Senior Member win200 Posted September 2, 2015 Senior Member Share Posted September 2, 2015 Don't mean to threadjack, Blake, but I have a somewhat related question. I had a 1,450 graft procedure in 2012 that produced an OK scar; not pencil-thin, but not "stretched" looking (maybe 2, 2.5mm?). What's unusual, though, is that the scar is still very pink. Does that signify anything to you, or is that simply just how some folks heal? I'm particularly curious because I'm going to Dr. Rahal in four weeks for a 2,000 graft procedure. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted September 3, 2015 Author Share Posted September 3, 2015 Td, You asked: "can someone with lax scalp still wind up with a good scar?" Yes. There is nothing stating you can't have a perfectly acceptable scar with a lax scalp. This is even more true if your laxity wasn't over utilized. What I mean by this is: laxity can be a very good thing because it allows for a large strip harvest. Like I said above, however, patients with lax scalp have a tendency to stretch regardless. So if you combine this with a wide strip, it could theoretically stretch even more. If you don't, however, and still take out a strip with a reasonable width, there is nothing saying you have to stretch simply because you have more laxity. You just may have a greater potential. It sounds like the clinic seems pretty confident about the repair. SMP is always an option as well. FUE into the scar may be an option too, but only if you have a very specific type of stretched scar. Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted September 3, 2015 Author Share Posted September 3, 2015 Home1212, Thanks! Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted September 3, 2015 Author Share Posted September 3, 2015 Hi Win, I don't think that's too off topic! I think it's likely just the way you heal. Scar tissue is generally 'hypo-pigmented' (lighter in color) compared to the rest of your skin. However, I've seen it heal pinker, slightly darker, the same tone, et cetera. I've seen some people lighten slightly darker scars with vitamin E. You should ask Dr Rahal what he thinks about it during your next procedure. Congratulations on the next case! I look forward to updates. Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member MAGNUMpi Posted September 3, 2015 Senior Member Share Posted September 3, 2015 Mav, I'm not sure if I'm following the comparison correctly, but I would say the guy with the increased laxity has an increased risk of scar stretch (despite the number of procedures). Also, thank you for sharing the above statement. I absolutely do NOT want to make it seem like I'm downplaying any aspect of the procedure. Patients need objective information from this site, and that's what I seek to give. I do apologize if it seemed like I was glazing over any details or looking at things through "rose-colored lenses!" However, I do want to address the above: I think if you read through what Dr Lindsey wrote, we are actually very much on the same page. He states that statistically, most guys fall into the "first group and wind up with good scars." This is akin to my "normal healers" category I discussed initially. I still do feel like the majority of patients fall comfortably within this group. This people heal with the simple "line." If they do "stretch," it's usually 1-2mm. What's more, Dr Lindsey actually described a few variables that always go through my mind as well: laxity during testing and ethnicity. As he said, these patients tend to heal with a bit wider of a scar, and this does reference back to the people I think we can somewhat identify as counsel appropriately. He also does discuss those who surprise you or seem to heal up less-than-ideal despite okay characteristics and a good closure. This does have to do somewhat with physiology, which I touched on above, but I do want to state the following -- and maybe this is where I should have been clearer before: there will ALWAYS be a degree of variability and unpredictability with medicine and surgery. No way around it! Call it whatever you'd like, there will always be some patients who don't heal up as expected, some who don't grow as expected, some who experience more swelling than you'd expect; and then there are always the "nice surprises" that you wouldn't expect either: guys with grafts that never actually shed, people who look like they just had a perfect "buzz cut" on day 3, very early growers, and, of course, beautiful scarers. Having said all that, I do still feel the following holds true: there are more ways to identify and classify patient scarring than we usually do read online; most fall into the "normal healers" category -- which I define as a thin line in good scenarios and a few mm when they "stretch;" and there are certain patients with certain characteristics that indicate they may not heal as well as others; however, I do believe these are a minority and good closure technique has a lot to do with keeping these guys in the minority; and I firmly believe limiting strip widths has a lot to do with this as well. I hope this seems more direct! Like I said before, I don't want to sugarcoat any of this. That's not what our community is all about! Thanks Blake. Good important info here. Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted September 3, 2015 Administrators Share Posted September 3, 2015 i really do enjoy your good cop role, in the F&B camp, don't every stop Very odd marketing, but I guess it gives them notoriety. I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted September 3, 2015 Senior Member Share Posted September 3, 2015 Hi Win, I don't think that's too off topic! I think it's likely just the way you heal. Scar tissue is generally 'hypo-pigmented' (lighter in color) compared to the rest of your skin. However, I've seen it heal pinker, slightly darker, the same tone, et cetera. I've seen some people lighten slightly darker scars with vitamin E. You should ask Dr Rahal what he thinks about it during your next procedure. Congratulations on the next case! I look forward to updates. Thanks, Blake! I'll be making a separate thread for my procedure soon. Link to comment Share on other sites More sharing options...
