Strip Scar revision. Need advice.

[Liamw]

Hello all! My first post here.

 

I had a FUT surgery back in may 2011. The initial results were really good in my opinion, but two years later, as my hair continued falling, my aspect went back to that going bald look.

 

The thing is I came to accept my balding condition, and to be honest I regret the first surgery. What I would like now is to be able to buzz my hair really short, like 1 guard or no guard, and not have to worry about my hair anymore, but the FUT scar really bothers me.

 

I've been searching around and looking into options on covering the scar, like SMP and FUE/BHT, and already done some online consultations with some world renowned surgeons and clinics, but I really like to hear your opinions on this.

 

Last year I shaved the scar area to access the situation (I'll try to attach a picture). The scar is quite flat with just a few elevated spots. The color is a bit lighter than my skin tone though.

 

I also read some posts about fraxel laser treatment on scar, to improve the texture, color, elevated or depressed areas and also to improve blood flow and colagen formation (don't know if that's quite correct).

 

What would be the best approach to my case in your opinion? And which surgeon would you recomend for scar repair (US or EU)?

 

About the fraxel laser treatment, what are your thoughts on that?

 

I do appreciate any advice or comments.

 

Thank you very much.

[Garageland]

Liam,

 

You scar doesn't look wide enough from the photos to try to revise and it sounds like you want to hide it and shave down do that option would be out.

 

Personally I would seek out a top notch FUE surgeon who can place grafts into it, you might need two session to cover effectively and I would use scalp hair as it will blend better and you are not limited to having to use beard hair right? You have plenty of donor left and you are cutting your losses and moving on.

 

SMP in scars is too unpredictable and could require many top ups or the dots could enlarge plus I don't think it enables you to wear your hair that short without it still being noticeable.

 

Depends where you are located you should check out the recommended surgeons on this forum near you.

[Liamw]

Thanks for the input, Garageland.

 

I already messed up my head, don't want to risk also messing my face, plus I really fancy my beard so BHT from my beard is out of the question, I think.

 

I understand that FUE also leaves some tiny round scars. So considering that my strip scar is hypopigmented the FUE procedure would probably leave lots of lighter skin tone dots on my head, right?

 

Do you know if laser treatment would help bring back the normal color to the scar, or there is no such ttreatment?

 

Once again, I appreciate your help.

[chrisdav]

I agree with you about the use of beard hair Liamw. I wouldn't want to use beard hair either for the same reason.

 

If you have shave your hair to that low grade, you will probably see the scars from FUE too. I would FUE into the scar in my opinion.

[gillenator]

Liamw,

 

IMHO, a scar revision would not be of any benefit because chances are, the new scar would come out the same in both width and appearance. And if your laxity is somewhat tighter, the scar could even potentially come out wider which would be counter-productive.

 

Since you are not interested in adding any further grafts, then a tri-closure is also not an option. Also, the tri-closure method does not guarantee that the strip scar would be thinner, just some level of hair growing through the scar. The skill really varies between surgeons in performing tri-closures as well.

 

I also agree that FUE from your scalp donor is definitely the best option for a case like yours. You just want to be careful not to over-pack the scar. You can always add more FUE into the scar along the way to see how the regrowth is coming along. From my observations over the years, it is best to do FUE into scars in succession, not dense-packing them in one procedure. It really won't take that many grafts either. The good thing is that your strip scar is not raised or inflamed.

 

I also would not recommend any SMP for now. If you have decent regrowth from the FUE grafts, then you probably won't need any SMP.

 

Also, ask your FUE surgeon to cherry pick your grafts from various zones in the scalp so that you won't have any shotgun scarring. If your FUE surgeon does not use any punches larger than .50 mm, then the scarring may not be visibly apparent at all. Again, it should not take that many FUE grafts overall. You also appear to heal well.

 

The reason that your linear scar appears so much lighter is because of the lack of blood flow through scar tissue. And those of us with darker or more olive complexions tend to show a more pronounced contrast in appearance of the scarring than if you had a fair complexion and light hair color.

 

Lastly, I always have advised men that once you have FUHT or larger sessions of FUE, there is a good probability that buzzing down to that level will show the scarring.

