Regular Member Dr. William Lindsey Posted April 9, 2013 Regular Member Share Posted April 9, 2013 This nice fellow stopped by with a bit of an unusual case. He’s in his mid 20s, and had a cyst taken off his crown a few years ago. He had a wide scar which he then had revised…and unfortunately that widened out too. He then had a popularly marketed FUE procedure which really didn’t result in much growth, and it appears he lost some significant donor density as seen on preop pictures. So this is tough because: 1. He is a poor scar former—so I’d not want to do any kind of strip case on him 2. He wears pretty short hair 3. He already has some donor density loss 4. He has a tough scar which is quite visible 5. He already had an unsuccessful FUE (and I’ve posted many times that FUE is more variable than strip), but is it due to the technique associated with the automatic FUE machine or will he get a poor response from FUE done by hand? We went over this in good detail and he opted to proceed. I think it’s unlikely that we’d deplete his donor region much more with a small FUE session spread over his entire donor area, AND I hope that we can make progress in addressing his scar. He’s an intelligent fellow, considered this option versus doing nothing and chose to proceed. Shown are preop pics, donor site pics, you might see some of the big scars from his previous FUE case in the shaved pictures, and postop pics. Also included are day 1 and day 7 pictures. His scar into which we placed the grafts had a good blood supply and I’m hopeful, but only time will tell. He lives in our area, and hopefully will come on and blog his experience and results regardless of the outcome. This is a tough case, but I’m optimistic we’ll accomplish something worthwhile. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted April 10, 2013 Senior Member Share Posted April 10, 2013 Nice work! Thank you for sharing. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted April 16, 2013 Author Regular Member Share Posted April 16, 2013 This was the easy part. Getting it to grow may be a bit more challenging. First he's had 2 poor scar outcomes and reasonably thick, but vascular scar tissue in the recipient site. Second he had a failed FUE before--albeit by an automated system that has its share of proponents and detractors. And third...its FUE, but there was no way I'd put a separate strip scar on a guy with this history of scar problems. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted May 16, 2013 Share Posted May 16, 2013 Dr. Lindsey's recap of my experience and procedure is 100% accurate - except that I am in my mid-30s (wish I was back in the 20s!). Dr. L was terrific to work with. He speaks candidly about your condition and the treatment options. Compared to my last doctor who did not spell out the whole process, this came as a much needed alternative. Speaking of past doctors, I won't name names, but do not try the Neograft system. After more than a year with that treatment, there was no noticeable regrowth. Dr. L and his assistant took about 6 hours in total and the procedure did not hurt at all. We were not able to harvest as many follicles as hoped, but we are hoping the results will still be good. In fact, unlike some docs who might say they will charge you a certain amount, Dr. L was honest about the lower than expected harvesting (if that's the right word?) and he charged me less money than I was expecting. I will post photos shortly but I have not seen much of a difference at this time. I realize it may take a few more months to begin to see growth. Here's hoping for the best! Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted May 16, 2013 Author Regular Member Share Posted May 16, 2013 Thanks for posting. As you and I discussed, you are a tougher than average customer in that you have had trouble with scarring--a couple of times, and a poor outcome with your previous case elsewhere, AND FUE is variable. But your grafts came out easily and certainly looked good. And your scar wasn't too hard and had a decent blood supply. I remain optimistic. Lastly, you are correct we got fewer grafts than our initial goal but your entire donor area had significantly thinned from your first case. I think we did the right thing by not expanding into other parts of your scalp in the hunt for more grafts to put into a scar. Dr. Lindsey William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted May 28, 2013 Share Posted May 28, 2013 Attached are photos taken on May 15. There seems to be progress, particularly on the right side of the scar. I will post again in a few weeks. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 3, 2013 Author Regular Member Share Posted June 3, 2013 Maybe wishful thinking but keep coming with the periodic updates. Thanks Dr. L William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member scar5 Posted June 3, 2013 Senior Member Share Posted June 3, 2013 He then had a popularly marketed FUE procedure which really didn’t result in much growth, And that would be of the Neo variety?. ... by any small chance? Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted June 19, 2013 Share Posted June 19, 2013 These photos were taken today. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 20, 2013 Author Regular Member Share Posted June 20, 2013 2 months down. Email or stop by late summer if you can. Thanks Dr. Lindsey William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted July 19, 2013 Share Posted July 19, 2013 Here are the newest photos. I believe there is improvement - and so does my wife (but perhaps she's just being optimistic!). I'll stop in next month for a visit to your office doctor. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted July 20, 2013 Author Regular Member Share Posted July 20, 2013 You may be right. Stop by. I'm not a great photographer as everyone knows...but using the same camera in the same lighting ought to yield a reasonable comparison at the 4 month mark or so. I just heard from a similar guy who really thickened up at 11 months..very similar case. And I posted an FUE into z plasty scar earlier this week and am doing his brother next week...both pretty similar to you. So yes, come on by sometime in late August. Thanks for the update. Dr. L William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member nathaniel Posted July 30, 2013 Senior Member Share Posted July 30, 2013 Speaking of past doctors, I won't name names, but do not try the Neograft system. After more than a year with that treatment, there was no noticeable regrowth. Scar5, there is no reason to speculate as to the "automated system"... Hope things continue showing promise for you! Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted October 22, 2013 Author Regular Member Share Posted October 22, 2013 So here are 6 month pictures. I believe the right side is denser than before and maybe I'm imagining but the left looks like it has hair growing as well. Granted it was a pretty tough scar, but appeared to have decent blood supply. We'll get another set of pics at 12 months and a final set at 16-18 months on this interesting case. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted October 22, 2013 Author Regular Member Share Posted October 22, 2013 Pics didn't "stick" on last submission. Maybe these will. Dr. L William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted October 26, 2013 Share Posted October 26, 2013 Updating the group with photos from today - about 7 months from surgery. Seems to be progress on the right side of the scar, and I am hoping to see more growth on the left in the coming months. Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted January 11, 2014 Share Posted January 11, 2014 Photo updates taken today - about 10 months from surgery. The scar area still seems to be a tough customer with growth. There are a few small hairs poking through though. Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted April 7, 2014 Share Posted April 7, 2014 Attached are the most recent photos taken today - one year from the FUE procedure. There seems to be continued growth on the right side of the scar, but the left continues to be stubborn. If in the end the scar area will not be receptive to regrowth, I wonder if could try scalp pigmentation to essentially hide it. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted April 7, 2014 Author Regular Member Share Posted April 7, 2014 I'm glad you did an update. We were talking about you last week and wondered how you are doing. Listen..putting grafts into that grissly (not sure if the spelling is off) scar means that it almost certainly takes more time for blood vessels to grow in and support the hair. Don't give up on growth in there for another 6 months or so...just as we discussed early on. AND I'd appreciate you stopping by sometime when its convenient. You are exactly where I thought you'd be at this 12 month time frame. Thanks for the update and do try to come by sometime. Dr. Lindsey William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted April 7, 2014 Share Posted April 7, 2014 Thanks Doctor! Didn't Tom Petty have a song about waiting be the hardest part? Not fully giving up, just considering fall back options. I'll swing by later this month. Link to comment Share on other sites More sharing options...
Senior Member Rootz Posted April 7, 2014 Senior Member Share Posted April 7, 2014 Best of luck with future growth, I hope the grafts pull through soon Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted April 8, 2014 Senior Member Share Posted April 8, 2014 Hopeful, Thank you for the update. Like Dr. Lindsey said, implanting into scar tissue is a bit of a gamble. It is difficult to know precisely what the vascularity is like and how the thickened tissue will respond to the grafts. I'm glad Dr. Lindsey was able to review your progress and offer his input. It sounds like good advice to me! I look forward to future updates. If you need help with anything else, please don't hesitate to ask. Best of luck! "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Regular Member Doug Monty Posted April 9, 2014 Regular Member Share Posted April 9, 2014 Dr. L was terrific to work with. He speaks candidly about your condition and the treatment options. Compared to my last doctor who did not spell out the whole process, this came as a much needed alternative. Speaking of past doctors, I won't name names, but do not try the Neograft system. After more than a year with that treatment, there was no noticeable regrowth. Dr. L and his assistant took about 6 hours in total and the procedure did not hurt at all. We were not able to harvest as many follicles as hoped, but we are hoping the results will still be good. In fact, unlike some docs who might say they will charge you a certain amount, Dr. L was honest about the lower than expected harvesting (if that's the right word?) and he charged me less money than I was expecting. I will post photos shortly but I have not seen much of a difference at this time. I realize it may take a few more months to begin to see growth. Here's hoping for the best! I am curious why the doctor was not able to harvest as many grafts as you might have hoped. 6 hours for 630 grafts seems like a very long time for such a small amount of Grafts. I think most posters would agree that this is a very long time for such a small amount of grafts. However after researching the doctor, the largest FUE case he has profiled on his website is only 750 Grafts. I was actually quite surprised at this. Considering how warmly he is received on the boards. I would consider this a Red Flag for FUE patients, especially those that need a lot of hair transplanted and quality growth all in one session (unless he just has not updated his website - then disregard). I think that most posters/doctors would agree that you should see more growth at the one year mark than what was shown. I did a side by side from your Pic #1 in your first post and your pic #2 from your last post and personally did not see a noticable difference. One of the questions I would ask, is, if the lenght of time for such a small case had any effect on hair growth? Seems like a "Red Flag" to me. Hope you have more hair growth at the 18 month mark. If not, I am sure the community could recomend another doctor who maybe specializes in transplanting into scar tissue. Note: I work for NeoGraft Link to comment Share on other sites More sharing options...
FUE-Hopeful Posted July 25, 2014 Share Posted July 25, 2014 Attached are the latest photos. Stopped in to show Dr. Lindsey in late May and we agreed to give it more time before reassessing next steps. Link to comment Share on other sites More sharing options...
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