Regular Member Dr. William Lindsey Posted July 15, 2013 Regular Member Share Posted July 15, 2013 This 16 year old son of a local doctor and his 18 year old brother (case 2 to be presented in a few weeks) both had lesions excised from their scalps by a local dermatologist. This evidently left a fairly large bald spot. A local plastic surgeon then did a z-plasty to narrow, but lengthen, the bald area. Both young men ended up with a small hypertrophic scar with no hair growing in it. After discussion with the parents about simply camouflaging this area with surrounding hair, both chose to proceed with a small FUE case. Today we did roughly 90 doubles, and 60 single FUEs using a Feller 0.9mm punch uneventfully. We’ll see him back for postop pics next week when his brother’s case occurs. I expect to be able to post periodic updates this year. Although FUE is variable, and putting hair in a fairly hard scar is variable, given how they’ve scarred in the past, I did not offer strip as a harvest technique. 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 TakingThePlunge Posted July 15, 2013 Senior Member Share Posted July 15, 2013 Interesting case Dr. Lindsey! I wish the best for both of these young men. David - Former Forum Co-Moderator and Editorial Assistant I am not a medical professional. All opinions are my own and my advice should not constitute as medical advice. View my Hair Loss Website Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 16, 2013 Senior Member Share Posted July 16, 2013 Very interesting case! 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 July 29, 2013 Author Regular Member Share Posted July 29, 2013 So here is a 10 day update. Mom is somewhat nervous about cleaning so its crusty...They are off to the beach this week and that should take care of the scabs. The donor site is well healed as expected. We'll see them in a few weeks and then at Christmas break from school. Given that we put FUEs in scar...it will likely take a while for growth to occur. 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 nathaniel Posted July 30, 2013 Senior Member Share Posted July 30, 2013 Dr. Lindsey, what is a z plasty? given how they’ve scarred in the past, I did not offer strip as a harvest technique. Are people who are prone to scaring (for example keloids) prone to bad strip scaring? Thank you! Nathaniel Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted August 29, 2013 Author Regular Member Share Posted August 29, 2013 A z-plasty is a technique for decreasing the width of scars and changing their orientation on the body, but at the cost of increasing the overall length of the scar itself. Google the term and you'll see lots of examples. I've been doing facial plastic surgery for 18 years now and have used a z plasty on 2 or 3 occasions, primarily for scars near the laugh lines on the face. I think that its a good technique, but like a lot of plastic surgery manuvers...its easier to draw on paper than to carry out on a 3 dimensional piece of tissue. For scalp scars I personally have never used it for precisely the reason these boys are at my office...I think it would leave a longer scar deficient of hair. I'd almost certainly push for excision of the scar, possibly in 2 or 3 surgeries so as to limit the length of the scar, yet still remove as much of it as possible, then do a small hair case like these guys received. 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...
Regular Member Dr. William Lindsey Posted January 6, 2014 Author Regular Member Share Posted January 6, 2014 Here's a 4 month update. He's got some growth, we'll see him again next summer. 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...
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