My donor scar is a mess after 5 months...

[hairthere]

Turbo, Is the scar visible when your hair is not pulled up? Do you intend on wearing your hair short where it would be visible? If not, then scar revision would likely be a better option than FUE. I think most doctors would say to wait at least 1 year before doing anything.

[Turbo]

My scar cannot be seen without the hair pulled up. I ask the barber to cut it as short as I can get it whilst covering the scar.. (I always go just before closing and insist on going last - this is annoying!) For a week or 2 after I have to continually make sure the back of my head isnt exposing my scar (windy days are a problem!) and then after it gets better.. I have managed to keep this from most people (apart from close friends - especially male friends who can perhaps sympathise!)and no-one has commented so far. Not a problem if people do find out, but regardless it's no-one elses business is it?

 

Regarding the ideal time to get something done, I was thinking about Dec 10, as I can use xmas as recovery time.. Also it will allow the area to settle and perhaps more importantly it allows me plenty of time before I agree on a surgeon and to do my research and book the procedure.

[Turbo]

Also I would ideally like to wear my hair say at a blade 3 at the back.

 

At the front I like it about about an inch but Im reasonably happy with the front as my hair is slightly wavy and I wear it down not brushed back and even though it isnt really all that full; with some spray gel on Im happy with it.

[Dr. Timothy Carman]

turbo-

I would strongly recommend that you wait at least one year between procedures. This period is critical, IMO, to obtain laxity in the scalp as well as allow the postsurgical areas (donor especially) to fully heal. I would not recommend placing any grafts into that scar prior to one year, let alone at 6 months. Given your propensity for tissue reaction, I believe in your case that "haste WOULD make waste". Allow time for healing- that will be a critical factor in your progress, as far as I'm concerned.

[hairthere]

I think December 10th is a bit soon to perform another surgery, but a qualified surgeon can tell you better. If you're looking to wear your hair at a 3 clip then I really think scar revision is the way to go. FUE makes sense if you're going to do a close buzz cut. Also, FUEing into that size of a scar would take a lot of grafts which means you'll have to shave a significant part of your donor area (which would really expose your strip scar), plus it would be much costlier than scar revision. You also need to think about the possibility of future procedures if you need them and how to best manage your donor area. One philosophy is to strip out your donor and then FUE whatever you have left. Keep in mind that FUE does create scarring.

 

I realize it's tough to wait, but I think your best course of action right now is to consult with as many TOP HT doctors as possible and then make a plan. Best of luck with whatever you decide.

[Turbo]

Sorry I think that that was lost in translation.. I meant December 2010!

 

Also I am confused with regards to scar revision.. Surely if there was laxity in that area then I wouldnt of had the stretching this time? - The area has been really tight until recently, which I think was a result of it being attached to a small area of scar tissue from the last HT. Like I said I havent done any weight exercises until this month and then none that stress the area.. I can't see how the whole of the area could be closed up without further significant stretching.. Or am I missing something?

 

I really do need a proper qualified physical analysis of my potential options with regarding what would be possible I think.

[hairthere]

Turbo, Sorry I should have added that your scar could stretch again after having the revision done. Unfortunately there are no guarantees. Definitely take your time and consider all your options and speak with as many docs and patients as possible.

[Turbo]

Yes I am from the UK. I have had a response from my HT doctor, that carried out all of my 3 HTs. He advises me that my scar can be improved a lot and can be made smaller.

 

After my 3rd HT I contacted him after a month as I had a problem with a lot of scabbing that wasn't easily coming off..

 

He advised me that I must wait a year from the last procedure. (This is of course normal and what I would of done anyway).. I have asked him for the cost and also advised him that in the meantime I will seek further qualified advice.

 

Regarding travelling I am quite prepared to fly to the USA if necessary for the best result. I have to do the right thing.

[Raphael84]

Turbo, it seems that you have a very good attitude toward your situation. With good patient research and many consultations from varying sources, I believe that you can have a far improved scar than current. Stay positive as you are.

 

In my opinion, I would stay away from the Dr that has undergone your previous HT's if you currently already have 2 scars in different areas. I do not understand why this is. Whilst you have every chance of a good outcome, HT related wise, it may be your last chance. Which is fine, it obviously just means you must choose well. Your attitude on travel is also the right one.

