Questions on strip placement and sizes

[hairsprint]

Hello,

 

I had some questions on strip/scar placement and sizes

 

1. Do the strip sizes (or, should I refer to them as lengths?) vary based on an individual's graft needs? Say someone decides to go for an FUT and he needs only around 750 grafts. In this case, will the strip be still the typical ear to ear or will be customized/shortened so that it is only as long as something that would give the required number of grafts? I don't remember seeing a shorter strip ever, so, I wonder if a strip is always a standard length

 

2. For someone undergoing multiple FUTs, how are the strip locations chosen? Are the strips always below or above existing strips? Apart from the safe-zone consideration, are there other factors that determine where the strips are made relative to an existing strip/scar location(s)?

 

Thank You

[gillenator]

The size of the strip specimen excised is based on a number of considerations and factors.

 

The surgeon initially wants to be sure that the patient has enough laxity in the scalp so that the scar will heal thin and not run the risk of becoming wide.

 

The surgeon will also estimate or calculate your donor density. Many strips average roughly .5 cm in width so depending how many grafts are needed for the procedure, the surgeon will calculate how many FUs there are in a 1cm2 area and then do the math so he/she will know how long the strip will be.

 

Again this is based on the presumption that the width will be .5 cm wide.

[hairsprint]

Thanks Gillenator, understood.

 

While I understand the factors you've mentioned, I somehow don't remember ever seeing a strip that's shorter than what's typical. Could this be because patients always prefer FUE for smaller graft (as in my example) requirements?

 

Thanks

[Steeeve]

Most people have, on the back of their head, a bump called the occipital bun. Most, certainly not all but most, FUT scars I have seen on people’s heads rest on that bump along the occipital ridge. Whatever the science behind that is I’m not sure of, however, that is usually where it rests. Maybe it has to do with the skin being better able to stretch and pulled together to be sutured. I don’t know. Speaking in terms of length, not width, scars can definitely be shorter or longer back there, as gillenator said, depending on how many grafts are required and how many grafts per cm2 you have back there. Do a google search of, “hair transplant scars”, and you’ll see a variety of scar lengths. A good doctor will cut the old scar out along with the new tissue being removed so that you are left with one remaining scar after the surgery.

[hairsprint]

Thanks for chiming in Steeeve. I tried looking up this topic and found a couple of articles that seem to mention that the areas immediately above and below the occipital bump have the most 'safe' hair. I could make out if there's some more science to this

 

On the scar lengths, I did search quite a bit before posting this question, the majority of the scars I could find are the typical ones we see all the time. I could find maybe one short scar for every 100 long ones, so, I am starting to think that FUT just doesn't chosen at all for small graft requirements

 

A good doctor will cut the old scar out along with the new tissue being removed so that you are left with one remaining scar after the surgery

Ok, I find this interesting. Does this mean that even after one has a second (or even a third?) FUT, one could potentially end with just one scar? Would this also mean that the size of the final scar, in terms of the width, would increase instead?

 

Thanks

[Steeeve]

It’s my opinion, and I feel that it’s a good one, that if you’re going for multiple strip procedures that you should accept nothing less than one scar. I know a guy in his late 50’s that lives in Houston that has had three FUT procedures with Dr. Arocha. This gentleman was left with one scar. That is an ideal result. I certainly wouldn’t want a doctor pulling tissue from the back of my head in different locations leaving multiple scars, however, it is my understanding that as more tissue is cut from the back of the head fewer and fewer grafts may be extracted due to skin laxity and donor depletion. It is also my understanding that as more tissue is removed the resulting scar is more prone to widening as it may stretch over time. That’s not to say that it absolutely will happen but the probability is high that it will.

[mattj]

The strip scars you see tend to be longer because of the number of grafts that were required. It has been mentioned already how donor density and laxity play a part. 750 grafts is a very small procedure for FUT and I would expect the scar to be shorter in length for a procedure of that size.

[gillenator]

I had 4 separate FUHT procedures so far in my journey and I have only one strip scar.

 

As long as there is ample time given allowing the scalp to regain enough elasticity for the proposed strip to be taken, there is good potential for the scar to come out just fine.

 

At the same time, the scalp does have a finite amount of play in it and it varies between individuals. On my last procedure (4th), my surgeon advised me that the laxity was getting tighter so he decided to use staples to close me.

 

After having 4 strips taken, my scalp is probably too tight for another FUHT procedure if I ever decided on another procedure. To be on the safe side, I would choose to go with FUE if I wanted more work done in the future.

[Speegs]

I've had three FUT procedures, and have one scar to show for it, Dr. Gabel was meticulously careful to make sure that when he did my second and third procedures, that he didn't make any additional scars on the back of my head from my procedure with another physician.

 

I've been fortunate in that I've had enough elasticity for three and only one scar-line, namely because of the skill and care of my surgeon to harvest from an area surrounding the minimal scar tissue and the fact he's made sure the tissue is not damaged so it can be donor hair in the future.

 

All three times my scar has healed successfully and been invisible to my hair dresser and the general public, the trichophytic closure successfully mitigating most scar tissue and allowing hair to grow through portions of the scar to further camouflage it.

 

The success of FUT and donor harvesting placement boils down to two main factors: your personal physiology in regard to donor availability and elasticity, and the skill of the surgeon you entrust with performing your procedure.

 

So choose carefully.

[hairsprint]

I've had three FUT procedures, and have one scar to show for it

I had 4 separate FUHT procedures so far in my journey and I have only one strip scar

I was not even aware that this was even possible! I always thought that #scars = #procedures. Assuming a patient ticks all the right boxes with regards to laxity, donor density and availability, would a surgeon have any other reason (say, surgery skill level required or maybe cost) to deny him the single scar option and instead create a new donor scar? Also, do single scar procedures and trichophytic closure always go together?

 

Thanks all for your comments

[Speegs]

I was not even aware that this was even possible! I always thought that #scars = #procedures. Assuming a patient ticks all the right boxes with regards to laxity, donor density and availability, would a surgeon have any other reason (say, surgery skill level required or maybe cost) to deny him the single scar option and instead create a new donor scar? Also, do single scar procedures and trichophytic closure always go together?

 

Thanks all for your comments

A competent surgeon should do everything in their power to have only one scar, and the tri-closure is a plastic surgery suturing technique known for mitigating scarring potential.

 

The justifiable reasons for having multiple scars are few, perhaps a previous surgery was taken outside of the safe zone of the scalp, or outdated techniques were implemented in the past causing a lot of donor damage.

 

But if any modern surgeon is doing it on an otherwise healthy scalp, run away.

[gillenator]

Could not agree more. As long as the patient has no issues with their physiology, has adequate laxity for the size of the strip specimen being excised, the rest is dependent on surgeon skill and competence.

[ArochaAngel4247]

Thank you so much for the props Steeeve!

 

ArochaAngel4247

[Steeeve]

Thank you so much for the props Steeeve!

 

For sure!!