Want to get a second HT, should I go strip or FUE?

[jzachery@hotmail.com]

So here's my deal. I had a strip style hair transplant done a few years back. I'm pretty satisfied with the results in the front, but I really hate the scar in the back.

I want to get another hair transplant this summer/early fall and I'm trying to decide if I should get FUE to fill in the remainder of the front and the donor scar from the first surgery in the back. Or if I should get another strip technique with the Trichophytic Closure.

I like to wear my hair really short, right now I can't go below a #4 with buzzers around the donor scar, and I really want to use a #2 or ideally #1. Any suggestions or info on which technique would be better?

[jzachery@hotmail.com]

So here's my deal. I had a strip style hair transplant done a few years back. I'm pretty satisfied with the results in the front, but I really hate the scar in the back.

I want to get another hair transplant this summer/early fall and I'm trying to decide if I should get FUE to fill in the remainder of the front and the donor scar from the first surgery in the back. Or if I should get another strip technique with the Trichophytic Closure.

I like to wear my hair really short, right now I can't go below a #4 with buzzers around the donor scar, and I really want to use a #2 or ideally #1. Any suggestions or info on which technique would be better?

[jzachery@hotmail.com]

Also, I'm a weight lifter, and move heavy stuff for a living as well. So the downtime after strip is a huge concern.

[MrJobi]

First of all , if you are considering FUE you will pay about double the price of strip especially if you plan on filling in the scar which will take a considerable amount. I don't think you could ever go down to guard #1 once you have had a strip unless you have a damn good doctor to fill in the scar.

 

Who did your first surgery?

 

a good strip with proper T closure could allow you to clip down to about 2 or 3 an would remove the old scar.

 

Talk to a qualified doctor but Strip is always better value.

[jzachery@hotmail.com]

Dr. Leonard in RI did my first surgery. He was pretty good actually. The strip scar in the back isn't bad at all really, but it is noticable if I cut my hair too short. The Trichophytic Closure technique wasn't around then, this was about 4 years ago. I just moved to San Diego, and was checking up on Dr. DeYarman when I rediscovered this board.

 

Granted I would not want to throw money away, but to me, I'd rather spend the extra $ for a better procedure and have it done great.

If I got the Trichophytic Closure, what does that look like in the donor area after it's done? Is there still a strip where there is no hair? I heard there is not supposed to be.

[PLEASE GROW PLEASE]

The trico is overrated and and its best used on virgin scalps.

Dont get me wrong "when" it works to perfection its better then no tricho but dont count on it.

If you need over a 1000 grafts I would say go strip and see what the tricho can accomplish.

[Dr. William Lindsey]

I would agree with PGP on the issue of if you need a lot of hair, consider another strip. Maybe I'd say if you need more than 1500... but it depends on your scalp.

 

A good scar closure, whether Tricho or not, should allow you to cut your hair really short. The skill of the doc is part of it, but your own healing plays a role too.

 

If you have to do crunches and arch your back when benching...and won't take time off, your scar won't be as good as if you can just not "stress" the suture line for a while. I just took out sutures on a repair case, at day 6, and he is off to the gym right now--but has been told to not pull "my scar line".

 

Dr. Lindsey McLean VA

[TheEmperor]

BS on the scar closure. I had one of the best in the industry perform tricho and I cant go below 1.5 inches on the sides or the scar will show.

 

Its the thickness of a matchstick.

 

Lots of variations in scar width.

[coscanoer]

I think I would get FUE into the scar if I were you. 1.5 inches is too long.

[coscanoer]

Dr. Lindsey, how do you "not stress" the sutures? I'm trying to picture what exactly about weightlifting causes scar stretching. Can you give examples of exercises that would be appropriate?

[lost my swagger]

Originally posted by coscanoer:

I think I would get FUE into the scar if I were you. 1.5 inches is too long.

 

 

this has bothered me for some time now, please do not take offense coscanoer, im not trying to single you out... but i see advice like this handed out all the time for people with bad scars...."just go get some FUE thrown in there, fix it right up" or i see this gem... go throw some BHT into that scar beard hair is thicker so it will grow through"

 

id just like to ask how many PATIENT POSTED results we have seen from guys who had FUE into their scar..

 

this is somthing that is NOT as easy as it sounds...

 

1. fue into the scar means you will be scarring other parts of your scalp OR face during the FUE process.

 

2. beard hair may be thicker but c mon, is there really any concrete proof that it yields any better then head hair FUE into scar tissue???

