My WHTC + Dr Mwamba - Strip scar repair by grafting

[Dr. Patrick Mwamba]

Our patient had a previous strip surgery prior to contact us.

During consultation, we noticed poor growth in recipient area with micro scarring and bad angle.

In the donor area, he had a thin linear scar of 3mm wide and 13 cm long.

He had coarse hairs and good donor density.

His goal was to fill in and recreate a new hair line and because he likes short haircut, to hide the donor scar.

We recommended grafts both the frontal zone and the scar by FIT shaven technique.

Results in the front was still poor and we modify our plan to do small sessions with injections of Acell to improve results .We already did 2 sessions and we will present this case later on if needed .

 

Our focus today is the results we get in the donor from scar grafting.

The scar surface was about 3.9 cm2 (13cm long/3mm wide) .Knowing that grafting at low density (beneath 30 Fu/cm2) lead to better yield, we decided to graft at 25 Fu /cm2 .The total number of grafts in the scar was 101 grafts.

What lessons do I want to share here?

1. Scar of 3mm is acceptable and it was also flat .But the contrast with the skin color and the anatomy of the scar (linear) attracts our sight and reveals it.

At the end it bothers the patient because it doesn’t look natural.

2. Grafting the scar improved the scar color and just with low hair density, we broke the contrast and it looks pretty much invisible.

3. We also noticed FIT /FUE scars also known as white dots .They are present in this case .Their anatomy blends easily with the surrounding area and it doesn’t attract our sight .Therefore it looks natural and normal and no one will pay attention to them .They are present but not noticeable .And our patient can have a short haircut as he wanted.

 

 

 

 

 

 

 

 

 

 

[Blake Bloxham]

Fantastic camouflage! Thank you for sharing.

[Mickey85]

Wow... very very nice. Disguises it VERY well. And only 101 grafts? Were mainly multi-hair grafts used?

[Dr. Patrick Mwamba]

Yes , it was .The patient had a very high calculated density ( i.e. number of hairs per grafts ) averaging 2.2 .

We cherry pick the big groups to achieve a better coverage in one pass .

Thank you for your comments .

[Mickey85]

Very clever. Thanks for personally answering the questions Doctor. VERY impressed with this repair case.

[HARIRI]

Great work Dr. Mwamba, Can you let me know out of these 101 grafts, which ones were double and triple? Or the overall hair count please. My scar needed 700 chest grafts which basically all single!

[JohnnyDrama]

Very impressive work Dr.

[irishsailor]

Great result.

[chrisdav]

One of the best cases I have seen for grafting into a scar.

 

It is non-existent now.

 

Very impressed Dr.

[WHTC-7706631290]

Far too many patients come to us after being told that they will have a pencil-thin strip scar if they were told of any chances of linear scarring at all. Many times the scar will stretch over time and the patient can never wear their hair short on the back and sides. Sometimes the orientation of the hair in the donor zone can be skewed because the hair above and below the scar can be misangled. This isn’t fair to the patient because they should be given full disclosure of all possible after effects of strip surgery.

 

To treat strip scars, we usually can achieve significant improvement with two small sessions of grafting by FIT. The approach to add lower density over more than one session has allowed us to conclude that the transplanted grafts have a much higher survival rate and better blood supply. Strip scars can usually be treated after six months.

This is an inspiring result because there are many patients who don't have the freedom to wear it shorter in the back. Not only will this patient be less self-conscious about being discovered in public but the patient can also walk away from any further surgery with a pristine donor area. I would speculate that most barbers couldn’t detect that there was any surgery ever performed on this patient.

 

This case provides significant hope that the latest advancements of our follicular isolation technique (FIT) procedure are in fact helpful to improve the aesthetics of our patients’ results in both the donor area and the recipient region.

 

 

 

New - London consultations with Dr. Patrick Mwamba - Sat., Feb. 15th, 2014

[WHTC-7706631290]

This is a great example of showing how an FUE donor area looks when it is in fact shaved down extremely low. I believe that every patient who seeks surgical hair restoration should see just how visible the effects of an FUE procedure can be. More specifically, this is a close and realistic view of an FUE & FUT harvested donor area that many fellow forum viewers only hope to see from a clinic. Many people don't know that there will always be a scar after any surgery is performed. The question is how visible will a wound be after it has fully healed. FUE isn’t flawless, but it does produce better aesthetic results in the donor area than FUT a.k.a. strip.

[Arrie]

Amazing!!!!

[sl]

Nice result Dr.Mwamba.

[Mickey85]

Far too many patients come to us after being told that they will have a pencil-thin strip scar if they were told of any chances of linear scarring at all. Many times the scar will stretch over time and the patient can never wear their hair short on the back and sides. Sometimes the orientation of the hair in the donor zone can be skewed because the hair above and below the scar can be misangled. This isn’t fair to the patient because they should be given full disclosure of all possible after effects of strip surgery.

 

 

 

So true.

[WHTC-7706631290]

This is a legit representation of donor harvesting by FUE (non-strip) method. The patient's donor was harvested by significant amount of grafts. The extractions were dispersed over the patient's entire donor zone. I tend to think of this one example of donor scar grafting as actually two commendable results in one. The complimenting donor healing and the camouflaging effects appear to be exponential. The scar looks acceptable for just one hundred and one grafts (a handful) that were placed inside of it. Dr. Patrick Mwamba did an excellent job for sure.

 

 

 

 

 

 

 

Free London consultations with Dr. Patrick Mwamba - Sat., Feb. 15th, 2014

[WHTC-7706631290]

The density of the graft placement was 25.8cm2 so that puts the hair density or the number of hairs per graft at about 3.7 This is an acceptable result considering the uniformed appearance and condition of the scar. It’s not always easy for patients to hide or explain a strip scar. The majority of strip patients are fully aware of this disadvantage prior to the procedure but a few of them aren’t. A lot of patients have the intention of wearing it longer in the back so the scar doesn’t pose any issues.

[MyWHTC-HairlossClinic-0f-B]

 

Although not perfect, the improvement is noticeable even after one hundred plus FUE by FIT extractions.

[MrGio-WHTCClinic]

Far too many patients come to us after being told that they will have a pencil-thin strip scar if they were told of any chances of linear scarring at all. Many times the scar will stretch over time and the patient can never wear their hair short on the back and sides. Sometimes the orientation of the hair in the donor zone can be skewed because the hair above and below the scar can be misangled. This isn’t fair to the patient because they should be given full disclosure of all possible after effects of strip surgery.

 

So true.

 

Even if all a clinic does is tell them that the average strip scar is between 3 to 4 mm wide and 13 cm long, a patient could at least understand that the scar will require them to wear their hair longer in order to conceal it.

 

A patient would realize how the attention and concern might probably shift from the transplanted recipient area to the donor scar.