This question comes from a member of our Hair Loss Social Community and Discussion Forums:

Several years ago, I underwent a follicular unit transplantation (FUT) procedure that, unfortunately, resulted in a significant “strip scar.” Now, I’d like to undergo hair transplant scar revision and I’m wondering what options are available?

In my opinion, hair transplant scar restoration (currently) breaks down into three categories:

1. Undergoing a scar revision procedure

During a scar revision procedure, the previous “strip scar” is excised in the same manner as strip removal during a follicular unit transplantation (FUT) procedure. After the scar is removed, a secure closure, likely a trichophytic closure, is utilized and the new wound, presumably, heals with less scarring. The most significant “down side” associated with this procedure is the potential for another unacceptable scar if the patient is prone to scarring. However, most talented hair restoration surgeons should be able to create a better closure and greatly improve upon the original scar.

2. Filling in the scar with grafts via follicular unit extraction (FUE)

During this procedure, grafts are extracted (via the follicular unit extraction process) and implanted directly into the scar. Although this procedure does not result in a second FUT scar, implanting grafts into scar tissue (which is generally thick and plagued by poor blood supply) can result in a lower yield and inability to fully camouflage the scar.

3. Camouflaging the scar with scalp micropigmentation (SMP)

Recently, recommended hair transplant surgeon and follicular unit extraction (FUE) specialist Dr. Sanusi Umar shared a presentation about leg hair transplants (body hair transplant) at the 2011 American Society for Dermatological Surgery (ASDS) annual meeting.

As a hair restoration surgeon, Dr. Umar is well known for his ability to successfully extract and implant hair grafts from alternative (non-scalp) sources during extreme hair transplant repairs. Although he’s frequently utilized body hair grafts from the beard, chest, and armpit regions, the ASDS presentation focused on the use of leg hair grafts during hair transplant repairs.

To demonstrate the validity of these grafts, Dr. Umar presented a repair patient who underwent a 1,000 leg hair graft procedure. Utilizing hair solely from the patient’s legs, Dr. Umar repaired a harsh, unnatural hairline created during a previous hair transplant surgery.

Two years after the repair procedure, Dr. Umar showed the leg grafts recreated a soft, natural hairline and permanently transformed the patient’s appearance. According to Dr. Umar’s blog, the leg hair graft’s natural fine caliber and ability to create a “soft,” gradual appearance makes them an ideal choice for transplant repair procedures.

Congratulations Dr. Umar!
_________________

Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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This hair restoration article was written by recommended hair loss physician Dr. Carlos Wesley, who is recommended on the Hair Transplant Network.

Factors Influencing Postoperative Hyperesthesia (Discomfort)
in Hair Restoration Surgery

Summary

Background While esthetic outcomes in hair restoration surgery (HRS) have improved markedly since the advent of follicular unit transplantation (FUT), various undesirable sequelae persist. We investigated the technical and demographic variables that may contribute to the frequency of postoperative hyperesthesia.

Methods A multicenter retrospective chart review involving 552 patients undergoing HRS from 1999 to 2009.

Results A total of 19 patients (3.4%) reported postoperative hyperesthesia in either the donor or recipient area of their scalp. Although many trends emerged, one variable significantly influenced the rate of this neurosensory symptom. While no patient who had all previous and current HRS sessions performed entirely within the same investigated surgical practice (n = 42) experienced postoperative hyperesthesia, 14% of our patients who underwent prior HRS by a physician outside of the investigated surgical group (n = 35) developed this complication (P = 0.0404). The amount of intraoperative electrocautery to maintain hemostasis (P = 0.0897), degree of tension upon donor wound closure (P = 0.3044), and extent of donor wound edge undermining (P = 0.4420) influenced the frequency of this sequela to a lesser degree.

Conclusion These results suggest that physicians planning repair sessions on patients who have undergone prior HRS by a physician at a different surgical center should include the specific caveat of increased incidences of postoperative hyperesthesia in their preoperative consultation.

Acclaimed hair restoration physician Dr. Alan Feller is a pioneer in the field of modern follicular unit hair transplantation and an esteemed member of the Coalition of Independent Hair Restoration Physicians. Dr. Feller is widely known as one of the world’s foremost experts in follicular unit extraction (FUE) and is the inventor of the “Feller Punch“, a tool that has been adopted by many leading hair transplant surgeons around the globe.