Senior Member Td06 Posted September 3, 2015 Senior Member Share Posted September 3, 2015 Td, You asked: "can someone with lax scalp still wind up with a good scar?" Yes. There is nothing stating you can't have a perfectly acceptable scar with a lax scalp. This is even more true if your laxity wasn't over utilized. What I mean by this is: laxity can be a very good thing because it allows for a large strip harvest. Like I said above, however, patients with lax scalp have a tendency to stretch regardless. So if you combine this with a wide strip, it could theoretically stretch even more. If you don't, however, and still take out a strip with a reasonable width, there is nothing saying you have to stretch simply because you have more laxity. You just may have a greater potential. It sounds like the clinic seems pretty confident about the repair. SMP is always an option as well. FUE into the scar may be an option too, but only if you have a very specific type of stretched scar. Thanks for the info Blake! Link to comment Share on other sites More sharing options...
Senior Member HairJo Posted September 14, 2015 Senior Member Share Posted September 14, 2015 I found this to be very informative. Thank you, Blake. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted September 14, 2015 Author Share Posted September 14, 2015 No problem, HairJo! Glad it was helpful! Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
cheetoman Posted October 16, 2015 Share Posted October 16, 2015 Dr Blake, You stated above that very specific scars respond to FUE. What types are those? I had FUE into my scar about 2 months ago. The scar had stretched to about 1cm on one side, .5cm elsewhere. My Dr said this would be the best option as I don't appear to scar well. Thus no scar excision. I'm now wondering if this was the best option for me. Also, Dr Lindsey mentioned there were other characteristics that effect scaring (race, and height I believe were mentioned specifically). Are there others? And what is extreme height? I'm 6-5 and feel I'm normal, (everyone else is just shorter than me!) Thanks for any insight. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted October 16, 2015 Author Share Posted October 16, 2015 Cheeto, The scars that are most amendable to FUE tend to be the ones that are very flat, thin, and appear to have good vascularization -- meaning they have more of a pinkish "flesh tone" compared to the pale color of scar tissue. The ones that are thick, raised, and avascular tend not to do as well. This is simply because the tissue isn't comprised of normal skin components nor does it have good blood supply. The only correlation I can think of between extreme height and the potential to stretch would be in individuals with Marfan's syndrome. These patients can be extremely tall. The disease is also essentially a type of connective tissue disorder, so it could affect the way your body scars as well. However, you'd likely know if you had this by now! Otherwise, being 6'5" is just cool. Especially if you can dunk! Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted October 16, 2015 Regular Member Share Posted October 16, 2015 Agreed. That is the only relation that height has to scars that I know of. The most important component to getting superior scars is minimal tension on the skin edges BEFORE putting in the skin sutures. Taking the load off with a deep layer or 2, whether its on a facelift or hair transplant, has been shown for decades to limit widening in most, but not every, patient. Thus, as I've posted many many times...1 in 30 of my hair patients gets a wider scar. Interestingly however, in 3600 or more facelifts, I personally know of only 2 cases of widening in front of the ears. Definitely more forgiving statistically than the scalp. Dr. Lindsey William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
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