Repair case: fixing a strip scar

[Hedgehog]

Hi all,

I have been reading for quite some time on this and several other fora.
I never felt comfortable writing down my story, but I will do so here and only here.
This forum is different; it is a more open and transparent place than all the others.
Besides that, there are several repair patients here and they are here a long time. That says enough for me.
Some of you repair patients have been an inspiration in coping with which is undoubtedly the biggest mistake I ever made.

Several years ago I had a HT, stepped into it naively and with blind confidence. I never should have had it.
I lost all native hair in the 2 years after it.
Maybe it's a blessing I didn't have any growth of the so called 1000 grafts.
So I stay behind with a strip scar, about 7.5cm long and 0.5cm wide, some nice stitch marks too.
I have been blade shaving my head for several years now, since it's the only option for me.
After initially feeling free from hair troubles, I became more and more self conscious about the scar.
Now it has more control over my life than I would like it to have.
I realise I need to do something to improve it appearance, so I can finally leave this behind and move on with more important things in life.
So I have been researching my options; revision, FUE, pigmentation..
But the information that is available on the internet stops at a certain point.
Especially the information I need in my case, which is fixing a strip scar that I want to shave forever, or keeping at a 0 grade.
I'm not expecting a miracle, a decent improvement would be sufficient.

I am interested in the experience of other repair patients, or clinics, in this matter.
For example I wonder how a scar would look like after FUE and then shaving.
Will there only be dots or will the color change too?
Several ppl on this forum had FUE in their scar. Maybe you do not shave, but do you have an idea how it would look like?
Who had a revision and did it make a big difference?
...

I want to find out which action(s) to take, in which order to take them and who to trust in taking them. But I feel like I need more info.
I almost read everything on this forum, and it has allready been of great help!
So I hope you guys can share your knowledge.

Big thanks!

 

[topccat29]

From what I have seen results are mixed. You could fue into the scar but the hair has to match if you are using donor outside of scalp and even then it €™s not always a sure thing. Is the scar raised, flat or does it sink below the rest of the skin? All that is probably going to matter as a flat scar would be the best place to start. Since you already shave your head you probably have a good idea on how the scar has healed. If the scar itself needs work it might be best to go with some type of laser treatment or something similar first and then fue into at a later date. There is a relatively long thread on hairlosshelp that might be helpful in the repair section.

 

[SADbutTRUE]

welcome to the forums, good luck in your journey to fix ur scar, theres several good guys on this forum, remember your not alone and there is ways to improve your situation,

 

[Hedgehog]

Topccat29,

The scar itself is just a little below skin surface, but its surface is flat.

I am aware of the fact that the donor hair for FUE has to be similar than the scalp. That is actually 1 of my big concerns. I am afraid that beard hair will appear to be too coarse..?

Thanks for the tip on the repair section of hairlosshelp, but I already worked my way throughout it.

 

[Hedgehog]

Thx for the welcoming SADbutTRUE

 

[topccat29]

Since you shave you head maybe take a picture of the scar area and post it. I'm sure many others would chime in with some thoughts.

 

[Hedgehog]

Pic removed as requested by patient.Bm.

 

[topccat29]

My opinion is that as far as strip scars go it's relatively small. I would also say the average person would not know what it was from and would think it's just a scar from getting hit in the head or something similar. I wouldn't worry about it but everyone is different.

I think you could probably improve it but getting back to before doesn't happen too often when you want to shave down like that. Doesn't hurt to try a 100 or so fue as it is such a small amount of grafts and further damage is highly unlikely.

Also look into laser as a way of minimizing the scar. I have seen some excellent results with facial scarring using lasers but of course research I'm sure there are just as many in that business that don't meet the standards many patients expect.

The reason I mention the laser and I'm probably telling you something you already know is that ideally you probably want that skin to be flat and as normal looking before trying fue because of the fact that you shave down.

 

[Westcoaster]

As Topccat states, 100 or so fue as a trial, if successful then add more.

 

[Bigmac]

A small fue session is a good idea to see how they grow.

 

[Hedgehog]

Yeah I will get some FUE in the scar for sure.
But I'm still researching if I could benefit from a scar revision first.

The scar is not so long, but a little bit stretched (5mm) and has suture marks.
Bringing the width down to about 3mm and getting rid of the suture marks before getting fue in it would give a much better result. But I am aware that it can stretch again and even get worse. So it's a difficult decision.

Anyone here who has experience with scar revisions?

 

[janna]

Hedgehog wrote:

Especially the information I need in my case, which is fixing a strip scar that I want to shave forever, or keeping at a 0 grade.
I'm not expecting a miracle, a decent improvement would be sufficient.

You are saying two different things here, which is you want to fix your old strip scar and be able to shave to a 0 guard while saying you're not expecting a miracle.

