Physician Answered Q & As

Concerned About Scar Stretchback – Should I Have An FUE Hair Transplant or a Strip Procedure?

The one thing that I keep reading about is the possibility of having a large or stretched scar from a strip hair transplant. I am seriously considering a hair transplant but this gives me pause. FUE would seem to solve this problem but I have not seen results that match strip hair transplants. Can scar stretching be prevented somehow and are there any new techniques to address this issue

This is a good question. We believe that the scarring from FUE is under reported as we have seen numerous cases where the scarring from FUE is quite evident even with less than a shaved donor area. While the scarring we have seen with direct visualization has been fairly common we also find that the sub dermal scarring from FUE is even more prevalent when we are removing a donor strip on a patient that has undergone a previous procedure using FUE.

Wide donor scarring, or “stretch back”, is not common in our practice and is rarely seen. This is because we take measures during our strip excision to help prevent this from occurring. When I remove a donor strip I am constantly checking for tension along the length of the donor area while I am excising the tissue. As I encounter areas of more tension I narrow the width of the donor strip and conversely as I encounter areas of less tension I make my incision slightly more wide. I consider the removal of the donor area to be a very important step in the overall procedure. In many cases, it will take me an hour and a half or more just to remove the donor strip as I want to do my very best to leave as little evidence as possible of any procedure having been performed.

One newer development for hair transplant clinics that use the strip method is that of the trichophytic closure. The trichophytic closure does not make for great improvements in the width of already narrow donor scars but rather it helps to camouflage the scar so that it is even more difficult to detect. This small addition to the donor area closure allows for hair to grow through the resulting donor scar as it continues to heal. We have seen donor scars that quite often are literally invisible under close inspection but the majority of patients will not have the coveted invisible scar. What the patient should expect to have is a donor scar that is quite difficult to detect even by your hair dresser.

The single biggest issue that you should consider is an excellent visual result. Without this, the whole issue of undergoing a cosmetic procedure (such as this) should be reconsidered.


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