This nice fellow from overseas had had 3 previous transplants in Europe. He is quite an athelete and felt like the scar was too noticable when he kept his hair the length that he wanted, and he wanted a revision. Additionally, in my opinion, he had had (at his previous surgeries) too little hair sprinkled over too much scalp, not really "fixing" anything, but rather giving him some coverage which was a bit thin.

We had LOTS of talks on the phone, internet and in person debating the double edged sword of trying to repair the scar; and at the same time, get more hair. Additionally, I told him that if we placed 1500 AMONGST the grafts that he already had, it still wouldn't be dense but would give him more coverage. He declined a denser placement up front and I felt that he had made an informed decision.

He called me this past saturday at 5am (forgetting that we are not in European time) to tell me his scar was widening. He sent me pics on Monday and I don't think he is widening at all. His scar is however red and will get redder and a bit lumpier for a few more weeks before improving. He is back exercising and although I can't predict the future or guarantee him no scar, I am pretty confident that he will wind up with a nice scar next spring.

Please note that I enclosed a few intra-op pics, not to show blood, but to show just how WIDE his scalp retracted prior to placing deep sutures. He had done a good job of scalp exercises and the closure was really quite tension-free.

Dr. Lindsey McLean VA

Dr. Lindsey, ill be really interested to see how the scar turns out for this guy, as you know, by seeing my scar, i can relate to how this guy feels when exercising... now when i play basketball im one of those guys wearin the headband the whole time.... i look like a damn fool but its better then the alternative IMO.

anyways the closure looks nice, i hope it stays tight for him... thanks for once again providing honest documentation... i think i speak for many here when i say its refreshing and appreciated.

I think it's going to look really nice Dr. Lindsey. I'm interested in seeing regular updates on this patient.

I also had a complex scar excised with my procedure. About 1850 grafts at the same time. When do you usually recommend scalp exercises and what kind. I'm laying off exercising or weights for awhile.

I tell almost everyone to do scalp exercises and to use 2 hands to compress the strip area that I will excise from above and below. They are to do this 1 minute before each meal, for 2-3 weeks preop.

I let this fellow go back to exercise at day 7...except crunches and benchpressing with arching on my scarline.

Dr. Lindsey McLean VA

We need to wait. It looks a little larger than normal scars at this phase, but of course this is not a normal scar.

Not normal at all. The 6 - 8 week pic will be worse. I am interested in the 3 month pic which is a good predictor. If he lived here, I'd have him in now for an exam and would use steroids if hypertrophic.

I am not much of a gambler, but I told him that I will bet him a meal of his choice in McLean that his scar will be less than 3mm wide.

Dr. Lindsey McLean VA

heheheh anyway, i know you did the best to him, do you think that by any chance the scar could come larger than it was before?

Aska,

The only thing I ever guarantee is that I'll do my best on any particular case. So no, I can't guarantee him that he won't look worse.

BUT, that being said, I am extremely confident that his scar will be dramatically better than before. And I bet it does not widen significantly. I am not always right, but I'll be very surprised if his scar doesn't look great by Christmas.

Dr. Lindsey McLean VA

Dr. Lindsey,

I have to say I'm quite impressed with how the patient's scar is coming along. I admit, I was pretty worried when I saw the intraoperative photos. But I'm thrilled to see that he's coming along so well.

Please keep us posted.

Bill (Falc)

Yeah, that scalp REALLY retracted didn't it? That is my index finger. Fortunately it pulled together with really minimal tension.

He emailed me pics showing normal redness but no widening. I should have 3 month pics from him in mid Sept. Those are the money shots.

Now he is a semi pro athelete and I hope that he is not stretching my scarline.

Dr. Lindsey McLean VA