Even with a scar revisions and fue into the revised scar may not allow you to shave to a 0 guard. Both procedures will likely be a big improvement, however, don't expect to shave to a 0. You may end up with really nice scar or barely noticeable scar but you shouldn't go into it expecting that for a final outcome. A 2 guard or possibly a 1 guard would be more of a realistic expectation.

What country do you reside in?

 

[Hedgehog]

I will never be able to shave at a 0 guard without the scar showing, I know that.

However, I will be maintaining a 0 or a 1 grade at max. I just want to make the scar appearance as good as possible with such a short hair cut. Make it less noticeable, not invisible..

At the moment I blade shave, and the white scar is very visible. But a little stubble highlights the scar even more by the lack of any hair in it.
So I want to get some hairs in the scar with FUE. But I don't know if that alone will give a desirable result.

That's why I am considering a revision first. Living in Europe by the way.

 

[janna]

Hedgehog wrote:

I will never be able to shave at a 0 guard without the scar showing, I know that.

Okay, that's good.

Did I miss a pic of what the donor scar looks like currently? To avoid using up a lot of scalp grafts via fue into the scar, I agree that a revision will be helpful.

 

[hairtech]

Hedgehog,
Hello Hedge...

I wanted to respond to your problem. I think you have some great concerns here. There are so many folks in your position and wonder what can get them to a place where they can shave down to a certain level that doesn't show a strip scar but can MAKE you/them comfortable.

Well that is a very difficult problem to solve. And I do not believe that there is any one single resolution after a strip. People post great donors scars, post great donors from FUE but the fact of the matter is that no one scars the same.

I personally believe that in certain situations... a resection helps. I personally believe that FUE into a scar helps. I personally believe that SMP into a scar helps. I have seen some interesting results in a combination with any of these options.

But I am not here to give you exact advice for what you should do because you have a scar and you are an individual.

I do want to show you a case where a person at lease changed the contrast between his scar and his scalp. This was apparently a same day pic of a fresh SMP. I agree with this improvement. Personally I would not resection this. And FUE alone maybe would get this improvement in two passes (my clinic). But maybe a combination FUE/SMP would be good in this case.

Cheers

 

[topccat29]

Personally I feel the only way to address a scar outside of fue into a scar would to actually lift most of the skin in the surrounding area away from the scalp and then suture it together as this would reduce most of the tension. When it comes down to it in my opinion all these giant stretched out scars are just a matter of too much tension and with all that pulling something has got to give really comes down to just basic mechanics and nothing more.

A good example would be comparing my strip scars from procedures long ago which were under a great deal of tension for a very long time to pictures of the scars from the hairlift where the skin was actually lifted away from the scalp and there was very little tension. The problem with lifting away the skin is that it becomes a major procedure where the possibilities of complications might very well be much higher. Anyway just a thought by looking at the back of my head one might think I have poor healing characteristics but if one were to look at that thin scar that runs along the temple they would walk away with a different point of view.

 

[Hedgehog]

I added a picture of the scar

scar

Really appreciate all the input!

 

[hairtech]

Hedgehog,

1. Yes, I would explore into trying to revise this surgically first. But definitely do your research because not everyone preforms a revision properly.

2. Maybe explore SMP. And again this is a very delicate option because not many clinics know what they are doing at this point. I have, however, seen some good results with scars. Research is needed here too. References and referrals, etc.

3. I hate to say this next opinion because it has to do with FUE. If you are looking to do a zero guard I would hold off on an aggressive FUE option as a first step. But if you find that a revision can cut down the surface area of the scar tissue, you might consider a conservative FUE session into the revised scar once it has completely healed. Hopefully this would be a matter of harvesting 100 grafts of less. And those extractions would need to be spread evenly throughout the donor area to minimize the appearance of FUE surgery.

*****And make sure you go to a clinic that discloses their punch size and make sure the punch size is below a 1.0mm*****

If you proceed with caution and patience I believe you will see an improvement. Not perfection, but improvement.

 

[DHI]

Dear Hedgehog,

The strip scar has to be estimated by a plastic surgeon in order to decide whether it needs reduction surgically or it can be revised through mesotherapy (especially if it is quite hard tissue.Concerning the discoloration of the healed epidermis, it can be treated either through implantation of hair grafts locally or through smp or tattoo.
Regarding FUE method, there is no hard scar tissue at all. The only problem may be a spotty discoloration (usually white spots) in every spot from which a hair graft had been extracted. Although, spotty discoloration is minimized by the use of the new extraction tools (0,7mm).
This condition shows only if the person shaves his head totally. If the lengh of the hairs is at least 0,5 cm, it does not show. If the person insists on shaving the hairs then the only solution is smp.