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FUT Staples


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  • Senior Member

Hi all!

I am trying to calculate how long I will have to stay near the clinic after I have the surgery done. Can anybody help with the below please?

1) How long after the surgery is it before the staples come out?

2) Can anybody take them out or is it better to get the same clinic who put them in take them out again? I am guessing the latter as they will be used to it but thought I will ask anyway.

3) Once the staples are out, can I go home then or do I have to wait around for something else?

4) Finally, what are the factors involved in if the staples themselves leave a "railway line" looking scar?

Thanks in advance!

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  • Senior Member

Staples normally stay in anywhere from 10 days to 2 weeks.  In my case, my Dr was 40 miler away so we simply made a follow up appointment to take them out and measure after-surgery progress. 

If you are a country away, your own general practitioner or family physician can certainly remove staples.

Once the staples are out, the area should be inspected to remove any scabs or left over crusts.

My first procedure used sutures, which my wife removed. 

A railway scar should be of no concern as you hair will grow over it most likely - but keep a T Scale train handy if you ever shave it down so the grandkids can have some fun when you're sleeping face down. 

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  • Senior Member

Staples?  Where are you getting the surgery done?  Staples are a thing of the past.  Typically prolene is used..It is one long suture line with knots at the end.  Cut the knot and pull.  There are several other techniques being used and a number of products.  Some even use dissolvable sutures.  These are normally removed 10-14 days post op.  I would encourage you to speak with the doctor and find out why he prefers to use staples. 

You can go to a local clinic but it is likely they will charge you.  Try always to return to the practice that did the work.

Typically 7 days after the procedure you can resume normal activity.  I would, however, avoid weight lifting, particularly all exercises involving neck movement for 6-12 months.  This has a tendency to stretch scars.

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  • Senior Member

Staples were used on my 4th and last procedure in 2006.  My surgeon decided on this because my scalp laxity was not as loose as he wanted to see it.

My PCP removed my staples 14 days post-op.  Then I discovered that one of them was buried and missed.  It became very painful and eventually had to have it surgically removed by my same PCP.

I would have gone back to my HT surgeon but he was over 1200 miles away and why I had my PCP remove them.

My strip scar came out fine and there is not any railroad tie scarring...that won't happen.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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4 hours ago, TrixGlendevon said:

Hi all!

I am trying to calculate how long I will have to stay near the clinic after I have the surgery done. Can anybody help with the below please?

1) How long after the surgery is it before the staples come out?

2) Can anybody take them out or is it better to get the same clinic who put them in take them out again? I am guessing the latter as they will be used to it but thought I will ask anyway.

3) Once the staples are out, can I go home then or do I have to wait around for something else?

4) Finally, what are the factors involved in if the staples themselves leave a "railway line" looking scar?

Thanks in advance!

Out of interest what surgeon did you settle for? I’m waiting for Dr Vila to confirm availability for surgery. 

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1 hour ago, LaserCap said:

Staples?  Where are you getting the surgery done?  Staples are a thing of the past.  Typically prolene is used..It is one long suture line with knots at the end.  Cut the knot and pull.  There are several other techniques being used and a number of products.  Some even use dissolvable sutures.  These are normally removed 10-14 days post op.  I would encourage you to speak with the doctor and find out why he prefers to use staples. 

You can go to a local clinic but it is likely they will charge you.  Try always to return to the practice that did the work.

Typically 7 days after the procedure you can resume normal activity.  I would, however, avoid weight lifting, particularly all exercises involving neck movement for 6-12 months.  This has a tendency to stretch scars.

Thanks for the the reply. I just assumed they would be staples because of the severity of what the surgeon is doing. I do not know if the clinic I am visiting in two weeks uses them or sutures to be honest. The point of my original post was just to know how long I will have to around the clinic. I am not travelling back to my country of residence and then back to the country I am getting the surgery in. I would rather just stay there. 

I live in a country with free healthcare so no problem with the clinic charging me.

Out of interest, you say 6-12 months of no weightlifting but this is the longest recommendation for absenteeism from the gym I have seen. Who has told you that?

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51 minutes ago, Raker said:

Out of interest what surgeon did you settle for? I’m waiting for Dr Vila to confirm availability for surgery. 

I want FUT anyway but just thought I would enquire with Dr Vila as she has her own clinic now. If her waiting list for consultations wasn't so long, I would possibly consider her but she can't even give me a consultation until early December and I want to be having the surgery done in December, if possible. So far, I have seen Drs Feriduni, Devroye and Lupanzula. I am going to see Dr Mwamba too as he visiting other cities soon for consultations. I am going to Switzerland to the Hattingen clinic in two weeks. Dr Feriduni has said he would prefer to do FUE in my case. Dr Lupanzula said he no longer really does FUT and thinks FUE is the superior method. Dr Devroye said he would do either and agrees that FUT would be the best option for me. Dr Mwamba will agree with Lupanzula I think. Hattingen does both but they specialise in FUT. I have had an online consultation with them already and they said FUT is the best option. As I want FUT, this narrows my choices down somewhat, less so if I can convince Dr Feriduni to do FUT too. 

