Hair Transplant Patient 
Seeking Repair Work on Linear Scar

This service is intended to provide general information only for the patient. Patient are advised to arrange an actual face to face consultation with a doctor before making any hair transplant decisions. Information provided here does not constitute medical advice and should not be construed as such. 

Patient Pictures - click to enlarge
Scar	Scar	Scar	Scar
Crown Crown Crown Front Right Side Left Side

Hair Transplant Patient 
Seeking Repair Work on Linear Scar

Dear Dr. Cole:

I post as "Tang28" in HairSite. This is kind of an urgency for me and I would greatly appreciate it if you could offer me some advice at your earliest convenience.

I am 28 years old and I had one session of strip surgery done before.  Due to the fact that I'm looking to go into the Fire academy and they make you shave your head down to a level 3, I am in desperate need to get my donor scar filled in as soon as possible. 

I posted pictures of my linear scar as well as the rest of my head at the top of this page. The linear scar stretches from above my ear to half way across the back of my head. At the thickest part it's about 1/4".

In April 2003, I had hair added to my scar by another FUE doctor. However, the work was barely completed and I would like to get it finished by a Doctor who has more experience. The pictures above were taken after my repair procedure with this other doctor. 

The reason you can't see any of the repair work is because I only had the procedure done on April 7th, 2003.  In addition, this FUE doctor only added 92 grafts after he made more then 242 sites.  He said, he couldn't get enough of a yield from my hair follicles. Basically, I think he was having a problem extracting my hair and didn't want to damage anymore of my follicles.  I guess he didn't think they would grow.  Which is very surprising since he told me I was a candidate for his FUE procedure.  There is a test he gives to see if someone is a good candidate for a FUE procedure.  Anyway, when he finished my surgery, he told me that I would have to get one more procedure, but I would have to wait eight months to a year.

Instead of going back to the same FUE doctor, I am exploring other options so that I can pursue my career with the Fire Department as soon as possible.

Questions:

1) If this other doctor is having difficulty extracting my donor follicles, does it mean that I might not be a good candidate for your FIT technique as well? What are the chances that you will also experience difficulty extracting the donor follicles? Last thing I want is to keep spending money on repair sessions that give me little or no yield in the scar tissue.  

2) Based on the pictures above, how many grafts do you think are necessary to camouflage or fill in the linear scar so that I can buzz cut my hair?

3) Is it true that not all the grafts may "take" in scar tissue? Can you give me a rough estimate as to what percentage of the grafts may yield in the scar tissue? 

4) Can I accomplish my goals with just one session?

5) What are other options besides using FIT to fill in the linear scar? 

6) How long is your waiting list? Do you have any stand-by program for patients who are in desperate need for repair work as soon as possible?  

7) Can you give me an estimate as to how much it would cost to fix the linear scar?

8) Have you done similar repair work on your patients before? Can I see some before and after pictures?

9) Is repair work of this nature pretty routine and straight forward? That was my assumption until I had my first repair session with Dr. Bernstein and I was quite disappointed with the results. Am I being unrealistic to think that filling in my donor scar with FIT grafts is a pretty routine procedure? 

Any advice would be greatly appreciated. Again, this has become a time sensitive issue for me as I am unable to pursue my career until I get this donor scar fixed. Your prompt response would be greatly appreciated.

Thanks.

Sincerely,
Tang28

Hello, Kenny:

I reviewed your photos.  It is my understanding that you want only work to improve the appearance of your donor scar.  You do not desire any work to improve the appearance of your hair transplant or thinning.  From the photographs i do not see any reason to add hair to the top of your head.  The coverage appears very good.

The donor scar appears to be about 1cm wide.  You do have some hair growing out of it.  I would not expect you to have full growth from the April procedure at this time, but it is possible.  Giving this hair an opportunity to reach its maximal potential is certainly advised because in my experience with donor scars a little hair goes a very long way.  Also donor scar grafts can take longer to grow for reasons that i do not fully understand.

You questions:

1.            I do not know any bad candidates for FIT at this time.  I have treated many patients that were fox negative and FIT positive.

2.            I suspect the number that dr. b. did originally would be best.  The problem is that we do not know if dense packing a scar will produce 100% yield.  I have recently packed one scar with up to 50 or 60 per sq cm.  The patient regularly posts on the internet, but I cannot reveal his name.  I have tried desperately to get him in to evaluate the results, but he is hard to pin down.  He lives in New York.  We did his surgery on April 1 or March 31, I think.  It will be very interesting to follow his progress.  I would not expect him to have full re-growth at this time, but who knows.  I’d sure like to take a look at him.  I certainly do see that grafts in the donor area work great and I’d say that i was perhaps one of the first to start doing this back in 1994 or 1995.  since then, I’ve planted 1000s of donor grafts and the results have been great.

3.         I do not know if all grafts grow in a donor scar.  This is such an important question today that it simply must be studied.  Again, my experience has been very good to date.

4.            Possibly one session.  Remember in the donor area a little goes a long way.  You will never be able to completely restore the natural geometry of the donor area.  Strip harvesting destroys the geometry.

5.             The only other option is to cut out the scar and close in two layers in hopes of reducing the scar.  Then you will need to fill it in with grafts because you cannot totally eliminate the scar.  Also simple geometry shows that any attempt to reduce the width increases the length.

6.         I understand you plight and will work you into my schedule.  It is not a huge procedure and obviously an emergency.

7.            We charge by the graft.  Dr. bridges and dr. rose are 6.00 per graft and I am 8.00 per graft.

8.            Photos are something that I am beginning to concentrate on for the donor scars.  You must understand that my efforts to repair scars date back to 1994 or 95, but i always did them because I wanted to make them look better.  It has only recently become a desire of patients.  I never collected photos back then.  I simply did it, then said, “oh that looks much better”.  In other words, i did it for me to make the donor area look better, not for the patients.  They rarely complained.  I am simply a little bit of a perfectionist. If I see something that is not right, I try to make it better. Typically the scarring was the result of another physicians handy work though.