I met a patient who had a hair transplant several years ago. He was in my office to check out his options for revising his scalp scar, but I had a hard time finding the scar when I parted his hair on the back of his head. He explained that he had come up with a method to hide the scar on a day to day basis.
I thought his way of camouflaging the scar was genius. I thought I should share his novel method and the photos with our blog followers. I am sure there are many people who can take advantage of this smart solution before they opt to do a scar revision procedure.
Two segments of scar with and without Honey-Beard Camouflage
As you can see in the image, he has used hair clippings from his shaver to cover the scar. He applies a thin layer of honey to make the scar surface sticky so that when he applies the beard clippings, they stick to the scar surface. This produces the appearance of hair on the scar, making the scar almost invisible.
This is similar to using microfibers such as Toppik and other similar brands but with use of your own hair.
Success Story: Hair Transplantation into the Scar
This blog is about how we successfully treated a 40 year old female patient with near total hair loss resulting from the complications of a facial cosmetic surgery that lead to significant scarring and hair loss in the patient. This discussion will provide details about her evaluation, treatment, and long term results.
The story evolves below:
Immediately After a Complicated Facial Surgery
The patient visited our office for evaluation of the significant hair loss in frontal areas of scalp after a complicated facial plastic surgery. It was necessary to delay the procedure for 6 months after the initial consultation so that whatever hair that had not been damaged or may have gone through the Telogen Eflluvioum could grow back.
The First Hair Transplant Visit with Dr. Mohebi
After enough time had passed, we began our first experimental hair surgery using only a limited number of grafts.
Test Hair Transplant in Scar
The first transplantation, consisting of 786 grafts, was put into 8 boxes with approximately 100 grafts each. We then evaluated her results after 6 months, and found that there was nearly complete growth in the areas which we treated.
Hair Transplant for Full Coverage
We were encouraged by these results and decided to perform another hair transplant procedure that would target the front and corners of the patient’s head. We increased the number of grafts to 2,716 for the second procedure.
Final Result After Hair Transplant in Scalp Scar
Our patient experienced total hair growth 18 months after the last hair procedure. She was tremendously excited by the prospect of not having to cover her head. She was also able to style and fix her hair the way she had before her accident.
We are proud of the progress she made in her long recovery and hope her story will bring inspiration to others who have experienced something similar.
News from ISHRS Scientific Annual Meeting in San Francisco 2013
The 21st Annual meeting of ISHRS was held in the Regency Hotel in San Francisco. The meeting was very productive with many useful presentations and scientific involvements.
This year the general session had many lectures on FUE transplant and the newest innovations in the field of hair restoration.
Partial Trichophytic Closure
Dr. Parsa Mohebi Lecturing on Partial Trichophytic Closure
I presented a novel method in management of donor wound in strip hair transplant. I have called this method, “Partial Trichophytic Closure” in which a traditional trichophytic closure is performed on the upper edge of the wound, while the lower edge is examined microscopically and only sections that have hair follicles with distal transection are de-epithelialized.
The advantage of this method is that the scar will appear smaller, because of the possibility of transected hair at the edges. This is the first time that this method has been presented in any medical meeting.
Among the interesting lectures, Dr. James Harris reviewed the FUE Research committee and its goals. He named the hair transplant surgeons who helped shape the current state of the art FUE techniques.
Dr. John Cole, the other hair transplant surgeon and member of FUE Research Committee commented about different punch sizes based on the classes of hair loss. He also reviewed the transection of hair follicles and in which situations we can be generous with our transections.
What is Piloscopy?
One of the interesting subjects discussed was the novel method in hair restoration presented by Dr. Carlos Wesley. Dr. Wesley introduced an endoscopic method for removing hair follicles. He called this method Piloscopy. Piloscopy is a tool that helps remove hair from below the skin surface. This device removes the grafts from inside which, unlike current techniques of hair restoration, can minimize the hypopigmentation at the skin level.
How does Piloscopy work?
