FUT Scar Grafting

[dubhain]

I have been a long time reader and have been help immensely by the information others have posted. I decided to start this blog in order to put my repair story out there for others to follow my scar repair and just provide another example.

I underwent a 3000 FUT procedure early last year and have only regret for ever doing it in the first place as I didn't fully have a grip on what I was jumping into and the information I was provided wasn't entirely accurate. My only aim is to camouflage my scar as best I can with an expectation of buzzing to a 2 guard with no visible signs of scarring and move on with my life.

In the photos I will add you can see my scar at a 2 guard from a couple of months ago. It is roughly 32cm in length and ranges from 2 to 4mm in width so a total of 7.7cm2 to maybe 9+cm2 in area. It is level with my surrounding scalp and has hair growing through it in places due to the closure used.

I spent a couple of months prior to grafting my scar applying silicone gel, dermarolling with emu oil in order to reduce the redness of my scar in order to get it as ready as I could prior to grafting it in July where I recieved 401 FUE grafts into my scar.

[dubhain]

In the middle of July I went through with scar grafting with Dr Jose Lorenzo. I had 401 grafts placed into my scar. the graft count was as follows:

 

1's = 77

2's = 193

3's = 121

4's = 10

 

I am nearly at 3 months post op and didn't experience as much shedding of transplanted grafts as I had expected which I hope is a good sign.

 

I will attach pre and post op photos.

[dubhain]

here are some 2 months post op photos. I feel like for 2 months they show some good growth and I didn't shed all the grafts. The right side looks angrier than the left side due to a greater amount of grafts being transplanted along this section. I'll update again at 5 months post op and so on hopefully the redness will have subsided by then.

 

Feel free to comment or ask any questions

[seeker2014]

Thanks, dubhain, for sharing your story. I am in an extremely similar situation at the moment (received 2,800 grafts via a FUT procedure 2 years ago) and was wondering if you could address a few questions:

 

(1) Your 2-month post-op pics look very promising. I am hoping to reach the same goal of shaving down to a 2 guard (possibly 1 guard, but that might be a bit too optimistic). Do you anticipate any further FUE procedures or did Dr. Lorenzo indicate the 400 grafts should be sufficient long-term?

 

(2) Did you consult with any other doctors (specifically, in the States or Canada) and did they advise the same course of action (in terms of the number of grafts)?

 

(3) How was the recovery process? How long was it before you could return to work?

 

Thanks for your assistance!

[dubhain]

Hi Seeker,

 

1) Lorenzo said it will depend on what my final yield is like whether or not I'll need another procedure so won't know for another year I guess. I hope I don't need another one and if I end up with a little bit of scar is still visible in spots without the full line being identifiable I can live with that I think.

Before this procedure I could hide the scar in any lighting from day light to bright florescent lighting at only an 8 guard after 3 months I have managed to accomplish this at a 6 guard and it looks almost perfect apart from a slight redness so I feel I am heading somewhere with it, hopefully a 2 guard.

 

2) I also consulted with Feriduni and Bisanga's rep Steve in Belgium. Feriduni thought the same as Lorenzo in terms of grafts and Bisanga's rep was a little bit more conservative somewhere around 330 to 370 for a first pass from memory but don't hold me to that one. I did not consult with anyone from the states.

 

3) Recovery was a lot easier than my previous FUT for sure. Because of how he shaved the donor area after about 10 to 14 days it was hard to see anything had been done really.

 

What is size is your scar if you don't mind my asking.

 

Hope the above helps

 

Regards.

[Muscleheadofhair]

Ive always been interested in FUE into scar procedures (got a strip scar myself, and I now shave my head completely) I'm going to watch your case closely. Who was your doctor that gave you the strip scar? Best of luck with your outcome!

Edited October 7, 2014 by Muscleheadofhair

[seeker2014]

Hi dubhain:

 

Thanks for the response and sorry for the somewhat last response on my end The past couple of days have been much busier than expected. I have never received official measurements, but I would approximate my scar is about the same length, but a little less wide. Currently, I can conceal it pretty well blending the scarred area (which I keep around 1/2 inch) with the surrounding area (1/4 inch). However, I am hoping just to take everything down to a 1/4 inch which will be much easier to maintain long-term.

