Stupid Question- Does FUT 'lower" the crown further down the back of the head?

[RadioRunner]

So I had FUT done about a year ago, and I cant tell if this is a byproduct of FUT, or if I am just imagining things, but it looks like the crown of my head is a little further down the back of my head, whereas pre-op it was more on the top of my head, albeit towards the back. It makes sense, i.e. during an FUT procedure they take a large-ish incision out of the back of your head, pull it down and staple it up. I even remember some of the docs on here saying there is a 'skin tightening' outcome on your forehead after an FUT due to pulling the skin on the back of your head to staple it up. I'm sure it isn't this literal, but is it possible for your crown to lower after an FUT procedure?

[Dr Blake Bloxham]

Radio,

 

Hope all is well! I remember your case.

 

As to your question ... No, this does not happen. I've been asked this before, both online and in consultations. Long story short, there is simply too much complex laxity and tissue redundancy in the scalp for this too occur. And FUT doctors are generally very careful about judging laxity and determining how much tissue can be removed without a permanent change -- like you describe.

 

So no changes in the crown, nape hairline, and we don't throw in complementary brow or upper-facelifts while doing FUTs either!

 

You may have had some additional thinning in the crown, however. Pictures may help.

[Al - Moderator]

Yes this can happen. Most people have more laxity towards the lower back of their head, so the bottom portion of the donor area stretch upwards. However there are some people who have a lot of laxity in the crown area. On these people the crown will stretch outwards and downwards if the laxity in the crown above the linear scar of the HT is more than the laxity below the linear scar of the HT.

 

When you remove a line of tissue from the back of your head, unless the scar is the same width as the area removed, then other areas MUST moved and stretch in order to close the wound area.

[ontop]

Dr Blake,

A question please can you tell me & other members if there is a way to test laxity in your scalp.

Have you a video on this kicking around be interesting to see how you guys can see if a patient has tight or loose scalp & if so could this be a factor on what kinda of surgery would & could be used in both cases...I hope I made sense then lol

Thanks.

[Rashid36]

Also doc can you tell us if it is suitable for those involved in contact sport and life style involving alot of exercise to have fut. Thanks.

[HairLostYears]

I remember Dr. Bhatti and Dr. Feller going back and forth a bit about this in a highly trafficked thread.

 

After reading what Dr. Bhatti would write, a conclusion could be 'what good are the extra grafts you may get by following the strip/FUE gameplan, if you'd just use up a good chunk of them filling in a stretched down crown and possibly in the strip scar itself?'

 

Then you'd read what Dr. Feller would say, while appreciating his cemented status in the field, and that would totally make sense too!

 

When I first started reading this forum, I guess it was just too easy for me to accept what a Dr. was saying as gospel. Really though, I suppose it's similar to something like where you get your news from. Whether it's CNN, Fox, etc...soak in the info from the experts, but it also may be wise to step back and consider the source.

[voxman]

Dr Blake,

A question please can you tell me & other members if there is a way to test laxity in your scalp.

 

Dr. Mohebi has a device to test laxity.

 

Laxometer l Parsa Mohebi

[RadioRunner]

I remember Dr. Bhatti and Dr. Feller going back and forth a bit about this in a highly trafficked thread.

 

After reading what Dr. Bhatti would write, a conclusion could be 'what good are the extra grafts you may get by following the strip/FUE gameplan, if you'd just use up a good chunk of them filling in a stretched down crown and possibly in the strip scar itself?'

 

Then you'd read what Dr. Feller would say, while appreciating his cemented status in the field, and that would totally make sense too!

 

When I first started reading this forum, I guess it was just too easy for me to accept what a Dr. was saying as gospel. Really though, I suppose it's similar to something like where you get your news from. Whether it's CNN, Fox, etc...soak in the info from the experts, but it also may be wise to step back and consider the source.

 

Yes, I definitely remember reading that in-between their bickering! I'm glad I'm not the only one who thought this, but I wish there were a definitive answer. Part of me feels like my crown definitely stretched down a tiny bit, but the other half thinks I am just imagining things.

[RadioRunner]

Radio,

 

Hope all is well! I remember your case.

 

As to your question ... No, this does not happen. I've been asked this before, both online and in consultations. Long story short, there is simply too much complex laxity and tissue redundancy in the scalp for this too occur. And FUT doctors are generally very careful about judging laxity and determining how much tissue can be removed without a permanent change -- like you describe.

 

So no changes in the crown, nape hairline, and we don't throw in complementary brow or upper-facelifts while doing FUTs either!

 

You may have had some additional thinning in the crown, however. Pictures may help.

 

Thanks doc!

[pkipling]

Dr Blake,

A question please can you tell me & other members if there is a way to test laxity in your scalp..

 

Here's an ISHRS article that goes into further detail about how surgeons go about measuring scalp laxity, specifically regarding the Laxometer that Voxman mentioned. Accurately measuring scalp laxity isn't something that you're able to do on your own, so a consultation with a HT surgeon is your best bet.

 

ISHRS Article: Scalp Laxity/Laxometer

[ontop]

Thanks guys very interesting indeed..because I thought most of the doctors just tested just by there hands & fingers prior, so it was going on ki da guess work which sounds kinda crazy especially if there doing FUT.

 

So saying all this, would it be fair to say, somebody who has a very tight scalp & say fine hair, would it be more suitable for that patient to undergo FUE than FUT as maybe for reason such it be harder to get more folicals out & there is more of a risk that the scar itself would stretch more than somebody whos kinda loose?

I sure hope thats not a silly statement / question there guys.

 

Interesting topic nevertheless, something which dont get spoken about very often I noted.

 

Thanks again guys great post.

[pkipling]

Thanks guys very interesting indeed..because I thought most of the doctors just tested just by there hands & fingers prior, so it was going on ki da guess work which sounds kinda crazy especially if there doing FUT.

 

So saying all this, would it be fair to say, somebody who has a very tight scalp & say fine hair, would it be more suitable for that patient to undergo FUE than FUT as maybe for reason such it be harder to get more folicals out & there is more of a risk that the scar itself would stretch more than somebody whos kinda loose?

I sure hope thats not a silly statement / question there guys.

 

Interesting topic nevertheless, something which dont get spoken about very often I noted.

 

Thanks again guys great post.

 

I think it would ultimately just come down to just how tight their scalp is and whether or not the scalp exercises end up being successful. If the patient is willing to consider FUT, then it would be worth it to meet with the surgeon, see just how tight the scalp is, give the exercises a legitimate shot, and see how much/if any progress is made. Then the decision can be made from there. But generally speaking, if the scalp doesn't have enough laxity for a strip procedure, it will/should be avoided.