Insert the scope underneath the skin
Visualize the hair follicle
Cannulate around the hair follicle from below
Clip the superficial epidermis on top that may get stuck to the hair follicle
Dr. Wesley is still working on the mechanics involved with this procedure as well as evaluating the scarring that may happen underneath the skin secondary to this procedure.
FUE Research Committee Meeting
Dr. Parsa Mohebi and other members of FUE Research Committee at 2nd Annual FUE Research Committee Meetin
The FUE Research Committee held its second annual meeting in which its achievements from the first year were discussed. The committee also discussed the plan for the coming year including its two major projects. The initial project, which compares the strip vs. FUE hair transplantation, will be launched soon. The second project of the FUE Research Committee will focus on the role of transection in FUE hair restoration. The committee discussed the details of the second study, which will also be launched soon.
As a tradition of the ISHRS Society, the Award Ceremony was held on the last night of the meeting. The winners of the golden and platinum award were announced.
Platinum Follicle Award: Dr. Sharen Keen
Golden Follicle Award: Dr. John Cole
Research Award: Dr. James Harris
Will I Have a Scar After Hair Transplant?
6 Months After FUE Transplant
Hello Doctor,
One of my cousins had a hair transplant about 10-12 years ago, maybe 15 years ago. You can easily tell that he had a hair transplant by looking at the back of his head (donor area). If he shaves his head, is it still the same case in 2013. Will the donor area look like he had a hair transplant if he shaves his head in the future?
A:
The answer to that question has to do with the type of procedure. If he has a strip procedure, he will have a linear scar on the donor area, which will be visible only if he chooses to shave his head, or to get a short crew cut on the back and sides. If he wants to keep his options open, to be able to shave or to keep hair very short on the side and back, his only option for doing the procedure would be doing a FUE transplant.
What could be done for the Scar of a Hair Transplant?
Q:
I had a hair transplant in past and planning to have another one. Part of the scar from the first procedure is often visible on the right side of the back of my head even when my hair is pretty long. It’s just a small section, but during the second procedure would it be possible to minimize its visibility further by transplanting a small amount of hair into that area (not sure if this is safe or not if the grafts are being removed from a nearby area) or through other means?
Stretched Hair Transplant Scar
A:
In order to minimize the visibility, we will do a double-edge trichophytic closure on the donor scar. We generally have more flexibility with our trichophytic closure during the second procedure due to the fact that we now know how aggressive we should be in bringing hair into the scar. The second time around, we know how your body scars and can anticipate what kind of stretching will occur. Going further, in the future we can place hair into the scar if needed with filling the scar with FUE transplant or even use SMP (scalp micropigmentation), which will minimize the visibility of the scar by placing pigments in it. Everything discussed above will be addressed in the future if necessary. Whether to use FUE or SMP to minimize the visibility of hair transplant scar is discussed in another blog post.
Scars from Secondary Hair Transplant Surgery?
Q:
Dear Dr. Mohebi,
I had a couple of hair transplant surgeries (FUT) in the past (about 12 years ago), and would like to do another surgery now. I have a question regarding the scar line in the back of my head. I obviously have a line now, but what I need to know is if you can use my current scar line as a part of your transplanted hair area, or if you would create a new scar line if I do another surgery? In other words, does a patient like me (who had surgeries before) end up with a new scar line, or does the new line overlap and cover the old line?
A:
Thanks for your question. The old linear hair transplant donor scar should be included in the new strip. That means you should end up with only one scar after your repeat hair transplants. We also perform trichophytic closure whenever we can in strip hair transplant surgeries to help hair grow inside the donor scar. This method allows some hair appear inside the final scar and make the final donor scar blend in with the surrounding skin when the scars matures. If your previous hair transplants were done many years in the past, it is likely that you have not received trichophytic closure. That means the final scar could be even improved comparing to what you currently have. Obviously, there are more individual factors involved in the process of wound healing and scar formation and we cannot always predict the final outcome. However we attempt to minimize the visibility of the hair transplant scar in repeat hair restorations whenever possible.