 

Sorry for another question, but did Feriduni or Bisanga ever mention the possibility of any permanent shockloss to the surrounding area, thereby widening the scarred area? Like I mentioned before, it appears you have experienced some excellent yield so shockloss isn't an issue in your case. Additionally, I have never read about a FUE scar repair procedure where this happened as shockloss typically occurs with HTs involving a large number of grafts. But I was just curious if any complications (outside the FUE grafts not taking) were mentioned during your consultations...

[dubhain]

Hi Seeker,

 

Nope shockloss was not discussed. I am not very knowledgeable on shockloss but from what I have seen other people say in other posts I believe it is more common with larger procedures but I believe for the most part this is temporary. I believe permanent shockloss only occurs through a poor harvesting technique where they transect follicles on either side of the graft being removed for placement. Currently at just over 3 months now, the pinkness is starting to settle now and hoping more grafts are coming through, thank you for the kind words on my yield so far.

 

Regards.

[dubhain]

Muscleheadofhair,

 

Depending on how long your scar is and the fact that you shave your head currently my best advice would be to do nothing to your scar. If I had a short scar I would do nothing to it.

 

FUE into your scar won't hide it when you bic shave your head. Depending on what your scar is like you may be able to get down to a 2 guard over time or maybe even a 1. There are other options out there such as SMP but I personally believe that can lead to a bigger disaster and a scar is easier to deal with than a blue head in my opinion so I would steer clear of that.

 

If you still decide to persue it you should also look into grafting scars with beard hair if you want to avoid FUE'n your scalp. There are a couple of cases out there such as northeastguy, pepperoni and topcat who have used bead hair in scar tissue and should be able to give you an idea of what to expect from a good FUE surgeon.

[Liamw]

I'm taking the same path as you, dubhain, please keep us posted.

 

I see that you used some silicone gel prior to grafting, but did you look into any other type of treatment to improve the scar appearance, I mean its texture and color?

 

I was looking onto fraxel laser, but consulting online with a doctor I got the following information:

 

"To improve scar pigmentation, scar vascularisation, we do recommend to inject growth factors in it. We will use Prp (Plasma rich platelet ) and Acell ( ECM , an extracellular Matrix).

Growth factors act like fertilizer and improve hair yield, promote blood circulation and also decrease scar formation. It speeds up the healing process."

 

This is my post, it has a picture of my scar on it, its about 20 cm long and 2 to 3mm wide: http://www.hairrestorationnetwork.com/eve/176641-strip-scar-revision-need-advice.html

 

Thanks a lot for sharing, mate. Good luck.

[dubhain]

Hi Liamw,

 

I used silicone gel for a few months. I also dermarolled once ever 2 weeks along with applying emu oil after each session for about 6 sessions in total before stopping a couple of months before my FUE. Not really sure the dermarolling did much for me as my scar was already level and I was just trying to reduce the redness but it is supposed to take time to see improvement so maybe it did help. On paper it makes sense that dermarolling would improve scar pigmentation and vascularisation through the bodies reaction to the tiny holes.

 

I also looked into fraxel last May. I had a consult and a test patch with a plastic surgeon. We discussed my scar and he said in time the scar's redness would fade and reach the same state that fraxel would get it too so decided not to pursue it and save the money as the redness was the only issue.

 

Never really read much about Acell being used on existing scars. Only heard about doctors using it during an FUT procedure from years ago with terrible results for the most part as the skin stretched pretty bad during the healing process of the scar. I don't know what PRP is so don't have any idea on that one. I wouldn't rush into those treatments without talking to people with better knowledge of it on here than me and seeing a few examples.

 

From your photo your scar appears to be in very good condition and you should get away with a two guard or a one if your lucky. What doctors were recommending 400 to 500 grafts to you, seems a little on the high side to me for those dimensions might be worth consulting with a few more Doctors and if you haven't already maybe talk to Bisanga, Feriduni, Lorenzo even just for a couple more opinions.

If all your going to do is graft your scar and nothing else I wouldn't be too worried about the FUE scarring as a good Doctor will spread out the extractions.

[seeker2014]

I second that advice. I haven’t really seen any conclusive results from fraxel lasers and have only read about negative experiences with Acell. Again, there could be users who did experience positive results with these two approaches, but I just have not encountered their threads. From personal experience, silicone gel does seem to help with scar healing. As dubhain mentioned, the concept behind dermarolling seems to make sense and I have read some encouraging testimonials about this device. Additionally, there isn’t a risk using the dermaroller because, worst case scenario, you are just out $20 if it doesn’t yield any results. In terms of the number of grafts, that is a tough decision. Some doctors might be quoting you a higher graft count in anticipation that some won’t survive (from what I have gathered, survival yields are usually 50%-70%). However, you also don’t want to dense pack the grafts since this could cause shockloss. I have read about people going in for one procedure and being satisfied with the results while other individuals need 2 or 3 sessions…this partially depends on how short you want to trim your hair.

