LAM FACIAL PLASTICS

Hi Dr. Lam,

Very informative forum!

I was wondering if you can help me...I had a hair transplant in 2003 which left me with an approximately 6 inch long/5mm wide, slightly raised and still a bit red linear scar on my scalp. Unfortunately, I'm still losing hair in a diffuse norwood 5-6 pattern and would love to be able to shave my head. What would be the best course of action to revise the scar and make it less noticeable?

I've been to see both plastic surgeon and cosmetic dermatologist here in California and both thought it could be improved to a large degree. The proposed treatment was a broken line revision with a double layer of stitches. The top layer done carefully around the hair follicles in a zig zagy line. For aftercare, silicon cream and possibly steroid to prevent raising. Then using a laser to get rid of the redness. I'd appreciate your opinion and how you'd attack something like this.

Thanks, Jay

first, i am sorry to hear of your situation. second, i think you have to be realistic about what is possible. no matter what you do to fix the scar, you will still have one and shaving the head will reveal it. geometric broken lines are very hard in the donor region. they don't heal that well. if the scar is red and raised, it could be due to a tension closure and in my experience, cutting and closing it again only leads to improvement in some cases but not always. i have had to go back and transplant the area with grafts to make it look as good as possible. i usually recommend a straight line closure with small degree of geometric broken line repair taking care to preserve the follicles during closure because with loss of follicles during closure that could lead to further widening. and then possible transplant 6 months after the first closure. i would do scar relaxing/massage techniques for 6 weeks to 3 months before the procedure and rogaine twice daily for 3 months to prepare the donor bed as well.
best,
sml