Hair Transplant Strip Scars and How to Revise Them

The following response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member “MrGio”, Online Representative for Coalition Hair Transplant Surgeon Dr. Patrick Mwamba:

stripscara_zps344439b9Far too many hair transplant patients come to us after being told that they will have a pencil-thin strip scar, if they were told of any chances of linear scarring at all. Many times a scar from follicular unit strip surgery (FUSS) will stretch over time and the patient can never wear their hair shaved short on the back and sides. Sometimes the orientation of the hair in the donor zone can be skewed because the hair above and below the scar can be misangled. This isn’t fair to the patient because they should be given full disclosure of all possible after effects of strip surgery.

Based their specific goals, some patients come to our hair restoration clinic to revise their strip scars and some come to us for treating complications with their strip scars. Even with performing trichophytic closure, we still effectively prefer follicular unit extraction (FUE) method over FUSS (strip).

To treat strip scars, we usually can achieve significant improvement with two small sessions of grafting by FIT. The approach to add lower density over more than one session has allowed us to conclude that the transplanted grafts have a much higher survival rate and better blood supply. Strip scars can usually be treated after six months.

The above image is a view of a strip scar in the donor region that displays hair growing in opposite directions.

How Common Are Poor Quality Hair Transplant Results?

This comment, addressed by Coalition hair restoration surgeon Dr. William Lindsey, was shared by a member of our Hair Loss Social Community and Discussion Forums: 

It’s been 15 months since my hair transplant on both temples, and I’m unfortunately unhappy with my results. One of my temples turned out great, the other one is very thin, with the hair direction off with my normal hair, and, really weird, I still have some thick stubbly hairs there.

I’m interested on what’s everyone else’s take on this?

Dr_Lindsey_photoThree of our frontal cases a year have better hair growth density on one side or the other that I can see from close conversational distance. Why? No idea. Now I can tell you that when we have a staff review that the placer on the good side thinks it’s her skill that allowed for a better result. But the problem with that theory is that half the time it’s on the side of each placer and the other 100 frontal cases aren’t different. So if indeed you were shaved in that area and packed and the follicular unit grafts were handled gently, well you may never figure out why.

As to the orientation. Just like with trees, if I dig a hole in your yard aiming northeast and have your nextdoor neighbor plant the tree, well it’ll aim northeast. So the direction is the doctor’s job. But, in repair cases, I have to match the angle of the newly placed hair to the stuff that is already there, even if it’s too straight up or the multiple directions look even worse.

Reasons Why “Shock Loss” Occurs After Hair Transplant Surgery

I’m experiencing shock loss in the recipient area after my 2nd hair transplant. I’ve been through this before with my first one. IWhy do some people experience shock loss while others do not?    FYI, I’m only 2 months out from my procedure.

This hair loss question was answered by  Dr. Glenn Charles of Florida who is a member of the Coalition of Independent Hair Restoration Physicians. His professional answer is below.

I wish we had an answer to the question of why shock loss occurs in some patients but not others. That would be like having the answer to how the lions could be that bad every year and not get better like most other teams. Unfortunately, I am also from Detroit and actually still watch them every Sunday. Not sure why. Where has Barry gone?

Any previously transplanted hair will come back. If you still had some original hairs that were very weak and ready to fall out they may be lost, but you will be replacing them with permanent hairs. Good luck.

Dr. Glenn Charles

Bill Seemiller
Managing Publisher of 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: , , ,

Separating the Best Hair Transplant Doctors from the Rest

One of the most common questions regularly asked on our hair restoration forum is “Who is the best hair transplant surgeon?” Because selecting a quality hair restoration physician is vital to get the best  result, this question demands an answer.

However, determining “who is the best” is as much subjective as it is objective. Thus, awarding a single hair transplant surgeon the gold medal for being the best isn’t always scientifically possible. However, a small group of leading  physicians regularly demonstrates outstanding work and stand out from the pack. Below we’ll discuss how their skill level, experience, and ethics form the characteristics of an elite hair replacement surgeon and how they continue to revolutionize the hair transplant profession.

An elite hair surgeon continually adapts and refines their technique to achieve the densest and most natural looking results. Reputable surgeons will customize individual hair restoration plans for each patient and always do what’s in the patient’s best interest. This includes standing behind their work and guiding patients through any potential questions, concerns, or problems. Continued education, regularly consulting with other leading surgeons, and dedication to excellence are key ingredients to separating the best doctors from the rest.

The Hair Transplant Network specializes in educating patients on available hair loss treatments and recommending only the best hair restoration surgeons. An elite group of surgeons who perform large, densely packed sessions of ultra refined follicular unit hair transplantation when appropriate for the patient are invited to join the ranks of the Coalition of Independent Hair Restoration Physicians. To see our demanding standards for Coalition membership, click here.

Strip Hair Transplant Surgery before FUE to Maximize Graft Count?

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Mike Vories:

You read all the time on the hair restoration forum to maximize the number of strip hair transplants and then go follicular unit extraction (FUE), in order to max out one’s available grafts. I often wonder how many patients actually go through with all that though. Or what % of patients is it even necessary for?

Dr_VorriesThis is an excellent point. I have always disagreed with the “FUSS first” concept. A follicular unit is a follicular unit, whether it was harvested by follicular unit strip surgery or FUE. One of the several advantages of FUE is that we can spread the extractions over the entire donor area, and so minimizing the impact on any one area. Also keep in mind that strip excision changes the scalp architecture, and harvesting grafts (especially below the donor scar) with FUE is made more difficult after strip excision.