Remember, were all here to support you along the way!

[Turbo]

The question I have now after all of your helpful advice, is how long should I wait until I get my scar examined?

 

I am thinking that if I have to wait a year for it to be rectified in some way, which will be June/July 2010; will it not be better to wait, say until spring 2010 for an professional examination so that there is a better idea of what is possible in the scar area?

 

I am thinking that the scar area could be different in a few months than it is now..

[TheEmperor]

Turbo,

The doctor may not have closed the wound properly. My understanding is that the better doctors do a multi-layer closure, which takes a significant amount of time and contributes to thinner scars.

 

Also, stretching does not necessarily mean tight. You can probably get a scar revision from one of the best doctors and be much better off. If the scar is still visible, then fue into it.

[rpachigo]

Echo what Emperor said. This is one situation you may want to go to one of the Head & Neck guys that does hair transplantation. That would be Dr. Lindsey or Dr. Konior. You don't have much room for error but they should be able to take care of it. With that wide of a scar, that suggests to me it wasn't closed properly. With proper closure, you should have a much improved appearance and FUE into that narrower scar if needed.

[bullitnut]

hi mate i had my scars revised by SMG and am over the moon with the outcome!!

 

heres mine from the UK norton clinic

 

 

 

and heres the same area after the revision with SMG

 

 

obviously there is a difference in hair length as the first pic is buzzed to grade 1 and the second grade 3 but the scar is fantastic now and im delighted as it was really visible before upto grade 4/5

 

SMG also do FUE into scars with good results

 

check out my weblog to see more pics of my scar good luck

[..]

Your scar turbo is one of the worst ive seen on here for a while , it looks so angry and thick .I think scar revsison is way to go but as u have stated everthing feels so tight already back there, have u emailed dr lindsey and asked his opinion !?. a question would be about air stretch bag option (and it being practical or possible) !? to gain skin elactisity , only thing that would mean is being finding some one local, reason i mention it is , only a couple of months ago i seen a program on tv and a guy who had a bike accident and was left with big scars across the top of his head .. later on he went on and wore the inflatible stretch bag, the scarring was then cut and close back up with great result , it was a nhs program in the midlands

[Turbo]

Thanks for that Bullinut, at this point I would even be happier with your initial scar as blade 3 or 4 I could cope with not my current inch plus haircuts at the back and sides!

 

Yes I know it's an extreme case. I've decided to not get too down over it.. As long as my hair is a certain length and I use thickening shampoo then it's not visible.. But we all know that hair soon becomes untidy.. Luckily Ive used the same barber for over 20 years and he knows my story and actually told me that he himself would of had rhinoplasty if he wasn't married!

 

Ive not heard of 'air stretch bag' and wouldnt that be for 'virgin' skin that hadn't already been stretched like in the case you mentioned? I will look into it.. I havent yet spoken to my local doctor as I feel it's my problem to have to deal with and it isnt like a normal accident scar I don't think..

[hairthere]

turbo, Scar stretching is not the end of the world if you have the hair to cover it, which it looks like you do. I'd be much more concerned with a fouled-up recipient area. The bottom line is you have the option of scar revision or FUE, and, in the meantime, you can always put on some Dermmatch if you feel insecure. Take care.

[Turbo]

Yes, point taken. I will try Dermmatch.

Regards

[Dr. Timothy Carman]

Turbo-

Ive not heard of 'air stretch bag' and wouldnt that be for 'virgin' skin that hadn't already been stretched like in the case you mentioned? I will look into it.. I havent yet spoken to my local doctor as I feel it's my problem to have to deal with and it isnt like a normal accident scar I don't think..

I believe the poster ".." is referring to the use of a tissue expander (not "air" filled.)

