FUT Scar

[TrixGlendevon]

Hi! I was all up for FUE but after seeing videos about FUT by doctors from this forum on Youtube and also reading through a debate that escalated quickly I am debating FUT. I am concerned about the scar however. So, for those who have had FUT, what do you do about the scar after? Is there some kind of surgery/technique etc. that you can do to conceal it after? I'd hate to not have the option to have my hair short as it really suits me.

[HairsGone]

I guess it depends on how short you like it? Some patients have FUE grafts inserted into the scar once it's fully healed to make it less visible. This is a recent photo of me, I've had 2 FUT's and currently month 10 post-op. The barber went from a grade 1- 2 at the bottom and then grade 4 a little higher up. The scar is not visible at all and the barber was finding it hard to even find the scar.

[TrixGlendevon]

Well, I'd ideally like to have a number 2 all over to be honest but we can't have it all I suppose. Thanks for your photo - he's right, you can't see where it is. As you've had both FUT and FUE, can you tell me about your experiences with them both? Recovery? Result? Advice?

[Dr Blake Bloxham]

Trix,

 

There are things you can do to address the scar IF you need to. I find most patients don't. Not because there isn't a scar, but because it just doesn't become an issue. I tell my patients that almost everybody falls into what I call the "normal healer" category. This means you have reasonable skin characteristics and scalp glide (which together create the scalp "laxity" effect). I don't really like the "pencil thin line" description of a potential strip scar, but I do tell these patients that normal healers will end up with something between the "pen line" if you're an excellent healer with all the right characteristics to something a few millimeters (2-3) larger like a "marker line" if you have the potential to "stretch" a little bit. Everyone in that realm can generally go down to around a #3 on the buzzer before the scar line is apparent. What a lot of guys are doing now, I've noticed, is the "fade" that hairsgone shared above. This still gives you the opportunity to go very short below the scar (and shorter than you could go with FUE dots down there) and fade up if you want the tight look.

 

Scarring is a reality of surgery. FUT, FUE, etc; you will have scarring and it is the trade-off for restoring your hair. So I don't think either type of scarring should be downplayed or over-hyped. You will always have some type of scarring back there, and it is something you must accept before surgery. I believe the trade-off is very much worth it for the vast majority of patients, and I find that the scars -- FUE or FUT -- tend to never really get discussed when I'm doing follow-ups with patients at 6 or 12 months AS LONG AS the results in the front are good!

 

I've attached a few videos of scar comb-throughs. Some are great, some are more of the "marker line" I described; but it should give you a good idea of what you might be looking at:

 

 

 

 

(PS: one of those scars is actually after two procedures totaling over 5,000 grafts).

 

Dr Bloxham.

New York

[TrixGlendevon]

Dr Bloxham. Great videos. Thanks. Shame you both don't practice in Europe. How long does it take for the scar to heal completely? Are these people on the videos people that have had their scars "addressed" or just normal scars (and what does addressing it mean in terms of procedure and result)? Are there not nerves and blood vessels in the area that the surgeon cuts that may make for long-term damage (it is the head, afterall)? Who would you say are the best FUT surgeons in Europe? I have a short-list already that I will visit next month but they are on the list based on being good FUE surgeons (some offer FUT too but I have never looked into FUT so I am just starting my research now).

 

Sorry for 20 questions!

[Dr Blake Bloxham]

Dr Bloxham. Great videos. Thanks. Shame you both don't practice in Europe. How long does it take for the scar to heal completely?

 

My pleasure.

 

Very interesting question. In my opinion, the scar does not completely "heal" for 12 months. Just like the results in the front, the scar goes through a period of "maturation." I often have patients come in at 6 months, and the scar is more inflamed, less organized, and still has some residual shock loss when I compare it to the final appearance at 12 months -- which is less pink, flatter, usually a bit smaller, and shock loss is resolved.

 

However, that's probably not exactly what you were asking. Although remodeling and maturation does take place up until the 12 month mark, it usually appears pretty much "healed" for most patients when any residual shock loss resolves (if it does occur). This can vary and also depends on what you do with your hair in the post-op. I sometimes see patients as soon as 8 weeks after surgery, and most look "healed" and normal for all intents and purposes in the back at that point. But, the question is a little more complicated and patient specific.

 

Don't you love those doctor answers?

 

Are these people on the videos people that have had their scars "addressed" or just normal scars (and what does addressing it mean in terms of procedure and result)?

 

None of these scars have been addressed. These are just normal strip scars. Addressing it usually means surgical revision, grafts into the scar, or SMP -- or some combination of these. Some doctors may also be working on other revision ideas too, so maybe more options in the future. But honestly, most people don't require these. Most of the scar "revisions" I do are when I'm doing a second strip and I'll skip around and be a little strategic to try and clean up a scar a little bit. It's usually something I do just to get the best possible appearance in the back, not because the patients are unhappy with the scar.

 

Are there not nerves and blood vessels in the area that the surgeon cuts that may make for long-term damage (it is the head, afterall)?

 

There are some superficial vessels and nerves that are cut. The body tends to regenerate or reorganize as it heals and I have not personally noticed "long-term" damage in my patients -- FUE or FUT. I think this is one of those things that is greatly exaggerated online. You can have some numbness that persists for a while -- in the donor and recipient -- but I have not yet seen it last permanently in any of my patients. Another nice thing about FUT is that the area of damage to the vasculature and the nerves in the donor region is contained to a small area. This is unlike FUE where the entire donor is utilized (and at the same depth for all intents and purposes) so the nerve and vessel issues can be more widespread.

