Effectiveness of FUE into Scar Tisssue

[Bigmac]

Here is an example of Fue placed into scar tissue that was performed by Dr Wolf around the beginning of 2006.The patient had 342 grafts placed into the scar to break it up.

The scar was 13cm long x 3cm wide.This patient had 4 prior strip surgeries by another doctor.

 

[janna]

That's about as wide a donor scar as I've ever seen. I'd like to ask Dr. Wolf if he considered excising part of the scar. I don't think you'd be able to excise all in one shot as it's too wide but perhaps 1/2 the width?

 

[Sparky]

those hardly made a dent in that thing.

 

[janna]

When dealing with scars, you have to be careful at what density you plant the grafts. The blood supply within the scar tissue is limited so many doctors tend to plant more conservatively for the first pass. Once you plant grafts and see that grafts grow, you can plant grafts to make it denser.

This result is also only 5 months post op so much more growth to look forward to. And it was performed in early 2006 - I'd say, nice job Dr. Wolf.

 

[hairtech]

In addition to Janna's post there are two other considerations to planting grafts into scars. In my opinion... and others:

1. The older the scar the better. Scar tissue is extremely dense. It takes considerable time to vascularize this type of tissue. (Capillary circulation growing into dense fibrous tissue). A scar that is one year out will more than likely not be able to support as many grafts as a scar that is a few years old or older.

2. Like Janna states... several passes into the scar may be necessary to achieve the desired result than a single pass only. This may in part be for this reason: The first pass in a low density manner may in fact "prime" the area if you will. Adding grafts to the scarred area may draw demand of capillary presence... Biochemicals secreted from the transplanted follicles demand nutrition and blood supply into the scarred area faster than just leaving the scarred area alone.

This occurs in non-scarred tissue with transplanted grafts. A graft has to eventually be fed by a capillary blood supply. Normal tissue can support more grafts than scarred tissue (theoretically).

Priming the scarred tissue with follicles in a lower density will provide a better blood supply for a second. third, etc... pass.

This scar could or could not have been excised though. The patient may have had this excised and it restretched?*nl who knows the story. I do like to see the growth though. This is a good case.

 

[Bigmac]

Thanks Janna and Hairtech for your insight.

bm.

 

[Tiberius]

What percentage of growth could i expect if i had fue grafts transplanted into my necrosis scar tissue?

 

[hairtech]

Tiberius... first of all you have to give us the "history" of your "necrosis", of your scar?

When did you develop a necrosis state? What happened? And please include the time line... how was it treated (antibiotics, etc) and is it resolved. ;ss;

 

[Tiberius]

hairtech wrote:

Tiberius... first of all you have to give us the "history" of your "necrosis", of your scar?

When did you develop a necrosis state? What happened? And please include the time line... how was it treated (antibiotics, etc) and is it resolved. ;ss;

Hairtech... thanks for replying, i`m of mixed race with typical Afro hair which i beaded beaded back for 5 years. I developed a bald area behind the hairline approximately 3 inches in length x 1/2 inch in width. I had this treated with a course of antibiotics a little over 2 years ago with 60% return of growth. The Necrosis was epidermal only as explained by my doctor.



However 2 years on i sport my hair with a grade 2 cut and you can clearly see the area where the hair has not returned, if you can imagine putting your index finger across your head from temple to temple and removing the hair by 50%! This is what i`m left with. Looking at fue pictures it would appear that i need roughly 3 maybe 4 hundred grafts to bring the area in line with the surrounding native hair.



The scar tissue is still visible, although i have no symptons of irritation or inflamation in the area.

Do you think it would be wise to proceed with the fue?

 

[hairtech]

Ok what I am gathering from your post is that you pull your hair back in beads. This is a common practice that sometimes leads to what is called traction alopecia. Traction alopecia simply means that you are pulling your hair so much that it literally eventually pulls the follicles out completely. This type of hair loss is seen in Africans, African Americans, Native Americans, Americans, as well as people that wear turbans such as folks from Islamic regions. Basically anyone that chronically pulls their hair back.

Fortunately and in my opinion, this type of hair loss is easier to correct than male pattern baldness.

FUE would be in my opinion would be a viable solution.

 

[Dr Arvind]

Transplanting fue grafts into a previous strip scar has various benefits. Unlike a scar revision, with its attendent risk of stretchback, fue into scar is less inavasive and has a higher chance of success in our experience.
Also, with enhnaced donor availability from beard and robust body donor areas, one need not waste any scalp donor hair to acheive camoflage of the donor strip scar.

Regards,
Dr. A

 

[Tiberius]

Thanks Dr. Arvind and Hairtech for the comments and feedback. Dr. Arvind, what would you say is the ratio of beard hair opposed to scalp hair to garner the same acquired density?

 

[Dr Arvind]

Tiberius wrote:

Thanks Dr. Arvind and Hairtech for the comments and feedback. Dr. Arvind, what would you say is the ratio of beard hair opposed to scalp hair to garner the same acquired density?

Dear Tiberius,
The beard hair is almost three times in terms of volume/coverage as compared to the scalp hair.
OTOH, beard hair grafts are mostly 1 hair grafts while the scalp hair may be 2 or 3 hair grafts.

Then there is the matter of difference in the hair growth cycles.

Figuring all factors, I will say that one needs roughly the same number of grafts when going for beard grafts instead of scalp.

Regards,
Dr. A

 

[Nervousnelly]

Great post. Excellent photos to visualize the growth. Ofcourse a scar of this nature will most certainly take a lot of work for total concealment. Thanks for all of the feedback as well.

NN

 

[Bigmac]

Hi Dr Arvind,what are the differences in the growth cycles.Also does the Beard hair grafts suffer from shedding like scalp hair.

Thanks bm.

 

[Dr Arvind]

Bigmac wrote:

Hi Dr Arvind,what are the differences in the growth cycles.Also does the Beard hair grafts suffer from shedding like scalp hair.

Thanks bm.

Dear BM,
Following is an extract


--------------------------------------
Hair Growth Tables
There are many factors that affect individual hair growth. These growth tables should only be used as a very generalized guide.

Telogen (%) Anagen (%) Duration of Activity

Scalp 15/ 85/ 2-6 years
Eye Brows 90/ 10/ 4 - 8 weeks
Cheeks 40 - 50/ 50 - 60/
Beard (Chin) 40/ 60/ 1 year
Moustache 45/ 55/ 16 weeks
Arm Pit 70/ 30/ 16 weeks
Pubic Area 70/ 30/ months
Arms 80/ 20/ 13 weeks
Legs & Thighs 80/ 20/ 16 weeks

Carl W. Bushong, Ph.D., LMFT
Richard A. Martin, Jr., M.D., FACEP
Kimberly L. Westwood, CPE, CCE
et al.

--------------------------------------

Regards,
Dr. A

P. S. - The following link is interesting information regarding beard hair http://jefffsbeardboard.yuku.com/forum/viewtopic/id/862 I think you will like reading it and its implications.

 

[Bigmac]

Thanks again Doc,very informative reply and that is an interesting link.

bm.

 

[Bigmac]

Does anyone know how long beard hair grows as you see some people with very long beards.

 

[Tiberius]

Thanks for the informative response`s.

 

[bullitnut]

Bigmac wrote:

Does anyone know how  long beard hair grows as you see some people with very long beards.

Yeah good question(if you had beard hair like ZZ Top you would be well sorted) Do you have to cut beard hair very regular too? As it grows quick on the face