 

Unfortunately, surgery produces scarring. The real issue is, "How visible will it be?" So for those of us who are not willing to accept our hair loss, there is a trade-off of having a new transformation yet also knowing and being willing to accept the fact that we may never be able to buzz or wear our hair as short as we would hope or want to.

 

Best wishes to you and welcome to this community Liamw...

[1978matt]

I'd go along with the comments so far. I think you stand a great chance of being able to cover the scar with FUE, especially since the scar does not appear to be a full 'ear to ear' length.

 

If you have some thinning on top you might want to add some grafts into that area at the same time.

 

Dr Maras has had some really good scar cases posted in recent times.

[Liamw]

Thanks a lot for the replies, guys.

 

The reason that your linear scar appears so much lighter is because of the lack of blood flow through scar tissue. And those of us with darker or more olive complexions tend to show a more pronounced contrast in appearance of the scarring than if you had a fair complexion and light hair color.

I see. That's why I'm looking into fraxel laser treatment, I've seen some interesting results and talked to a guy online who had his strip scar and recipient area treated with fraxel and now he shaves his head down with razor and all.

Of course I'm always skeptical about photographs in the internet.

 

Lastly, I always have advised men that once you have FUHT or larger sessions of FUE, there is a good probability that buzzing down to that level will show the scarring.

 

Unfortunately, surgery produces scarring. The real issue is, "How visible will it be?" So for those of us who are not willing to accept our hair loss, there is a trade-off of having a new transformation yet also knowing and being willing to accept the fact that we may never be able to buzz or wear our hair as short as we would hope or want to.

Yes I know that, and I knew that when I had my HT. But I was losing my hair, my selfesteem, I was emotionally a mess and thought everything would be fixed with that HT. I did not see ahead, nor I was advised by the surgeon about the need for subsequents HT.

 

The scar is 18cm long, and 3mm on the wider parts, and yes I do heal really well. Most surgeons say I'll need something around 400-500 grafts.

 

I like the concept of doing it in multiple sessions with a small calibre punch, I'll keep that in mind.

 

1978matt, I do have some thinning on top, more on the frontal area. But TBH I really don't care anymore, as some one said I just want to cut my losses and move on. Don't want to go into why I gave up HT or clinical treatment for that matter, is just how it is.

 

Once more, thank a lot guys, you have been so helpfull

[seeker2014]

Hey Liamw:

 

Your experience/mindset is almost identical to what I am going through at the moment. I have compiled a list of surgeons I am considering for scar revision (I still have to contact them for consultation), but was just curious if you have arrived at a solution yet? Any info would be much appreciated. Thanks!

[Liamw]

Hey seeker2014, my current plan is to try and improve the appearance of my scar, both in texture and color, and then do some FUE into it.

 

At the moment I'm looking into fraxel laser, trying to understand what kind of improvement it could yield. There are many cases around and many different opinions. The hair transplant surgeons don't seem to know much about it, or at least don't want go commit to any type of advice or opinion.

 

The only actual comment I could get from a HT surgeon (or his staff, I don't know) was something in this line: "Attempting fraxel first is required as I would not recommend it after grafting."

 

I have contacted many top notch surgeons about my case, and now I have a pretty good idea of what I'm getting into, both in terms of expectations and total cost. There are still a couple more I would like to contact, but I'm pretty sure the answers will be very similar.

 

I think it all comes down to which one to chose now.

 

If you want to PM me about the surgeons I talked to feel free.

 

Good luck to you.

[Frank1nfo]

Do nothing.

 

Your scar is one of the best of FUT scars. The best way to correct bad (wide) FUT scars is scar revision (cut and suture again), anyway your scar does not need it. Scar revision will not give you better (thinner) scar.

 

Implanting hairs over the scar is too invasive and just waste of hairs from donor areas. I do not recommend violating untouched beard area, you can not be sure if they look natural over the scar. And, you can not be sure if implanted hairs will survive over the scar (because scar tissues receive less blood supply than normal skin and there will be positional difficulties to protect them after implantation), and the hair density over the scar still might be insufficient for your need to cover it.

 

All other treatment modalities from outside (laser, pigmentation, etc) will not work, -just waste of money.

 

Obey these wise guys' advices and do nothing, just keep your donor area hairs long enough, short hair-cut still looks possible to cover this good quality scar.

 

Again, do nothing.

Edited September 21, 2014 by Frank1nfo