 

3.. yield in scar tissue is inconsistant at best, so can one really count on achieveing enough density in the scar to be able to shave any lower without STILL having a noticable scar back there... seems to me buzzing shorter will do nothing more then expose the SAME SCAR YOU HAD BEFORE, only difference being that you will have the OCCASIONAL few hair grafts that actually grew, sticking out with unnatural density throughout the scar, leaving you with the same problem.. you have to gow your hair out longer, to get coverage

 

until i see otherwise from REAL patients, and not the one cherry picked result umar has posted where the guy has LONGER HAIR in his post op, im FAR FROM SOLD on FUE into the scar... its just not that simple...

 

B-spot--- a while back informed us that SMG was gonna be doing FUE into the scar, it was long enough ago that if he had ANY proof it was being done with great success he surely would have posted SOMETHING by now..... nothing

[PLEASE GROW PLEASE]

I had 350 or so fue thrown into my scar with a high growth rate Problem is 350 is a small number .

Im going again to do one more pass and hopefully break it up even more and have them take pics

I figure another 350 and Ill be set.

I havent seen alot of fue into scar pics myself.

Hell you dont see many scar pics from fue or strip.

[lost my swagger]

Hell you dont see many scar pics from fue or strip.

 

feel free to change that for us

 

was it SMG who did your fue into the scar??

 

was it spead all over of focused on one particular area and do you feel you got decent density, or enough density to be able to shave down to a 2 and have the grafted scar be significantly less noticable..

 

also what was the reason for on350 grafts.. thanks and sorry for 20 questions but im curious

[PLEASE GROW PLEASE]

Yes SMG.

I was one of the first to get fue there so the numbers werent as high as they are now.

I actually had a little over 500 with 350 in scar and the rest to build some temple points.

They were spread out

I think a 2 would be too low but Im hoping that with another pass a 3 would be totally undetectable.

Before I ever went to SMG I had a nasty scar that was as thick as a pinky finger and to be able to go down to a 4 right now is so much easier.

I will have Janna take some pics before and after they shave my head

[Bill - Seemiller]

jzachery,

 

Your question about whether to go the FUT strip or FUE route are certainly viable especially considering you aren't happy with your scar.

 

As you can tell by the below responses which I feel are quite balanced, there is no surefire solution for scar repair. Your remaining donor elasticity and amount of baldness left to be covered may also impact your decision on which procedure to go with.

 

The trichophytic closure technique can be great, but there are still a number of unknown variables that can result in a stretched scar even if the doctor does everything right and you care for it properly. On the other hand, it may take a great number of grafts extracted via FUE to potentially improve the appearance of the scar - that's assuming you're a good candidate for FUE and that they grow. Scarring will also form in any area where hair is extracted. Though best case scenerio with the right tools, with the best scalp characteristics, and in experienced hands, scarring will be minimal and barely noticeable with both FUE and FUT strip.

 

In my opinion, consult with a few leading physicians and explore your options in great detail. Then you can proceed and make an educated decision on what type of procedure to get next to both maximize the amount of new hair and minimize the appearance of scarring.

 

Best wishes,

 

Bill

[the B spot]

I don't work for a clinic that needs to "hype" or rush our results on the net--we talk about it, we develop a patient base, we formulate a realistic expectations, we talk about what we are doing with posters and at some point Dr. Ron will give his opinion and we will post our results/findings.

 

I'll admit, I got a little over excited initially, but Dr. Ron and Matt calmed me down--let me know that we will take our time, then present our findings.

 

FUE into the scar is

#1 Low density passes--likely to need at least 2 passes.

#2-not guaranteed--so many factors like scar vascularity--but still a solid option because it has minimal impact on available donor.

#3--not necessarily the best option initially.

 

We charge 1500.00 for FUE into the scar--I think that is the lowest cost for scar repair by far in the industry. The same as Dr. Ron charges for a strip scar repair.

 

Additionally, would you have me rush 1-2 successful patients on the net--declare the procedure an overwhelming success??? I, and many others have grown tired of clinics rushing procedures/tools/"the latest and greatest new thing" only to be faced with the reality that for some it works, for others it doesn't and for many it's just OK. Look at how long it took for Dr. Feller to produce a real piece of equipment?

 

When we have 10-15 patients grown out and we can establish a successful cross-section of patient results I will put them out there.

 

FUE into the scar does work--but it is process and not without risk and will likely need at least 2 passes to achieve results.

 

We have a guy coming over from the UK who has 175 2-3mm white dots all over the back of his head--we are doing fue into those dots to see if we can get this patient back to being able to buzz down to a #2-3 guard --which may take 2 sessions or 3. FUE is his only real option.

 

My point is, each situation is different--for each patient the risks to gain have to be considered. For some that means a strip scar resection and low tension closure. For others that is FUE into the scar.

 

Take Care,

Jason