 

Who would you say are the best FUT surgeons in Europe? I have a short-list already that I will visit next month but they are on the list based on being good FUE surgeons (some offer FUT too but I have never looked into FUT so I am just starting my research now).

 

I'd start with the recommended doctors here. Look at who is putting out consistent FUT results, who is interacting online, who has patients posting, etc, and then reach out and speak with those doctors.

 

Sorry for 20 questions!

 

Ask away. Research is key.

[Dr Blake Bloxham]

 

It's so variable that it is difficult to answer. "Shock loss" truly means that the follicle has been pushed into a "resting" (telogen) phase and needs to wake up from this before regrowing a hair. Telogen generally lasts 3 months. However, not all thinning appearance under/around the scar post-surgery is true shock loss. Sometimes it's just delayed regrowth -- with resolves within 6-8 weeks or so -- and sometimes it just looks thinner/shorter for a while because of the way the clinic trims. So I've seen it resolve as quickly as a few weeks, and I've also seen it take 3-6 months to really wake up, and it still needs to grow a satisfactory hair after this to really get rid of the thinned appearance. The good news is that the prolonged period isn't the norm and it's -- from my experience -- always temporary.

[TrixGlendevon]

My pleasure.

 

Very interesting question. In my opinion, the scar does not completely "heal" for 12 months. Just like the results in the front, the scar goes through a period of "maturation." I often have patients come in at 6 months, and the scar is more inflamed, less organized, and still has some residual shock loss when I compare it to the final appearance at 12 months -- which is less pink, flatter, usually a bit smaller, and shock loss is resolved.

 

However, that's probably not exactly what you were asking. Although remodeling and maturation does take place up until the 12 month mark, it usually appears pretty much "healed" for most patients when any residual shock loss resolves (if it does occur). This can vary and also depends on what you do with your hair in the post-op. I sometimes see patients as soon as 8 weeks after surgery, and most look "healed" and normal for all intents and purposes in the back at that point. But, the question is a little more complicated and patient specific.

 

Don't you love those doctor answers?

 

 

 

None of these scars have been addressed. These are just normal strip scars. Addressing it usually means surgical revision, grafts into the scar, or SMP -- or some combination of these. Some doctors may also be working on other revision ideas too, so maybe more options in the future. But honestly, most people don't require these. Most of the scar "revisions" I do are when I'm doing a second strip and I'll skip around and be a little strategic to try and clean up a scar a little bit. It's usually something I do just to get the best possible appearance in the back, not because the patients are unhappy with the scar.

 

 

 

There are some superficial vessels and nerves that are cut. The body tends to regenerate or reorganize as it heals and I have not personally noticed "long-term" damage in my patients -- FUE or FUT. I think this is one of those things that is greatly exaggerated online. You can have some numbness that persists for a while -- in the donor and recipient -- but I have not yet seen it last permanently in any of my patients. Another nice thing about FUT is that the area of damage to the vasculature and the nerves in the donor region is contained to a small area. This is unlike FUE where the entire donor is utilized (and at the same depth for all intents and purposes) so the nerve and vessel issues can be more widespread.

 

 

 

I'd start with the recommended doctors here. Look at who is putting out consistent FUT results, who is interacting online, who has patients posting, etc, and then reach out and speak with those doctors.

 

 

 

Ask away. Research is key.

 

Great reply Dr. Bloxham. Thanks for that. And it does answer my question - 12 months was the answer (that I extrapolated anyway). Thanks again for your time

[HairsGone]

Well, I'd ideally like to have a number 2 all over to be honest but we can't have it all I suppose. Thanks for your photo - he's right, you can't see where it is. As you've had both FUT and FUE, can you tell me about your experiences with them both? Recovery? Result? Advice?

 

Check my last thread for more info. The last procedure was mainly FUT but then FUE day 2 to maximise the number of grafts in one procedure. I would only recommend this if you've already had a FUT as you don't want to take too many grafts FUE but save for future FUT sessions. My advice would be to consider FUT if you have or will likely have fairly extensive hair loss in the future. Then you can move on to FUE once you're stripped out.

 

Recovery wasn't too bad after the first few days. You could return to work after 7 days if you wish but 2 weeks is better. No exercise for a few months to avoid stretching the scar.

 

For FUT in Europe check out Bisanga and Feriduni in Belgium. Also my two surgeons have served me well.

[TrixGlendevon]

Check my last thread for more info. The last procedure was mainly FUT but then FUE day 2 to maximise the number of grafts in one procedure. I would only recommend this if you've already had a FUT as you don't want to take too many grafts FUE but save for future FUT sessions. My advice would be to consider FUT if you have or will likely have fairly extensive hair loss in the future. Then you can move on to FUE once you're stripped out.

 

Recovery wasn't too bad after the first few days. You could return to work after 7 days if you wish but 2 weeks is better. No exercise for a few months to avoid stretching the scar.

 

For FUT in Europe check out Bisanga and Feriduni in Belgium. Also my two surgeons have served me well.

 

Thanks for the reply and answering my questions. Feriduni is actually on my shortlist for FUE so I am glad he also has a good reputation for FUT. What is Bisanga's reputation like for hairlines?