Dr. Cole

A general discussion about hair restoration.

Dr. Cole

Postby JohnnyO » Tue May 30, 2006 7:29 pm

Can you dense pack a scar if there is plenty of healthy donor hair and that is the main priority of the patient? If so, can dense packing allow a patient with a relatively "normal" size linear scar (not wide) to keep a buzz cut (#1 or 2)without notice of a scar? Thanks.
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hair transplant repair surgery of donor scars

Postby drcole » Wed May 31, 2006 6:29 pm

A number 1 or 2 is really not all that short in our experience.

We can dense pack a scar quite sucessfully. The concern always with dense packing a scar is growth and the short term result. Dense packing always carries a risk that the growth will not be ideal. in other words, an ideal growth would be 100 hairs from every 100 that are planted. typcially we see about 90 hairs for every 100 that are transplanted. Anything less than 100 would be less than ideal. We would not be suprised with anything above 78 hairs per 100 that are transplanted. Dense packing could carry a lower yield, but should be 78% or better, though i suspect that a lower yeild would be possible. Dense packing can make a scar red or bright pink for 6 months to 1 year. the scar can also elevate a little. Scar tissue tends to be much less compliant because it does not contain eltastic tissue and cannot expand and contract like normal skin. therefore, adding hair mass can make it stand up a little. in our experience this elevation is short term and resolves on its own. a less dense packing may reduce all these risks of redness, decreased growth, and elevation. it will also necessarily produce less hair. therefore, anyone considering scar repair surgery with grafts should consider all the risks and benefits. if all the hair grows from dense packing , you are going to be much happier than if you had accepted a lower density.

another alternative is to place a lower density and then go back later to add more hair if the density proves unsatisfactory. consider your options and then make a decision. with scars, you should be able to wear a number one or two without too much concern though it may require more than one procedure to reach the desired density. you do not need to worry about harming the surrounding hair. strip surgery typcially reduces the density immediatly surrounding the strip scar so it is easier to reach the density of the surrounding hair in one or more grafting procedures. the one thing we cannot resovle is the change in hair direction that results from strip grafting. the hair above the scar will always be more acute in angle and the hair below the scar will always be less acute in hair growth angle. also, the hair above the scar will have less of an angle on the x, y axis while hair below the scar will always have a more x,y angle. this is better explained elsewhere on our website. usually, grafting the scar will take care of the angle differnces, however.
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OK

Postby JohnnyO » Wed May 31, 2006 7:13 pm

SO it is better to do a number of sessions to reach the density desired than to do it all at once. Here is a silly question: If we use 3 or 4 surgeries to graft the scar with a desired density, is that (the total # of surgeries) considered dense packing, thus carrying the risk of raising the scar? Or do we only assume those risks if we dense pack all at once.
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Postby GirlTech » Tue Jul 04, 2006 6:44 pm

I'm not quite sure on the exact meaning of "dense packing", but the connotation is that high density is placed in one surgery.

Because elevation often resolves on its own, giving yourself time to heal between surgeries will probably reduce or eliminate elevation regardless of the ultimate density placed.
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