FUT Closure Question

[hairlossPA]

Hi community-

I know all surgeons take precautions to avoid this scenario, and measurements and skill come into play... but what would happen if a surgeon took too wide of a strip from someone’s donor region, and could not close the flesh together?

 

I don’t understand how people can have multiple FUTs

[mattj]

A valid concern, but any good doctor is going to ensure that there is enough scalp laxity to remove the strip while leaving enough room for closure.

The width of the strip is rarely going to exceed around 15mm and if the patient has never had previous surgery, then there will be enough 'slack' to remove a strip safely. The same will usually go for a second surgery. The amount of stretch available in the average scalp varies, but it's actually possible to increase this with stretching exercises. Doctors will normally instruct patients to do these exercises before FUT surgery. It's rare but not unheard of for a patient, especially one who has had multiple procedures, to be told that FUT surgery isn't possible due to a tight scalp. Better to be told this than to end up in the scenario that you're imagining! Really, it's a question of choosing a good doctor.

[mattj]

Oh, and I should add that I've never, in all my years of involvement in this subject, heard of someone having a strip removed and not having enough scalp for closure. Perhaps I've missed a rare and horrific case and someone will point me to it, but I doubt it.

Edited July 6, 2018 by mattj

[hairlossPA]

4 hours ago, mattj said:

Oh, and I should add that I've never, in all my years of involvement in this subject, heard of someone having a strip removed and not having enough scalp for closure. Perhaps I've missed a rare and horrific case and someone will point me to it, but I doubt it.

Thanks Matt. I would hope not lol. But I guess I'm interested to hear surgeons stories about the subject. What they would do, etc.

also laxity seems to change from the side of the head to the back of the head. its all crazy to me lol and it makes me nervous

anyone? 

[Melvin- Admin]

This should never happen with any of our recommended surgeons. A patients laxity is tested prior to having any surgery. In rare cases, the closure may be more difficult than expected, but I’ve never heard of a surgeon not being able to close it in all the time I’ve been a member here. Warmest regards 

[Bill - Seemiller]

Well I remember a long time ago seeing a photo of an open donor been left on touched and it healed that way.  Credibly, it looked just like a very  wide, uneven and scaly score that nobody would ever want to.   I honestly don’t remember the specifics of the case for why the donor wound was never closed…  but maybe it was just as you say in this scenario, maybe it couldn’t be close. That said, that’s the only case I remember ever seeing and I don’t know why it was the case.   To answer your question, that’s probably what would happen. I wouldn’t be able to close it and it would heal terribly. 

 That said, I can’t imagine this ever happening even in an experienced hands let alone an expert hair restoration physicians hands.

best wishes,

Bill

[Al - Moderator]

It's extremely rare that this happens because the Dr checks for laxity before cutting the strip, so he knows approximately how wide he can go. However it did happen to me long ago during a scalp reduction. I had 5 scalp reductions and this was the last one done. It was actually done to remove some large plugs, cut them down, and place them into the frontal third. Anyway, my head didn't have much laxity left from all the previous surgeries, so they weren't able to completely close the wound. They used stitches to close it as much as they could and then put a bandage over it. It healed OK except with a wide scar in the area that they couldn't close. I've since had grafts placed over that area.

 

[gillenator]

The issue is really not a case of having enough to close the area, it's more a situation of having enough scalp laxity for the closure to be complete and successful without there being undue tension on either side of the scalp from where the strip was excised.

And if the patient does not have the accommodating laxity for the width and size of the strip being excised, the outcome many times will be an unacceptable wide scar which nobody wants.