When (at what period following hair transplant surgery: days, weeks, months) does maximum stretching of the scar tissue occur? Is keeping the stitches or staples in longer more effective in reducing the width of the donor scar?
Donor scar width is generally proportional to skin edge tension. Therefore, whatever can be done to reduce this helps keep the scars from stretching. At our office, we favor long, skinny strips so that there isn’t a lot of scalp to pull together. Additionally, deep sutures can take the load off of the skin edges so that the wound doesn’t pull apart or the scar stretch after the sutures are removed. In general, sutures should come out between days 6 and 10. Frequently, getting doctors to agree on anything is like herding cats, and you will find no consensus regarding when sutures ought to come out. Just follow your hair transplant surgeon’s advice as he has a reason for the time frame.
We take sutures out 7 days after hair transplant surgery unless there is some issue that would prevent that. Leaving sutures in for an extended period will not likely keep a scar from widening if the deep layers are not holding the skin edges together, nor will they keep an incision together that is falling apart due to infection.
Back when I used to do head and neck cancer surgery, we’d still take sutures out by day 10, even in necks that had huge surgeries and in tissues that had already received radiation treatments. Sutured properly, those scars were consistently a “B” and often an “A”. But if there was an infection or breakdown deep to the skin, the wound would fall apart regardless of sutures being left in.
During your evaluation process and consultations with hair restoration physicians, ask them their preferences and reasons regarding suture removal and ask to see some representative scars. At our consultations we show a great scar, one that is our average scar, and often times I’ll show the worst scar we’ve had in the past few years.
That is why pre-op communication and education with sites like the Hair Restoration Forum and Social Network is so beneficial.
Dr. William Lindsey – Mclean, VA
David – aka TakingThePlunge
Assistant Publisher 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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