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Stretched FUT scar. Looking for advice on what to do next

Parasol

Parasol

member
Hi everyone! This is my first post here, but reading around, you all seem very knowledgeable and friendly!

I’m 36 now. Roughly 10 years ago I had two FUT procedures with Dr. Scott Boden. I’m finding the older I get, the more I’d really love to wear a shorter hair style, but my scar has stretched quite bad (mainly above my ears), so I can’t really clip it below a #8 guar

Yesterday I buzzed it down to a #5 so I could get some feedback on what to do next. This is also a length I like so would love to improve how pronounced scar looks this clipper setting. I’m reading a lot about the risks of scar revision, especially in cases where the patient is prone to stretching like I appear to be. FUE seems like a better option, but success rates of FUE’ing into scar tissue seem really hit or miss, so I’m unsure the best way to go from here and would love to get some opinions.

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Bigmac

Bigmac

Administrator
Staff member
Hi Parasol. If you’re wanting something to give an almost instant effect I would say SMP, then I’d have Fue grafts placed into the scar. Doctors have had a lot more success placing into scars these days. Sons will only place half of what is required to see what the growth is like, then place more once they’ve seen the result.
You look as though your donor is very good and you have the option of beard grafts to use.

As for excising you’re scar out. If you’re prone to stretching there is the risk it could be made worse. The area around the ears usually don’t have the same elasticity as the back of the scalp which makes it difficult sometimes for a pencil line scar.

Have you asked Dr Boden or any others what they think is the best option for you?
 
Parasol

Parasol

member
@Bigmac Hey thanks for the reply! Dr. Boden and I have never discussed the scar in detail, but I did just send his office an email so I’ll let you know what he says.

Honestly, I didn’t pursue this earlier, because I’ve never been satisfied with the transplant results in general. We just never achieved enough density. I knew if I went in to fix the scar, I’d want to try to fix the top too, but at that stage it just wasn’t the right time in my life for another transplant.

So, I went years and years and didn’t really think about my hair at all (not a bad thing!).

Recently, I decided to take a long hard look at it and man, it’s not good. I’ll attach some pictures. Maybe it’s time I come up with a game plan. I’ve sort of got the double whammy going on with the see-through scalp and the see-through scar. :)

I know without before photos it might be tough to fully judge, but I’d be curious to get some opinions on what it might take to make some improvements on the top too.

Sorry the photos are sideways. Editing the images doesn’t seem to fix how they display on the site.

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Bigmac

Bigmac

Administrator
Staff member
It`s hard to judge with no pre op picture. How many grafts did you receive from your 2 surgeries and are you using any hair loss medications?
I would go back to see Dr Boden, see what he advises. I`d also consult with a few other clinics in the New York area. There is a good selection there including Dr Carlos Wesley who does quite a bit of repair work and Dr Dorin.
I`d say at a rough guess you`re going to need around 3000 grafts to fill that area as it stands. This could be with FUE or another FUT if the doctor thinks you`re suitable and it`s something you are willing to try again.
 
Parasol

Parasol

member
It`s hard to judge with no pre op picture. How many grafts did you receive from your 2 surgeries and are you using any hair loss medications?

Rough ballpark, I think I received 1200 or so grafts during my first procedure, and around 1600 give or take the second time around. So somewhere in the neighborhood of 2500-2800 total. I definitely agree pre-op pics would be useful so I’ll see if I can get them.

Regarding medication, I did take 1mg of finasteride daily for a few years, and minox briefly, but I gave those up a long time ago after not seeing much improvement. Though seeing where I’m at now it’s probably high time I pick them back up! Yikes.

Man, looking at the pics I just took is really bumming me out. Don’t get me wrong, it’s not like I don’t I see myself in the mirror, but I haven’t taken top down shots like this in forever. Especially now with the shorter hair cut. Wow. Just wow.

I’ll see if I can get a full consultation with Dr. Boden. And thanks for recommending other doctors I can consult with too. I was convinced way back when that 2000-3000 grafts would be enough for my loss pattern, so the thought of doing this all over again and the cost of it all just guts me. But yeah, I agree with you. it’s obvious there just isn’t enough density going on to look natural and I’ll need another pass if I want to balance it out.
 
Bigmac

Bigmac

Administrator
Staff member
At a guess, I`d say most of the hair you have left is the transplanted hair. You probably gradually lost your remaining hair slowly over the 10 year period since your hair transplants. Finasteride could have prevented this loss if you stuck to using it, there was a good chance it would have stabilised and prevented the future loss. If you try Finasteride again, you may grow enough dormant and weak follicles eliminating the need for another surgery. Otherwise, you could have another and find yourself in this same situation in a few more years.

What I will say is your hair still looks natural, just a normal thinning pattern. You have not been left with a look that screams poor hair transplant. Hair fibers or other types of concealers could help you out right now if you want the fuller look.

I just presumed you`re in the same area as Dr Boden which is why I suggested others not too far away. Distance should never be an issue, there are many good doctors out there. Others I`ve met patients from are Bradley Wolf, Hasson & Wong, Shapiro Medical group, Jerry Cooley, Steven Gabel, James Harris, all of which looked very good.
 
Parasol

Parasol

member
@Bigmac I’ve been feeling really low the last couple of days, but your replies and interest in my case have made me feel a lot better. I want to thank you from the bottom of my heart on that.

