A question for Janna

[pvtpoint2010]

Hi Janna not sure if you have been following the post

http://www.hairlossexperiences.com/view_topic.php?id=2301&forum_id=2

But would be interested in your opinion regarding my case......Even though we spoke in the past was wondering in light of the new photo's...and remarks...

Does the game plan sound like a good idea to you?...ie FUE ....Strip scar revision later on?

Other then Cole does do any of your Dr's due non shaven FUE?

Also if i were to go the strip route do you think the top scar can be used

And if so other then personal healing whats the odds on getting a tighter scar with say a 1800-2300 graft session.....

 

[janna]

Hi Pvt,

I wanted to run your question by Dr. Shapiro so had to wait until he had a break from today's surgery.

While the plan/approach can vary depending on several factors...ie, scar size, laxity and density. Dr. Shapiro's approach would be to take care of your frontal 1/3rd with approx 1500 grafts with hope that he can harvest 2000 grafts safely. He liked your current location of your hairline so he didn't recommend bringing it down or you'd end up needing a lot more grafts. You may have enough donor supply to lower at another time but first things first. First goal would be to strengthen and refine your existing hairline and add density behind it. This would be his goal for front without thinking of your donor situation.

I then showed him your donor scar in the link and he said the approach would depends on which approach you felt most comfortable as there are few possibilities....

1) Excise old scar only. You'll get some grafts from the revision - some patients get as much as 500-600 grafts from this. Then plan normal strip session to address frontal 1/3rd.

2) Take bottom portion of old scar only and try for as much grafts as possible - approx 15-2000 grafts with scar revision session planned for next session.

3) Take whole scar + get grafts - 1000-1500 grafts possible. More risk of stretching scar. However, this is much like approach #1 with good possibility of not needing another session if your scar heals well. There's a good chance you may get 1500 grafts with use of Vitrase and Acell wound strips.

My personal opinion is #3. One session approach with possible 2nd session if and only if the scar heals badly . The other two definately requires two sessions.

As for non-shaven fue, we do not do this in the donor. I imagine it's an expensive procedure as it's very time consuming. Considering you have strip scars, he didn't see why you'd do fue. Your front would not have to be shaven (although, it's nice if it is).

Hope this helps.

 

[pvtpoint2010]

Thanks Janna And say thanks to the Doc ...

I agree The FUE idea is expensive as Dr Cole charges $10 per unshaven graft ........Though i already have scars its still a catch 22 ..........Do another strip hoping we get the needed Grafts along with praying it doesn't make it worst...It could re stretch worst then it is now, it can extend past its end points into the sides ( to get the needed grafts), or it could heal perfect....

Too many "if's" .........I feel .........though the FUE option is more expensive I think 2-3 small sessions of 500-700...500-700...and/or 300-500 in a third.....all done over 1 year to 18 months....

Then after all is said and done option 1 ....Just the scar revision ....if more grafts are needed in the future we can cross that bridge at that time....This would give me a total of about 1500-2200........



Personally I'd rather get it over and done with in 1 shot via strip but the chance of opening up a new can of worms scares the hell out of me......

I think the FUE/revision idea is an extremely safe approach ......... offering the lest chance of unforeseen trouble along with giving most if not all of the needed grafts....

 

[janna]

You have to go with what you feel is the most comfortable approach. If you were to ask which of the two procedure to do first, I'd say do the revision first before the FUE. This way, if the scar did not heal well, you can plant grafts to the scar line via FUE.

Whatever you decide to do, best of luck.