HAIR TRANSPLANT FORUM

Good evening everyone,

Below is an example of trichophytic closure following a strip procedure. The patient was told the scar would not be visible due to the trichophytic closure. Obviously, this is not the case. As usual, the strip scar is totally unpredictable. It does not matter what technique you use to close the wound. We do think that trichophytic closures offer some potential advantages, but they do not guarantee unnoticeable scars. In this example, we see a very noticeable strip scar.

patients are generaly told that strip scars are not visible if a trichophytic closure is performed. This simply is not the case. In fact, usually the scar is only less visible at best. This procedure was performed at another clinic. He was told his strip scar would not be visible. This underscores that the greatest concern scar wise with strips is that you simply cannot predict what they will look like even with a trichophytic closure. One millimeter wide scars are not common and trichophytic closures will make only these very thin scars invisible. You will still have changes in hair growth direction to contend with from any strip procedure.

FITness,

It's like "Whoa". Logically if you double handle grafts then it could mean unneccessary damage, but strip method will leave noticeable scars regardless in almost all cases it seems.

The trichophytic closure ensures a better result for most, but a worse result for a few. You can get ingrown hairs, infection, and coarse/darker hairs surrounding the scar. Sometimes the scar is even worse due to these complications. It's sort of like laser hair transplants in the mid-nineties. Sometimes its just as good, but sometimes the results were terrible. There is no reason to take such risks.

In fact, when hair transplant surgeons meticulously close the edges of a donor wound, they generally end up with a fine, linear scar that is approximately 1-2mm in width.

Sometimes, when people have the tendency to form queloids, or the edges of the scar are closed too roughly or have too much tension, the scar can be a cosmetic problem.

Most of the scars i've seen average 2 to 3 millimeters. 1 millimeter scars are not common. It is normal to form up to a 5 millimeter wide scar. You have to do something awful to create one larger than 5 millimeters. this is where excessive tension and perhaps undermining of the wound were used. frankly, i've never quite known how to make a scar wider than 5 millimeters. what ever they do, it is not a good thing and they should stop doing it becasue there is no reason for a scar wider than 5 millimeters.


keloids are not common in strip harvesting of the donor area. i've seen only one in 8000 procedures. It was in a man of color.

Hypertrophic or raised scars are more common though they rarely happen with a virgin strip. it is usually something you see after multiple strip harvests. Good technique helps to avoid hypertrophic scars, but some people form them even with good technique.

It is best to totally avoid STRIP sugery. Especially darker complexioned individuals. I have been searching for photos of olive skinned guys with undetectable scars and haven't found on yet...

You will not find many undetectabe strip scars. There is usually some evidence.

I know about doctors doing strips on 25 year olds and younger but havent seen one shaven head on these undetectable scars. Is there something that I am missing?

Unfortunately there are surgeons out there who do not consider the overall welfare of the patient before performing a potentially lifelong scarring procedure on a young patient.

A young patient has to appreciate the natural tendency of hairloss as one ages. For example, a patient who is 25 years old may get a strip procedure done to improve his overall appearance, from hairline to density.

But as the patient ages, one thing is for certain: he will lose more hair. Now take this same patient and fast forward to the future, lets say another 15 years. Now the patient wants more hair transplanted to keep up with his maturing hairline or to improve density. The hairs that were naturally going to fall out now need to be replaced with more donor hair. Now you're talking about potentially going back in and trying to harvest hair in yet another strip procedure and sacrificing one scar for possibly an even bigger one (remember, there are NO GUARANTEES when it comes to scar formation!). Hopefully in this scenario the patient selects FIT to either repair the scar and/or harvest more donor for the next transplant.

But one of the issues at hand is that the scar itself may stretch over time. To wear the hair really short is almost impossible because the chances of the scar being seen is quite likely. Had the patient undergone FIT, there would be no worries about keeping a close haircut, and some patients really need this for their profession (ie. athletes, corporate executives, etc).

If you dig hard enough you may find a few good strip scars out there in young people. This isn't the norm. But I would be most interested to see what happens to them when they are ten years down the road from that procedure... are they happy? Has the scar stretched? Has the scar changed its pigmentation? Did the scar affect the angulation of some of the hairs around the scar?

As a physician, it is our duty to protect the patient first and foremost. It is our duty to give patients information about what can happen in the future with these procedures, not give them false hope, and certainly to not prey upon their desire to turn back the hands of time.

If The Cole Group was interested in just making money, we could easily do strips on many young impressionable patients. But The Cole Group tries to educate patients and turns away many patients just to protect them from unrealistic expectations. It is our hope that this honesty helps the patient make the best lifelong decision for their needs.

Jay Darji, M.D.
The Cole Group