Too far gone for a scar revision?

[spartan13]

I was hoping some of this would fill in, but now that I am closing in on 15 weeks post-op I've resigned myself to the fact that this is the best it will get and began researching scar revision. There's a ton out there, but many of the pics/videos I've seen that indicated a "wide" scar were still only about half the width of the empty patch I've currently got. The average width of my scar is about one full inch, though behind my right ear (the left side of the attached pic) it extends even farther...maybe 1.5 inches. Can this possibly be fixed?

[Aftermath]

At 15 weeks its likely you will have some shock loss there so this may improve a bit over time. Who was your surgeon? have you contacted them for an opinion?

[Spanker]

Are those three stacked scars?

[spartan13]

At 15 weeks its likely you will have some shock loss there so this may improve a bit over time. Who was your surgeon? have you contacted them for an opinion?

 

Dr. Haber in Cleveland was my surgeon, although the lower ones were from prior surgeries. I have not contacted him figuring I will wait until my 6-month follow-up as I'm not sure what he could tell me anyway. Frankly, I doubt I would go back to him if a revision is even an option for me.

[spartan13]

Are those three stacked scars?

 

They are. What's weird is that I still never had such a gap until this last surgery. So...is this beyond hope?

[Aftermath]

They are. What's weird is that I still never had such a gap until this last surgery. So...is this beyond hope?

 

Why on earth didn't your surgeon excise old scars while performing new strip ops, surely this is standard procedure? Every strip surgery I have had, they have always excised the previous scar! 3 scars in a row is bordering on negligence IMO.

 

As far as repairs, I'd get a better series of pics and email dr Lindsey for an opinion

Edited April 24, 2014 by Aftermath

[quidproquo82]

I don't understand why this was done this way. Why would the existing scar not be excised away with each new procedure? Please help clarify.

[Garageland]

Spartan,

 

Thanks for the photo it is a little unclear as to the extend of your scarring are you saying the 3 scars are around 1- 1.5 inches in total or are you saying that is the result of your last surgery?

 

You may still have some shock around the last scar that should grow back but it can take to around 7 months to fully recover. Were you aware the Doctor was taking a new scar above the two older ones that you had? If he made you aware of that then it would possibly been done for two reasons firstly you both choose that you wanted more grafts and were not concerned about the previous scarring or the old scars were simply too low and in the wrong place for revising.

 

As for a revision now it really depends on where the scar(s) are located if the first two are below the bump then you may not be able to improve them with a revision and placing grafts into them via FUE would be your best option. It also depends on what your donor supply is like and whether you wish to use grafts into the scars, do you require more work in other areas that concern you more?

 

I would wait it out for the 1 year mark to assess your results and see what the scar is looking like then before making any further decisions.

[Garageland]

Quidproquo82,

 

In most cases the Doctor will remove the previous scarring ie a patient going back to the same surgeon for a second session will remove the old scar and utilize the grafts available around the scar leaving only 1 scar. In some cases of patients that had older work done or went to the wrong clinic the scar is just not in the correct position.

 

I have seen scars that are below the bump and more on the nape of the neck the skin is not so tough here and is liable to stretch add to that in cases of advanced hair loss the nape hair around the neck is not always permanent.

 

Not saying this is the case for Spartan but could be an explanation but I expect the case might well be to remove the two old scars would just not of yielded many grafts even if it was possible.

[Garageland]

Quidproquo82,

 

In most cases the Doctor will remove the previous scarring ie a patient going back to the same surgeon for a second session will remove the old scar and utilize the grafts available around the scar leaving only 1 scar. In some cases of patients that had older work done or went to the wrong clinic the scar is just not in the correct position.

 

I have seen scars that are below the bump and more on the nape of the neck the skin is not so tough here and is liable to stretch add to that in cases of advanced hair loss the nape hair around the neck is not always permanent.

 

Not saying this is the case for Spartan but could be an explanation but I expect the case might well be to remove the two old scars would just not of yielded many grafts even if it was possible.

