Hair Restoration Blog

Q:

We discussed the possibility to close the scar, which I think is a good idea, but again, I had already achieved camouflage with longer hair. While it may only be a 2-hour operation, I admit being very weary of such an operation because my skin is already so tight. I understand that the skin exercises you recommended should help a great deal, but for whatever reasons I am not comfortable with such an operation, especially considering that I would like to cover the whole head with some hair anyway. Perhaps you will convince me on the scar revision, or maybe you will advise me to pursue the FUE plan which would cover the rest of my head. Assuming I have an “average” density in the donor area, how many grafts do you think you could extract from it? How good or bad would be the mini-scars scattered all over the back of the head? I am assuming the surrounding hair will camouflage them?

A:

If you don’t want to pursue scar revision, the only option will be an FUE transplant into the scar from neighboring areas.  I recommend for you to wait until we see you in your follow up visit with a little longer hair before continuing. You also need to schedule for the FOX test to determine your eligibility for a Follicular Unit Extraction procedure.  The answer to your questions about how many grafts could be harvested in one session of your FUE procedure will be answered the day we do FOX test and confirm your eligibility.

You need to contact US Hair Restoration to schedule the FOX test as soon as you are able.  FOX test’s are done quite easily and assisted by numbing a very small area on the back of your scalp. The small scars of the FUE are going to be scattered throughout a larger area.  That can minimize the visibility of those pinpoint scars.  If you keep your hair not too short it is generally not possible to see them at all, but with a shaved head the tiny scars might be detectable from a close view.

Q:

Scar of face lift surgery

I believe I am a casualty of a brow lift gone wrong.  Three and half years after my brow lift surgery, I am seeing extreme hair loss on the top of my head, with itching burning and a crawling sensation at the affected area.

If this conclusion is correct will any treatment stop the hair loss? Will hair transplantation work?
Thank you

A:

Recession of hairline in a male patterned after a face lift surgery

The condition you are describing may be the beginning of cicatricial alopecia or hair loss secondary to a face or brow lift surgery.  You need to be seen by a good hair restoration surgeon or dermatologist for a close evaluation.  Brow Lift or face lift surgeries require incisions in the scalp that result in scarring and hair loss at the point of incision and around it on the temporal or frontal areas.  This hair loss condition could be seen as a complication of the face lift procedure with unknown mechanism.

Although a rare side effect of the face lift surgery, as a hair transplant surgeon with particular experience and interest in scalp scar revisions, I see many patients with hair loss after face lift procedures in our California hair transplant offices.  Your condition has two components; 1. the scar of incision in the hairy part of scalp; 2. the loss of hair on the temples and frontal areas.   Both these problems can be easily treated with transplanting hair into the scar and on the hair loss areas of the scalp.  If the procedure is done through follicular unit transplantation the result should be quite natural.

Many hair transplant patients are concerned with the scar of cosmetic surgeries including hair transplants. Several techniques have been suggested to minimize the scar such as corticosteroid injections, irradiation, ultrasound, silicone applications into and around the forming scar. However, the effects of most these methods were far from satisfactory. Botox is a new method that could be used to minimize the size of both facial and scalp scars. The use of Botox for reduction of facial scars from surgeries was first suggested by plastic surgeons who were trying to reduce postoperative effect of facial muscles on stretching and widening of scars.

In many patients with ugly scars of the face, Botox or botulinum toxin was used successfully to induce temporary paralysis of the muscles during revision surgery. Botox with the same mechanism can help minimizing tension on the healing wound edges until collagen could mature and scar if completely and firmly formed.

The use of Botox has been suggested for the treatment of stretched scars on the face by many plastic surgeons now. Hair transplant surgeons also use Botox for treatment of the hair transplant widened scars of the donor area that do not show improvement with a simple scar revision procedure. There are reports of successful decrease in the final size of the scars with injection of Botox into the muscles surrounding the maturing scar. We at the Los Angeles hair transplant offices of US Hair Restoration don’t offer Botox to every patient who is having a hair transplant surgery through strip technique, but it certainly could be used for the patients who suffered from widened scars of prior surgeries and did not respond to the other methods of scar revision.