I used this technique extensively in the past in burn reconstruction, where large areas of injured scalp required excision. We can also use tissue expanders in other cases, such as hairline lowering procedures in women who have congenitally large foreheads. The procedure is quite successful, though it is very costly and time intensive, requiring visits twice weekly to the surgeon's office to slowly fill the balloon with saline over a period of 2-3 months. The principle is as follows:

Using your situation as our example, an incision is made along the scar, and the scalp is separated from the underlying bone (skull) as far forward as the frontal hairline, a process known as undermining. The width of the undermining would be about 15-20 cm, about the width of your scar. After tunneling, a flat (deflated) surgical balloon is advanced so that it lies under the scalp that has normal hair (anteriorly, toward the front, not under the scar). A small port that attaches to the balloon via a tube is placed under the skin, usually just behind the ear. This is where the saline will be injected during the inflation process. The incision is sewn up, and the would allowed to heal.

Successive filling of the balloon over 2-3 months leads to a very bizarre looking scenario due to stretching and expansion of the area under the normal hair bearing scalp.

At the end of the filling period, the patient is brought back to the OR, and the balloon is removed. The result is a large area of uniformly expanded hair bearing scalp that can be pulled over the area where the scarring occurs. The scars are completely excised, and the normal hair to normal hair edges are approximated under no tension whatsoever.

The results are immediate and dramatic. (You can imagine in the case of our burn patients.)

Again, this is a costly and much more invasive procedure than a simple transplant scar excision as discussed above, but the results are very, very gratifying. I pass this on to you so that you and everyone are clear as to what I believe ".." was referring to.

[..]

Thx for the heads up on the expander question doc . like i say the the person on tv seemed to have a great result , would "stretch back" be a problem down the road, or a lot less likely than a straight normal excision ?, were these skin expanders used for scalp reductions also ?

hope u can get this scar improved turbo.

[Dr. Timothy Carman]

As the closure in the case of the tissue expander would be under virtually no tension, this may mitigate the reformation of the scar. (Less likely.)

Expanders can be used for scalp reduction, as I described in the case of a patient with extensive grafted skin to the scalp secondary to 3rd degree burns.

[Dr. William Lindsey]

I feel your angst over your scar. Its not the worst that I have seen and is hidden by your hair at present. That may not be of much consolation, but, listen to what a number of posters have said, and that is to wait until a year is up. Its not that I'd expect alot of improvment(but it could happen), but rather your skin will be physiologically more ready for some type of repair at that point.

 

Without actually squeezing your scalp I can't tell you how much you could remove at one setting, but I'd bet that you could get most if not all of that scar in one setting. Then you would need to wait and see if you re-stretched, unlikely but possible. If not, that may be all you want, but a second excision or FUE into the scar could be options.

 

But do not make any decisions yet. It might get better or worse in the mean time, and your skin isn't ready for more work yet.

 

Lastly, I'd find no indication at this point for considering tissue expanders. Single or serial excision of the scar would be a better solution in my opinion, but that too may change by a year.

 

In the interim, keep your hair a bit longer and enjoy the winter. Don't rush physiology.

 

Dr. Lindsey McLean VA

[Turbo]

Thanks for all of your recent comments, especially the professional opinions which I really appreciate. I will of course leave the area alone until the middle of next year before seeking further advice.

 

It seems to have stabilised now and doesn't feel tight. I had a really long-lasting numbness at the top of my head that has also 90% gone in the last month. This has been very gradual.

 

One thing that I'm wondering if it's a good idea doing is to ask a close friend to take some decent pictures of the area every month or two so that I can compare it over time. Then I can perhaps give the doctor a more accurate idea of how the area is and is perhaps likely to behave with a scar excision?

 

Regarding scar excision I have to say I would be very concerned about stretching again as after the last HT, it was very tight to the extent that I didnt have much movement in my head and lifting even a wheelie bin onto 2 wheels was really difficult. But as has been mentioned I shall see how it develops and continue with wearing longer hair..

[Ulates]

Hi,

 

I'm new here. I feel your pain, I have three of these on the left side of my head, one on top of the other. I have had them for about 20 years now. Unfortunately when I was in my early twenties I was hacked and have been paying for it ever since.

 

I've been researching again to have these fixed properly, as well as my crown, which was also scarred and ruined. Worst mistake of my life, that I get to relive daily.

 

Things are not as they were 20 years ago, if this was just done and it doesn't improve, I would think about it carefully. I went back to the same doctor to have mine fixed months later and they did nothing but re-cut me and put me through the same torture for the same results.

 

I'm not saying this will happen to you, but I hope you can side-step what I've had to go through (and others I'm sure).