Recently, Feller Medical announced the launch of their new, state of the art multimedia website. The new site features a unique, interactive patient results gallery, a patient video gallery, testimonials and more. Balding men and women seeking a solution to hair loss are encouraged to visit their new and improved website at Feller Medical to learn more about their experience, technique and high standard of patient care.

To discuss Dr. Feller’s new website, visit the discussion forum topic, Feller Medical Debuts New and Improved Website.

—-

David (TakingThePlunge)
Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

To share ideas with other hair loss sufferers visit the Hair Restoration Social Network and Enhanced Discussion Forum

Get Proven Treatments at the Best Prices by visiting our new Online Hair Loss Treatment Shop.

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Technorati Tags: hair restoration, Dr. Alan Feller, hair transplantation, Coalition of Independent Hair Restoration Physicians, follicular unit extraction, FUE, Feller Punch, hair transplant, Balding, hair loss

This article was submitted to us for publishing and was partially written by Dr. Carlos Wesley, who is recommended on the Hair Transplant Network. For a complete list of contributors to this article, scroll down to the bottom of this article.

Hair Transplantation Procedures

Overview

Background

Hair transplantation procedures are used to treat various forms and degrees of permanent alopecia in both men and women. Intact hair follicles may be harvested from within the safe donor area of a patient’s scalp by either strip method or follicular unit extraction (FUE); each harvesting method has unique advantages and disadvantages. The refinement of follicular unit transplanting over the last decade has led to markedly improved hair survival and natural-appearing results.

This article provides a broad overview of the techniques used by various hair transplant surgeons throughout the world. Founded on the principal of donor dominance (ie, hair follicles continue to grow in the new recipient area to which they are introduced as long as they would have in the donor area from which they are extracted), the field of hair restoration surgery (HRS) has evolved considerably since its inception in the 1950s. Natural-appearing results are consistently achievable and reflect a surgeon’s technical skill and artistic creativity.

Indications

Hair transplantation is a surgical procedure used for the correction of androgenic alopecia (AGA), cicatricial (scarring) alopecia, or any form of permanent hair loss in both men and women.^[1,2]

This question, asked by a member of our Hair LossSocial Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Sanusi Umar:

I have noticed more and more cases recently of surgeons like Dr. Umar showing some impressive hair transplants using nape hair in addition to hair from the “safe zone”. I am curious as to what people’s views are regarding the use of nape hair in hair restoration surgery.

For most individuals, nape hair* is more DHT (dihydrotestosterone) resistant than the hair in the area of baldness. In other words, nape hair is not necessarily lost in all cases of male pattern baldness (MPB) and what’s more, the safe donor area (SDA) is functionally the area bordering the fringe of hair that would be left in a terminally bald person such as a Norwood 7 or higher. Yet, we know that the majority of individuals do not experience this degree of hair loss.

The role of nape hair has hitherto been defined by:

1. The notion that it is generally DHT susceptible.
2. It is not typically an area subject to harvest given the limitations of the strip harvesting methods available.

The second factor has been cancelled by the advent of follicular unit extraction (FUE). Since then, nape and temple hair (donor areas outside the SDA) have been widely used in successful repairs of strip-donor-depleted patients: Those would-be patients whose capacity for further follicular unit transplant (FUT) surgeries has been exhausted. It is the extension of these experiences with repairs that opened the prospect of using nape hair as the vanguard hair of transplanted hairlines. Obviously, patient selection is key. Using criteria such as the degree of balding relative to age, visual evidence etc. nape hair can play an important role in hair transplantation.

This question, asked by a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. Glenn Charles:

I am over a year post-op from a disastrous facelift by a ‘top’ UK surgeon who surgically removed my sideburns without my consent and elevated my hairline above my ears. It’s difficult to find anyone with significant experience of female sideburn reconstruction. There are just a few pics on the Internet and it’s the same few pics constantly circulating.

Some hair restoration surgeons appear to have fantastic results with female sideburn reconstruction using follicular unit transplantation (FUT) but I am a bad candidate for strip surgery as I already have a .8 x 7cm bald strip on my head courtesy the facelift surgeon where he pulled too tight and the scar stretched. My hair fell out and I now have this bald strip. Coupled with the loss of sideburns, I have lost a lot of volume and my hair was thin and fine to begin with so I cannot risk a stretched scar from strip.