[Mickey85]

Sometimes a surgeon cannot or will not remove previous strip scars if they are placed too low. That area is prone to stretching due to it being connected to the neck muscles and making the excision in that area again will most likely lead to the new scar also stretching. In cases like these, I think the surgeons should not recommend strip for a patient, because they will have more than one linear scar, but that is just my opinion. Sadly, I don't see how these 3 scars can be solved with a revision, stretchback is not uncommon even if a scar is placed right on the occipital region, let alone low on the donor.... You could look into grafting body/beard/some scalp hair into it along with SMP. Cases like this really make me sad..

[spartan13]

Sometimes a surgeon cannot or will not remove previous strip scars if they are placed too low. That area is prone to stretching due to it being connected to the neck muscles and making the excision in that area again will most likely lead to the new scar also stretching. In cases like these, I think the surgeons should not recommend strip for a patient, because they will have more than one linear scar, but that is just my opinion. Sadly, I don't see how these 3 scars can be solved with a revision, stretchback is not uncommon even if a scar is placed right on the occipital region, let alone low on the donor.... You could look into grafting body/beard/some scalp hair into it along with SMP. Cases like this really make me sad..

 

I've been thinking about the body hair/SMP thing more most recently because I'm just not sure that I want my scalp cut anymore, even for a revision. My surrounding hair is still thick enough that it is relatively easy to hide as I've always worn my hair longer, so I feel like that gives me time to make an informed decision without the scar affecting me day to day in the meantime.

[spartan13]

Spartan,

 

Thanks for the photo it is a little unclear as to the extend of your scarring are you saying the 3 scars are around 1- 1.5 inches in total or are you saying that is the result of your last surgery?

 

You may still have some shock around the last scar that should grow back but it can take to around 7 months to fully recover. Were you aware the Doctor was taking a new scar above the two older ones that you had? If he made you aware of that then it would possibly been done for two reasons firstly you both choose that you wanted more grafts and were not concerned about the previous scarring or the old scars were simply too low and in the wrong place for revising.

 

As for a revision now it really depends on where the scar(s) are located if the first two are below the bump then you may not be able to improve them with a revision and placing grafts into them via FUE would be your best option. It also depends on what your donor supply is like and whether you wish to use grafts into the scars, do you require more work in other areas that concern you more?

 

I would wait it out for the 1 year mark to assess your results and see what the scar is looking like then before making any further decisions.

 

The three scars together are a combined 1 inch, with the very right side of the scar creeping up closer to 1.5. What I was trying to get at was that I had never noticed any significant level of scarring in my donor region prior to this last HT. For some reason this last one seemed to magically expose everything else that had been done previously. It is sparse right under the newest scar, so maybe you are correct about it still being shocked, and that is why I'm noticing all this now.

 

At this point, I'm leary of getting cut anymore, so I may look to FUE some day to help fill things in. It will depend on how successful or not this last HT is. If I don't get any yield from it, then I will likely just look into undoing the 90's work if possible (pitting and larger grafts) and be happy with a balding head. If that comes to be, then I wouldn't mind using FUE grafts in the scarring area. If it produces some results so that I have a normal, mature looking front 1/3rd, then I might not want to use grafts in the scar.

[StaggerLee123]

What does the front look like? Unfortunately those scars can't be combined at this point, I have two stacked scars so I know how it is... crappy. FUE into your scars would be the way to go if you have the donor left, I probably wouldn't attempt another strip surgery.

[spartan13]

What does the front look like? Unfortunately those scars can't be combined at this point, I have two stacked scars so I know how it is... crappy. FUE into your scars would be the way to go if you have the donor left, I probably wouldn't attempt another strip surgery.

 

I have a blog in which I've posted some of my pics at three months, which is my bottoming out point so far as that is when my shockloss finally subsided. I'll be posting monthly pics there, so I'll be doing 4 month ones next weekend sometime.

 

As you'll see from my picture of the back, I can still hide the scar pretty well, even from myself. I completely agree with you about strip. Even before this issue, I had resolved that this would be my final procedure to "bulk me up" a little and then not worry about my hair from then on. Because it isn't an obvious defect right now, I'm going to just let it be until at least Fall to see if there is indeed some shockloss that might grow back and mitigate it some.