The only questionable benefit I can see to performing FUE after strip excision is the chance to try to cover up the strip scar with FUE grafts. However, the results of this are variable, and in many cases the strip scar does not have the vascularity to support the grafts. For this reason it is much better to avoid the strip scar than to plan on covering it with FUE grafts.

Dr. Mike Vories
Editorial Assistant and Forum Co-Moderator

Why Non-Surgical Hair Loss Treatments Complement a Hair Transplant

Rogaine PropeciaToday’s revolutionary surgical hair restoration procedures allow a qualified physician to move individual follicular units (hair groupings as they occur naturally) from the sides and back of one’s scalp to balding areas. The end result is a natural looking head of hair, undetectable to even the harshest critics. And while this miracle hair transplant procedure can restore hair to completely bald areas, it does nothing to stop the progression of genetic baldness. What if hair loss continues? Will a second or even third hair transplant be required? Is there enough donor hair to keep up with the progression of baldness? Should proven medical hair loss treatments be used in conjunction with hair transplant surgery? Why or why not?

Forum member “Roy” is about to undergo surgical hair transplantation with Coalition member Dr. Ron Shapiro and wants to know what risks are involved in proceeding into surgery without taking Propecia (finasteride)  to attempt to slow down continued loss. Visit “Going into Hair Transplant Surgery without Medication” to discuss why non-surgical hair loss products complement a hair transplant and the risks included in not taking them.

Bill Seemiller
Managing Publisher of 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 treatments, , , , ,

Do Subsequent Hair Transplant Procedures Have Delayed Results?

While today’s hair transplant procedures provide naturalness and density that can mimic nature, it often takes more than one procedure to get the best results. This is especially true for men (and women) with extensive thinning hair and baldness. But for those who need more than one procedure, what can they expect from each hair transplant? Will growth yield be similar in subsequent hair restoration procedures as the first? Will results be delayed in following hair surgeries?

In “Do Subsequent Procedures Have Delayed Results“, forum member “Time to Do Something” asks if results take longer in additional procedures. You are encouraged to read what other members have said and to offer your own input on this discussion topic.

Bill Seemiller
Managing Publisher of 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: , , , ,

Are Hair Transplant ‘Grafts’ and ‘Follicular Units’ the Same Thing?

I got a quote from one of the Hair Transplant Network’s recommended clinics of 4000 follicular units. Now, from what I have learned, I think 4000 follicular units = 4000 grafts but the sales executive from this reputed clinic is saying that 4000 follicular units means 2000 grafts. Am I mistaken or taken for a ride?

questionIn response to your question, I’d like to begin by discussing hair transplant nomenclature as it can be somewhat vague.

Often, strip surgery if referred to as “follicular unit transplantation” or “FUT” in contrast to FUE which is follicular unit extraction. However, we prefer the term FUSS or follicular unit strip surgery to describe strip harvesting because, technically speaking, both FUE and strip are forms of follicular unit transplantation.

Follicular unit transplantation in either FUE or strip form refers to state-of-the-art implanting of hair grafts in their naturally occurring clusters of 1 to 4 hairs. These clusters are what we term a “follicular unit” or “FU”.

By that definition, grafts and follicular units are one and the same.

There are instances when a hair restoration physician may opt to use some double follicular units (DFU) combined with FUs to create additional density. In such a case, you would have a difference between the number of grafts and the number of follicular units. However, this is not particularly common.

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

Where Can I Get a Hair Transplant Strip Scar Revision?

This question, asked by a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair restoration physician Dr. Timothy Carman:

Having had multiple hair transplants, I feel my scars over time have become more noticeable and is something I need to address. Do any clinics offer scar revisions/trichophytic closure?

As to revisions, what is the overall success and satisfaction of those that go that route?

Dr_Carman_photoHair transplant strip scar revision can be successful, but that success is individualized and also very dependent upon how many previous procedures have been performed. That option should be available in any state of the art surgical hair restoration practice, given an experienced surgeon.

As for the trichophytic closure, in my opinion, that closure was more of a trend to address poor technique which characterized well-intentioned but less than standard of care donor closures. Adherence to sound plastic surgery techniques when harvesting and especially closing the donor area virtually eliminates the need for any type of trichophytic manipulation.

What’s more, with short, straight hair, the trichophytic method can leave a tell-tale pattern in the hair as hairs along the incision are angled in an unnatural direction due to the mechanics and geometry of hair growth through the scar tissue.

I hope this is helpful.

Dr. Timothy Carman
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

Follicular Unit Extraction (FUE) Hair Transplant for Curly Hair?

I recently went to a hair transplant surgeon for a consultation and I told him that I wanted to go for FUE but he said that I had curly hairs and so I was not a good candidate for FUE and suggested that I’d go for strip instead. So is there anyone out there with curly hairs who has got an FUE hair transplant?

curly hairVery curly hair such as African American hair is a challenge to harvest via follicular unit extraction (FUE) because the hair continues to curl under the scalp making it difficult for the surgeon to score without transecting the grafts.

Surgeons will sometimes perform a small test procedure on patients with curly hair in order to determine the quality of the grafts. Others may simply turn risky patients away or recommend follicular unit strip surgery (FUSS) instead.

Of course, this can be a serious issue for patients traveling abroad. You could arrive at your destination only to find that you are not a candidate for FUE.

I suggest consulting with a few more FUE specialists before writing yourself off as a candidate. If you haven’t already done so, you may wish view our list of recommended hair restoration physicians.

Editorial Assistant and Forum Co-Moderator 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 loss forum and social community.