I recently had revision surgery to try and minimize the elevated hairline (flap rotation and temple redraping) and to excise the bald strip but this, unfortunately, failed. The bald strip simply stretched again resulting in yet more hair loss and the rotation had no impact on the elevated hairline. My only option now is limited to follicular unit extraction (FUE) and I really need to get it right as the emotional and financial impact continues to devastate me.

This question comes from a member of our Hair Loss Social Community and Discussion Forums:

I began investigating hair transplant surgery and the possibility of shaving the back and sides of my head to a “zero” (very close cut) after the operation. I’m wondering, will an ultra-refined follicular unit transplantation (FUT) scar be visible at this hair length? If so, is follicular unit extraction (FUE) a better option?

At a “zero,” even the best, most “pencil thin” follicular unit transplantation (FUT) scar will be visible.

However, keep in mind that while scarring is very, very minimal with follicular unit extraction (FUE), I wouldn’t be surprised if you could see some scarring in the donor region with a “zero buzz” post-follicular unit extraction as well.

Obviously the type and overall visibility of the scarring will be different, but at this point in time, both these techniques are surgical procedures and will leave “some” type of scarring.

However, if you are an acceptable candidate and do plan on wearing your hair very short, FUE may be a better option. Consulting with a talented hair transplant surgeon will help evaluate your FUE eligibility.
____________________
Blake  – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

Technorati Tags: Hair Loss, hair transplant surgery, follicular unit transplantation, FUT, hair length, follicular unit extraction, FUE, hair transplant surgeon

Selecting a quality hair restoration surgeon is crucial to obtaining dense and natural looking hair transplant results. This is why patients have the final say as to which physicians are recommended on the Hair Transplant Network.  Thus, we’d like your input regarding the potential recommendation of Dr. Sanusi Umar of Redondo Beach, California.

Dr. Umar is arguably the world’s foremost expert in BHT (Body Hair Transplants – transferring body hair follicles to balding areas of the scalp) and has been performing advanced follicular unit extraction (FUE) procedures at his clinic in Redondo Beach, California since 2005. Dr. Umar is very hands on and extracts and places all FUE and BHT grafts himself.

Dr. Umar developed a passion for alternative hair transplantation due to a botched 400 graft strip surgery he endured several years ago. Dr. Umar’s specialty is in state of the art FUE and specialty repair cases.

You are encouraged to view the Potential Recommendation of Dr. Sanusi Umar to view the highlights regarding Dr. Umar, his credentials and his patient photos.

To see our standards for recommendation, click here. To see the list of all current physicians recommended worldwide, click here.

We look forward to receiving your input.

Onwards and Upwards,

The Hair Restoration Network Team – Pat, Bill, Dave and Blake for the Hair Transplant Network, the Coalition Hair Loss Learning Center, the Hair Loss Q & A Blog and the Hair Loss Forum and Social Community

This question comes from a member of our Hair Loss Social Community and Social Network:

Obviously, the rapid evolution of minimally invasive hair restoration solutions (such as stem cell hair loss therapies, injectable hair loss solutions, et cetera) is very promising, but I’m wondering if we will ever see permanent hair restoration via a single medication (tablet) or procedure?

I don’t know if the “tablet theory” (i.e. take a single tablet and cure your ailment) will ever be true for any complex medical condition, but this does not mean we won’t see some “miracle” treatments in our lifetime.

All discussions about highly debilitating conditions (AIDS, Cancer, MS) aside, I personally think baldness is too unique and complex of a condition to ever be “cured” with a single therapy. However, I definitely think we’re going to evolve and invent to a point where a combination of treatments and therapies will allow for an non-invasive, satisfying reversal of genetic hair loss.

In my opinion, I think we’ll probably progress somewhere along the following lines:

1. An injectable hair loss solution that helps regrow around 15-20% of lost/miniaturized hairs. I feel like this will be somewhere along the lines of the current reversal seen with Rogaine (minoxidil) and Propecia (finasteride), but without the need to stay on the medications for the same duration of time. Frankly, I believe this therapy is probably the furthest away.