Addressing the Challenge of Scalp Scars
Parsa Mohebi, MD
Since the advent of hair transplant surgery, hair transplant surgeons have been challenged to address the scarring that is inevitable from the donor wound in strip hair transplants. Other types of scalp surgeries such as neurological surgeries can also leave linear type scars in the scalp.
In addition trauma to the head can leave a person with unwanted scar. A patient’s natural hair coverage can obscure the visibility of a scar in most cases. However, proximity to a patient’s hairline and or wearing the hair too short can make a scar more obvious.
A hair transplant surgeon can easily repair or camouflage most scalp scars. The variations in a scar shape, location and size are key factors affecting the techniques that a surgeon will use in the revisioning of the scar. The singular and most important purpose of the scar revisioning is to obscure or minimize its appearance to the naked eye. Scar revisioning is not merely cosmetic. Disfigurement from scarring often affects a person’s sense of well being and self worth. Do to the inherent nature of the work they do cosmetic surgeons are at the forefront of minimizing the appearance of scars. We have developed an algorithm utilized in hair restoration and other surgical cosmetic practices that effectively meets the challenge of scarring from these procedures. Many of the same techniques are also employed in addressing scalp scarring from trauma and scalp surgical procedures.
Medical excellence is predicated on examination. Physically examining the scar is essential in determining what proportion of scar visibility is due to stretching, hypertrophic reaction and or hair transaction.
A scar that is wider than expected gives evidence that some level of stretching has occurred. Skin that is stretched typically has a contrasting color to neighboring skin. Minimizing this contrast is one of the key approaches to reducing this type of scar. Hair transplant surgeon can reduce the contrast by bringing hair inside the scar by a variety of techniques to minimize the contrast between the hair bearing scalp and non-hair bearing scar. That is done through placing follicular unit grafts with FUE procedure or by performing trichophytic closure on one or both edges of a scalp scar. Many people may need more than one hair transplant into their scalp to improve the reduction in visibility of the scar.
Every cosmetic surgeon should be familiar and knowledgeable about the cosmetic products or non-medical methods that could be used to improve scars. When managing a scalp scar, we always consider and discuss with the patients the role of a variety of techniques that might be used solely or in conjunction with surgical procedures for further improving appearance of scars. Some of these are; microfibers, foundations, and coloring agents for skin and hair or tattooing of scalp.
If you are suffering from a scalp scar, you need to find a good hair transplant surgeon with plenty of experience with treatment of scalp scars. A simple consultation would make the overall plan clear. The plan may include a surgical procedure, using cosmetics for hair and scalp and hair style changes.
Hair Transplant New Technology – Laxometer II
Laxometer II
Often times we receive inquiries at Parsa Mohebi Hair Restoration about the latest hair transplant technology, and we feel obligated to spread the news about the latest hair transplant technology. We are excited about the new generation of Laxometer, the newest hair transplant device invented by Dr. Parsa Mohebi. The Laxometer II is a handheld device which revolutionizes the art and science of hair restoration. Being in the growing sector of the cosmetic surgery arena, progressive updates on hair transplant new technology is critical.
Applications
The revolutionary Laxometer II increases the number of hair grafts which can safely and precisely be transplanted in one surgery. A hair transplant of more than 3500 hair grafts once upon a time took two or more surgeries to complete, but with this latest technology in hair transplantation, it can be done in only one procedure.
The Laxometer II, the new technology in the hair transplant industry, is basically a measuring device which is used to calculate the laxity of one’s scalp. An accurate measurement of scalp laxity is critical when determining how large the donor strip can be. This latest breakthrough hair transplant technology gives a precise measurement which can be increased as a result of patients actively doing daily scalp exercises. The larger the available strip, the more grafts can be made available for transplantation.
At the International Society of Hair Restoration Surgery’s 19th Annual Scientific meeting in Alaska in September 2011, Dr. Mohebi unveiled his new invention for purchase to all hair transplant surgeons. This latest technology in hair transplant surgery was welcomed with anticipation and applause as it will help to continue the industry progressing forward.