I set up a phone meeting with a doc for Monday so I can get a prescription for Finasteride again. I’ll get back on it and Mixonidil before I make any impulsive decisions about surgery for sure.

Yeah I think you’re right the hair I have left is mostly transplanted. I have an identical twin brother actually and aside from a small patch going from his crown to his forehead, he has no hair on the front half at all.

I’ll see what Dr. Boden has to say and go from there. Likely I’ll get some other consults too. I’ll treat this as my personal hair journey thread and update if there are any developments.

Thanks again for the support!
 
Bigmac

Bigmac

Administrator
Staff member
Hair loss can get you down but try to be positive as the Finasteride could help your situation, plus the Minoxidil which many say when both used together produce better outcomes.
Hopefully, the doctor can help you out.
You could always try SMP into the scar and maybe your thinning area whilst you wait to see what the meds do.
If you aren`t too far from New York there is Ahead Ink who do temporary SMP, the owner Eric has had a few hair transplants so he could probably give you some good advice. There`s also Matt Lulo who gets lots of good reviews.
 
Parasol

Parasol

member
I just heard back from Dr. Boden's office. Our Facetime consult (since we can't do in-person due to COVID) is scheduled for mid-August, but after seeing the same photos I posted above, he was wondering the same thing: am I on any medication to help keep my natural hair?

What a big mistake stopping Finasteride and Minoxidil was. This is the first time I've seen my progress photos from my two FUT transplants. Granted, they are not the best photos to compare with because my hair was super long back then, but the difference is pretty clear, at least to me. Let me be an example though. Follow your doctor's orders and take your medication!

The good news I guess is my doctor prescribed me some Finasteride and I just ordered some Minoxidil, though obviously I don't expect to gain what I've lost over the last 7 years.

Below are some of the photos Dr. Boden sent over. The first set of 5 are from before I had any surgery at all from back in 2009. The second set of 5 is my one year follow up in 2010. The third set of 5 is from my one year follow up for my second and final procedure, taken in 2011. Implanted graft total I actually think is wrong in my first post and was closer to 3,750 but I'm not 100% positive on that.

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Bigmac

Bigmac

Administrator
Staff member
You have lost a lot of hair after stopping the medications when comparing to your results after your surgeries. It is easy to stop using them thinking you have plenty of hair and won`t be affected by future loss. It`s good that you`re going to take them again, you may have a good response with dormant and miniaturised hairs growing back, I`ve seen it before.
I`d give it 6 months on them before deciding what to do next, obviously, Dr Boden will give you his professional opinion when you have your in-person consultation. He can check your donor and look for miniaturisation and advise accordingly.
Good to see he kept your records and images.
 
Parasol

Parasol

member
I agree with you 100% @Bigmac

This is exactly my thinking. I do think the smartest thing would be to take my Finasteride and Minoxidil for the next 6-12 months, then reassess. Give it a chance to (hopefully) work or stabilize me before taking the plunge again, you know? It really is astonishing how much hair I’ve lost since back then. I had no idea it had gotten that bad! I’ll never make that mistake again.

Unfortunately for the foreseeable future, Dr. Boden is not doing any in-person consults. They have to be via Skype, FaceTime etc due to the pandemic. His office is only open for surgery. Hopefully he can still still give me a thorough professional opinion with video chat.

His office told me today they’d call me if anyone cancels their video consult so I’ll update this thread whenever him and I can have a chat.
 
Bigmac

Bigmac

Administrator
Staff member
I wasn`t aware you meant no in person consults but that won`t matter if you`re trying the meds for 6-12 months before deciding what to do next. It is scary how much hair we can lose in a relatively short few years. This is always a danger for people who opt for surgery but won`t use the meds.
Fingers crossed you respond well.
I`ll look forward to your next update.
All the best.
Bm.
 
bullitnut

bullitnut

4 awesome repairs with SMG
Getting back on the meds is a good idea. There is loads of people asking about getting hair transplants who aren`t on any meds and some do not know anything about meds.
Good luck dude with starting them again.
 
Parasol

Parasol

member
Thanks @bullitnut for the support. I’ve been taking 1mg of Finasteride and applying a full cap’s worth of Minoxidil 5% foam daily for the last few days. It feels good to be back on them.

Really kicking myself for stopping. It’s almost like I threw my 2 transplant procedure’s money in trash. I’m happy to see Big Mac sharing my story, especially with people new to the forums, as a cautionary tale.
 
Bigmac

Bigmac

Administrator
Staff member
Hi Parasol. Luckily your doctor planned your surgeries well, your hair looks just like someone who is naturally thinning. A lot of people jump in without thinking of future loss, they use up all their donor and don`t realise what can happen.
 
bullitnut

bullitnut

4 awesome repairs with SMG
biofibers or smp
Biofibres are a big no imo every person I've seen through the yrs on the forums with them have ended up with some kind of problem or infection.

Your scar doesnt look too bad at that length at the back really... it's the corners at the back of your ears where it's more noticeable....SMP would help to disguise them a little but FUE into them areas would make the most improvement dude if your wanting your hair at a similar length.
 
Bigmac

Bigmac

Administrator
Staff member
Biofibre hair is banned in certain countries.
 
K

k-dog

member
Does FUE into scar work well? I read conflicting reports that grafts dont always grow out of the scar due to poor blood suply. Or is SMP the better way?
 
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