Here is a patient who recently presented to me with these strip scars from another physician. The patient had multiple strip hair transplant procedures and on the last procedure these very wide scars formed. I do not know exactly what the physician did, or how the patient presented to the physician prior to the last procedure, but this should serve as a warning to both physicians and patients that this can happen if you are not careful. Each patient must be throughly evaluated to determine elasticity, especially after multiple procedures. Each time a strip is harvested the donor elasticity decreases, thus increasing the possibility of scar widening, or the inability to close the would. Tension on the would closure also increases the chances of shock loss of hair around the donor region. Many times the hair lost from shock loss comes back over time, but sometimes it does not.
Sometimes you don’t know you’ve gone too far, until you’ve gone too far. Patients will push the physician in some cases to go for more grafts. Physicians will want to make the patients happy and feel confident in their abilities. No matter how good you are, you must always be cautious and prepared for the unknown. It’s always obviously better to stop before you get to a problem.
With my success performing FUE I have been encouraging my patients who have had multiple strip procedures to consider an FUE procedure which will not affect a previous strip scar. If I feel it is medically permissible to harvest another strip, I always try to educate the patient that there is always the possibility of scar widening or shock loss around the donor region.
In this case, the treating physician tried to resect the scar with no success. I opted to treat the patient by extracting FUE grafts from the beard and transplanting them into the scars. I hope to post a follow up photo in 6 months showing the results of my procedure.
All the best,
Marc Dauer, M.D.