[Liamw]

Thanks for the input, guys.

 

Well, some surgeons say I would need from 300 to 400, others 400 to 500. I have only done online consultations so they could not access the scar in person. Dr. Mwamba said he would prefer doing more than 1 session, to ensure a better yield, with 2/3 scalp hair and 1/3 beard hair if I didn't want to use all scalp hair.

 

I'm taking my time, researching all the possibilities. I was quite enthusiastic about the Fraxel Laser, but as seeker2014 pointed out there are no conclusive results about it, and all the surgeons that I've consulted didn't want to express their views. It might turn out just a waste of time and money.

 

I tried contacting Feriduni, but did not get any answer. Gonna try again later.

 

I have no idea what a dermaroller is, or the concept behind it. Will do some research on that.

 

My primary concern with the scar is its texture and, on my case, the hypopigmentation. I don't think much can be done about the hypopigmentation, though.

[dubhain]

Liamw,

 

sent you a PM with a link for dermaroller information etc.

[dubhain]

Here are some 4 month post op photos. We tried our best to part the hair along the top line of the scar to try and keep the photos honest. Experienced quite a bit of pinkness up to around 3 months post op but it has subsided greatly and only has a slight pink tone which will hopefully fade with time. Seems like the grafts are coming through faster in some area with gaps in others but as I am only 4 months I hope those sparse areas will fill in as the months go by. In all I think I have experienced good growth so far.

[Peperoni]

Hi Dubhain ....

 

Wow the scars are looking great after only 4 months. The redness has subsided and the hairs are looking healthy and thick already. I have noticed in the last week that I have some new hairs coming through and being around the 4 month time frame like yourself - then you may also see some more hairs coming through. I was looking to buzz my hair down at the 5 month mark as per instructions, but since I have some new growth appearing at the 4 month mark, then I may leave it a while longer to let them get established.

 

I am itching to see how my scars are coming along, but patience is the key for me and so I will wait until I believe no new hairs are coming through. If I feel okay about a reasonable coverage, then I may not even do the buzz, but I cannot really see that will be the case. We shall see .....

 

Keep growing sir !

 

You are looking great already and I feel sure you are going to be over the moon when all is said and done.

 

Regards

 

Pepe

[dubhain]

Pepe,

 

Thanks for the kind words, it is appreciated. Yeah I was told the same thing about wiating until the 5 month mark before cutting hair although I did do it a couple of times to a 18mm guard as I was unaware of that instruction at the time.

 

You bring up a good point, I might email Dr Lorenzo about the waiting until all the grafts are growing before using a shaver cause I believe we should both continue to see further growth for the 1st year. I don't really want to wait longer than the 5 month mark to have a cut. Maybe there is some other reason as to waiting for just 5 months prior to using shavers.

 

Looking forward to seeing your outcome and definitely feel your on to a winner already.

 

Regards

 

Dubhain

[seeker2014]

Hi Dubhain:

 

Your progress is looking good. Like Pepe mentioned, it seems like the hairs are definitely coming through. If you don’t mind me asking, what length do you have your hair in the picture? Are you still expecting on shaving it down to a 2 guard? Thanks for posting your progress…the information on this thread has helped me consider future options.

[dubhain]

Hi Seeker,

 

My hair in the photos is well over 1 inch maybe 1.5. I probably won't try going for the 2 guard for some time but I will try and go shorter at 5 months but I am happy enough with the hair length for now more planning for the future really by grafting into my scar. I think I am getting pretty good growth for 4 months. There are some gaps etc and hopefully these will fill in with time.

[ej]

Hi Dubhain,

 

You are looking great! It is an immense feeling of relief to get these type of scars improved upon.

 

All the best

 

ej

[dubhain]

Cheers ej,

 

Your blog was one among many that showed me something could be done to improve scars.

[aaron602]

Thanks for your update dub, you scar is looking good at even this early stage

Thanks for sharing your pics so frequently

Your giving me hope i can one day leave my apartment

[n00b]

Hello dubhain,

 

Am very eager to see your progress. Would you please share some pics?

Thanks in advance.