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Topic Title: scar stretching
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Created On: 04/30/2004 01:19 PM
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 04/30/2004 01:19 PM
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truthseeker
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I want to find out how common scar stretching is nowadays. Does anyone have any personal experience or first hand knowledge of strip scars stretching? How likely is this to happen from a World Class Doc? What are the odds? Have the better docs figured out ways now to reduce the risk to as minimal as possible? In addition, does the scar show through when you go swimming or sweat alot at the gym? This especially goes to guys with thinner donor hair. Lastly, has anyone experienced permanent numbness and pain from the donor area that never went away from a strip surgery?

Thanks

-------------------------
2004- Wong, 2,750 grafts
2006- Wong, 2,400 grafts
1991- Weidig, 100? plugs
 04/30/2004 02:12 PM
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jackster
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i think no one can predict if a scar is going to stretch over a 5 or 10 year period...of course the skill of the surgeon is a factor and i think the percentage goes up if you have had multiple strip surgeries done due to the lack of elasticity of the scalp....some guys have a very elastic scalp and will heal nicely and have a pencil head thin scar...its best to reserve some donor hair for future touchups needed down the road via FUE..so dont waste all your donor hair in a few sessions..be smart and think ahead....
 04/30/2004 02:17 PM
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bukkaroo
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I think scar stretching is pretty common with the exception of not more than a handful of docs, with which it seems to occur close to never (Hasson, Wong, Cole, Feller, Alvi - end of list)

Edited: 04/30/2004 at 02:19 PM by bukkaroo
 04/30/2004 03:14 PM
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uknoobie
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There has been positive posts from Dr Wolf's patients about being consistent with leaving fine linear scars. Scar revision is also one of his specialities I believe. Another name to add to Buckeroo's list.
 04/30/2004 05:04 PM
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dj
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I agree, Dr Wolf is not only great with scars but does one of the best hairlines around. With strip anyone can end with a wide scar, this is the risk with strip but the top doctors percentages are pretty good... Only a few doctors to trust with strip and only a few with fue, and only a few with hairline work, which is a different subject....... ) dj
 04/30/2004 11:14 PM
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MoHair4Me
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Bukk,
I think there is one patient of Feller's that mentioned his scar stretched. I THINK it was bald414 or something like that (could be wrong). He said it stretched but didn't seem to concerned about it as his hair covered it. I think he was generally very happy with Dr F's work. It just shows even top docs can have it happen (rare though). I like the results Feller has been showing recently and I give major Kudo's to Feller for his FUE work and contribution to it.
 04/30/2004 11:31 PM
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bverotti
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I do not know if my scar stretched, but I know that there is some scar tissue buildup in one part. So when I run my fingers accross this area I can clearly feel a small bump. It is not painfull or anything, but this adds to the problem of not being able to wear my hair short. By short I mean 1 cm, even at this length one could see a subtle change in the hairline right at the scarline. Maybe I'll throw some grafts in there ....
 05/01/2004 04:45 AM
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ETERNAL_HOPE
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Patients can achieve pencil thin scars with skilled surgeons, if proper research and education is adhered to. In a small percentage of cases, scar stretching may be unavoidable due to many different variables with certain patients. We all have different characteristics that will effect the final results whether the procedure was identical. Choosing the right doctor is very imperative in these situations to prevent further problems/repairs and to bring peace of mind to the patient. I have seen the best and worst of linear scars, and the main reasons for these outcomes is usually the skill level and reputation of the presiding surgeon. Education is a must.


Ciao!
 05/01/2004 05:21 AM
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hairloss.com.cy
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We have done many strip cases in the last few months in Cyprus. I can call in the patients especially if they are local and can examine the scar. It is very important to strip patients to have very narrow scars. It is my impression that the scar formation shows in the first few months. If you do not get a scar in the first few months after surgery then you most propably got away with it.
It is true however that the Doctor is the most desisive factor on scar width. Dr. Cole does amasing work in leaving thin scars. The same goes to results as far as yield is concerned and natural hairlines. I would say FIT is the only way to avoid scars altogether.
 05/01/2004 06:34 AM
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Dr. Feller
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I believe MOST scar stretching is physiological. I've performed the same exact strip closure procedure on thousands of patients and have experienced a range of scar sizes.

I believe the only substantial control the doctor has over the ultimate result are:
1. The amount of skin removed per session
2. The tension of the closure
3. The geometry of the incision, that is, following the roundness of the skull as opposed to going straight across
4. Thinning out the strip as the incision approaches the temporal area.
5. Use of cautery equipment which burns skin (which I believe is the number 2 cause of bad scaring second only to patient physiology). I never use it.

Most of the worst scaring I've seen has been the product of plug donor removal wherein the donor tissue was punched out with 4mm punches, followed by a linear incision cutting through the holes, and then the entire area being sewed together. This old and outdated technique, along with cautery is probably responsible for most of the worst scars out there.
Dr. Feller
Specializing in FUE and Strip HT
Feller Medical, PC
Great Neck, NY
www.fellermedical.com
516-487-3797

Here are some photos of various kinds of scars







Dr. Feller
Feller Medical, PC
Great Neck, NY
www.fellermedical.com
[email protected]
516-487-3797
 05/01/2004 06:47 AM
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truthseeker
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Thanks Dr. Feller for the great pictures and your input. Greatly appreciated.

-------------------------
2004- Wong, 2,750 grafts
2006- Wong, 2,400 grafts
1991- Weidig, 100? plugs
 05/01/2004 07:33 AM
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hairloss.com.cy
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I talk from a practical and observational point of view and not from a medical point of view.
Each doctor can leave various scar widths on different patients according to what Dr. Feller is describing. But some doctors leave scars of 1-4 mm wide and others leave scars of 4-10mm wide. This is my point when I say it depends primarily on the doctor.
So the paitient should be carefull which clinic he chooses for his HT.
 05/01/2004 08:40 AM
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Dr. Feller
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I agree with you hairloss
 05/01/2004 08:39 PM
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Vantri
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Dr Feller,
In the last photo, "stretched scar", was that scar able to be revised?
That is very similar to how my scar looks.
Thanks
 05/01/2004 11:52 PM
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backnats
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Edited: 05/01/2004 at 11:56 PM by backnats
 05/01/2004 11:53 PM
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backnats
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Dr Feller, thanks for those pics. I like seeing barely visible donor scars.
 05/02/2004 05:20 AM
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truthseeker
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Dr. Feller,

If everything is right from a top doc and they utilize the principles you discussed, how likely is it for a scar to stretch? And, like hairloss, will a stretch scar stabilize or stop stretching at a certain point?

Thanks

-------------------------
2004- Wong, 2,750 grafts
2006- Wong, 2,400 grafts
1991- Weidig, 100? plugs
 05/02/2004 06:49 AM
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ETERNAL_HOPE
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I certainly hope it stops stretching at a certain point, considering that I had a few strips many many years ago. I haven't measured my scars the last few years and hope I don't have a 20mm scar by now. (okay, a little exaggeration)

I meant 19mm.

Ciao!
 05/02/2004 06:52 AM
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hairloss.com.cy
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The scar stretches in the first few months and then it stops streching at a certain time which veries from patient to patient. I would say it would not stretch any more after max a year.
 05/02/2004 07:54 AM
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truthseeker
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Thanks for the input. It will stop stretching by one year? Can anyone else comment on this. I hope this is right, but can anyone explain the physiology behind this?

-------------------------
2004- Wong, 2,750 grafts
2006- Wong, 2,400 grafts
1991- Weidig, 100? plugs
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