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  • Senior Member
1 hour ago, gillenator said:

Staples were used on my 4th and last procedure in 2006.  My surgeon decided on this because my scalp laxity was not as loose as he wanted to see it.

My PCP removed my staples 14 days post-op.  Then I discovered that one of them was buried and missed.  It became very painful and eventually had to have it surgically removed by my same PCP.

I would have gone back to my HT surgeon but he was over 1200 miles away and why I had my PCP remove them.

My strip scar came out fine and there is not any railroad tie scarring...that won't happen.

Thanks for your reply. Why won't it happen? 

As you had staples on your fourth procedure, what did you have done for the other three?

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  • Senior Member

I have met with a number of patients that DID NOT LISTEN when post op instructions were given to them.  They went to the gym as soon as they could.  In every instance the scar widened.  Mind you, these were FUT cases.  I have heard this from many physicians.  And, just to add, in the 80's, doctors felt that the finest hair for hairline work came from the nape.  Very soon they found out that, since the area is so close to the neck, scars widened.  

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  • Regular Member
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From Bernstein’s website.  I had FUT with him in July.  Staples came out in two steps.  They were removed at his office, but said he could instruct someone to else how to do it  

 

March 19th, 2007 
 

Q: I recall that you wrote an article about Monocryl for the donor closure in hair transplants. Why are you now using staples? — R.S., Park Slope, NY

A: I have been using staples in almost all of our follicular unit hair transplants since the beginning of 2006. When we published the Sutures vs. Staples study in 2001, some doctors were still not convinced. Because of this I continued to look at the issue, not in a bilaterally controlled experiment, but just looking at my cases done with the 5-0 Monocryl and those with staples that I continued to use from time to time. After doing hundreds of additional cases, I was still convinced that, overall, the suture line looked better with the 5-0 Monocryl sutures than with the staples.

However, it occurred to me that perhaps we were looking at the wrong thing. I began to think that perhaps we should be looking at hair preservation, rather than cosmesis alone.

The problem with the appearance of stapled closures is that it results in a very well demarcated, geometric line. Monocryl sutures, on the other hand, results in a much softer, more smudgy line – the characteristic that made it look better in the study.

This effect is produced by two things. The first is that the very fine 5-0 Monocryl sutures placed very close to the wound edges allow perfect wound edge approximation. However, the running suture actually destroys some hair as it makes its spiral course through the skin, destroying some hair and producing this smudgy appearance. We had felt that suturing very close to the would edge, using fine suture caliber 5-0 Monocryl, advancing the running stitch on the surface rather than in the SC space, and the mechanism of action of Monocryl absorption (via hydrolysis rather than by an inflammatory reaction) would all mitigate against any hair loss – but there was still some. It seemed that although the overall look was better with sutures, it might be at the expense of some hair loss.

To test this, I began to look at the hair yields in the donor strips of second hair transplant procedures where the new harvest completely encompassed the old scar. It seemed, at least anecdotally, that the strip containing an old incision that had been sutured closed contained slightly less hair than that from one that was stapled closed, even if the former looked better. Although I did not do a rigorous study, this was my “sense.”

In addition, I realized that staples could be left in the scalp for 3 weeks after a hair transplant without causing excessive inflammation (patient discomfort not withstanding) and this gave me more flexibility in using staples in patients with slightly tight scalps without having to rely on subcutaneous sutures. I began to take out alternate staples at 7 to 10 days and the remaining staples at 18-21 days post-op.

With the issue of hair preservation, rather than just the cosmetic benefit, as the main goal and with the added flexibility of being able to leave in alternate staples for up to 3 weeks, I started using staples routinely in almost all of our hair transplants.

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  • Senior Member

Great post! I would argue that the the staple must destroy some hair too though as it leaves "train track" scars. Who knows though, he is a doctor and did studies on the subject. I personally would also go for the most cosmetically appealing option of the two, which is the suture.

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  • Senior Member

Virtually anyone can take the staples out. You just need a disposable tool that the clinic can provide. No medical training whatsoever is necessary.

Regarding sutures vs staples, consider focusing on the result rather then the method and look for surgeons who consistently leave the least detectable scars. 

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  • Senior Member

Trixglendevon,

I said it won't happen because each staple only has 2 tiny entries into the scalp...the railroad effect that you are referring to is only a temporary depression by the bridge of the staple which does not cut into the scalp...make sense?

Also, sutures were used in my other 3 procedures.

Spaceman, it does make a difference that someone has the skill to remove the staples...it's not as easy as it may appear and as I mentioned before, one of my staples was missed and eventually got buried under my scalp (epidermis layer) and extremely painful having it removed.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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12 hours ago, gillenator said:

Spaceman, it does make a difference that someone has the skill to remove the staples...it's not as easy as it may appear and as I mentioned before, one of my staples was missed and eventually got buried under my scalp (epidermis layer) and extremely painful having it removed.

Gillenator, sorry to hear one of yours was missed. That’s an unpleasant complication. In my case, Hasson and Wong gave me a staple remover at discharge, and instructions on how to remove them so I did it at home. In case anyone is interested, the instructions are here:

 

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