as opposed to outside the safe donor area which is more likely to miniaturize over time. Either way both scars either linear or punch scars are hidden by your donor hair.

[Lotsofhair]

Thank you Dr. Mejia your schema - aaaBBBaaa - was very hopeful! I do see exactly now what was meant by "removing completely the first scar". Very interesting!