Advice on scar after FUE

[Keith]

Hi there. I have just reached the 6 mths post surgery mark after FUE. As you can see from the 6mth post surgery photo i have inherited a scar on the top of my scalp that formed after scabbing formed from Day 4 after surgery onwards ( see photo) i have also included a photo of Day 0 straight after surgery,

I am concerned on multiple levels , so was wandering if anyone could provide some advice on the following:

1) is there anything i can do to reduce the appearance of the scar ? i was hoping that hair would grow within it but the grafts have died so unfortunately there's no hiding the scar.
2) if i get another FUE done in the scar area will this be successful and how much will this cost approximately?
3) is the surgeon who did my FUE to blame for this and should i be claiming any compensation?
4) finally i am concerned overall with my hair growth so far after 6 months. I do have some hairs coming through but there is no thickness to it . I have therefore purposely kept my hair short as it looks silly with just individual strands with no texture. Is this growth as expected for the 6 month mark or should i be concerned?

Thanks in advance

Keith

 

[Hemingway]

Who did your transplant mate?

It looks you might have some growth but there are no photos to compare. It would appear to be much less than expected at this stage in any case.

 

[Keith]

Who did your transplant mate?

It looks you might have some growth but there are no photos to compare. It would appear to be much less than expected at this stage in any case.

Hair Growth Centre in Manchester, UK
When you say there's no photos to compare you mean before the procedure? I'll try to find some of them but pretty much had no hair in the area they transplanted beforehand

 

[Keith]

Hi I've not had any responses to my post yet. Would be great to have the opinions from a doctor

Am I on the wrong forum for this? If so which forum should i be using ?

 

[NZK Medical]

Hi there. I have just reached the 6 mths post surgery mark after FUE. As you can see from the 6mth post surgery photo i have inherited a scar on the top of my scalp that formed after scabbing formed from Day 4 after surgery onwards ( see photo) i have also included a photo of Day 0 straight after surgery,

I am concerned on multiple levels , so was wandering if anyone could provide some advice on the following:

1) is there anything i can do to reduce the appearance of the scar ? i was hoping that hair would grow within it but the grafts have died so unfortunately there's no hiding the scar.
2) if i get another FUE done in the scar area will this be successful and how much will this cost approximately?
3) is the surgeon who did my FUE to blame for this and should i be claiming any compensation?
4) finally i am concerned overall with my hair growth so far after 6 months. I do have some hairs coming through but there is no thickness to it . I have therefore purposely kept my hair short as it looks silly with just individual strands with no texture. Is this growth as expected for the 6 month mark or should i be concerned?

Thanks in advance

Keith

Hello @Keith, comparing your day 4 image compared to the 6-month image. The blood scabbing looks to be in a very similar position over the top of your head. This could be necrosis. This cannot be reversed if the case. The cause can be a number of reasons, hard to speculate. Did you have any correspondence with the clinic at the time?

Hair can be added to scar tissue. But, it´s recognised the yield can be lower than in virgin skin. Often it is better to start by placing a lower hair density and building up the fullness over time. To promote the best yield. Regarding the general growth, can you post a before image to compare. Six months' growth results at this stage can vary greatly. But generally, the basic shape of your transplant is visible. Aspects such as hair density still need to improve. This often includes your hair quality, strength, and thickness.

 

[Keith]

Hi there and thanks for your response. At first i was non the wiser when i saw this scabbing thinking it was part of the normal process but then i looked online at other peoples scabbing in the first week and it was nothing like mine so i called my clinic. They invited me on several occasions to do PRP injections in the scabbing area to ensure that the infection doesnt spread. Unfortunately they didn't admit to me at that point that it was necrosis , maybe so not to worry me.

Regarding a photo pre surgery. See attached. it is hard to see a comparison really as i have had SMP procedure 2 years ago prior to my FUE surgery .. I haven't got the ones that were taken immediately but these will give you an idea

Can you recommend anything i can do to help my transplanted hairs grow faster? i had 3000 grafts so i was hoping for a bit more density by now. I am currently taking Biotin tablets ( 12000mg per day ) and am using washing my hair with caffeine shampoo ( Alpecin) every other day. Plus i am moisturizing my scalp day and night with coconut oil . is there anything else you recommend?

Thanks

Keith

 

[NZK Medical]

Hello @Keith, from the picture it certainly appears to be necrosis I´m afraid. You should have been on an antibiotic at the time. While it is not possible to turn the clock back and remove the scarring. As said previously, hair can be added to the area. As far as the hair growth is going. For 6 months the hairline is roughly in place. But behind the 3000 graft placement is spread and the old smp makes it harder to define the hair growth. With respect to making it grow faster. Not really. Treatments such as minoxidil help blood flow. But the grafts are probably going to grow as and when they want to at this stage. Good luck

 

[Bigmac]

Hi Keith.
Here are a few suggestions I received

if the tissue is atrophic I like to prepare the area couple months before a hair tranplant with fat grafting.

It’s damage to the Su dermal plexus whether it’s size of blade or proximity of grafts or both. You don’t see scalp necrosis without vascular compromise

I would do fat grafting as early as 3 months
Wait 3 more months
And then add new FU at 15-20 per cm with 19G needle with depth control

 

[Bigmac]

3000 grafts to cover that area will only provide a thin coverage providing everything grows.
As we thought in your other threads the area of concern looked like necrosis and unfortunately, this is the case.
The above post mentions what some doctors have said about your scar.
It’s up to you if you look into fat grafting to help the area improve before having more grafts added there.
Who was the doctor that did this work?

 

[Keith]

Hi Keith.
Here are a few suggestions I received

if the tissue is atrophic I like to prepare the area couple months before a hair tranplant with fat grafting.

It’s damage to the Su dermal plexus whether it’s size of blade or proximity of grafts or both. You don’t see scalp necrosis without vascular compromise

I would do fat grafting as early as 3 months
Wait 3 more months
And then add new FU at 15-20 per cm with 19G needle with depth control

@Bigmac thanks for your reply but your response seems to be to someone who has medical knowledge. Can you please respond in layman's terms?

 

[Bigmac]

Basically, the cause of the necrosis could be loss of blood supply to the area.
You can have the area treated to increase blood flow, make the area improved.

You should consult with another hair transplant clinic to get their opinion on how to proceed.

Are you wanting more grafts placed in the scar?

Who was your doctor?

 

[Kevboy]

Did this scab turn out to be necrosis? It looked nasty.

 

[Bigmac]

Hi Keith, it would be great to have an update from you.

 

[Keith]

Hi there @Bigmac apologies for the delay. Yes although not confirmed the condition did seem to be necrosis. The scar redness has eased a bit now however as you predicted there is no hair growth here

My main concern now is that my hair growth in general has been poor. I'm at 11mths stage now after a 3000 graft FUE in March 2022 and I have neither the volume or the hair length. This is very disappointing so I have lost interest in my FUE now as it seems like it has been a total failure. Here's some photos. Let me know what you think or suggest

Also worth noting, i never actually went through the shredding stage were i lost my initial hairs and grew new ones ( not sure this is because of the necrosis, however that was in a small area ) have you ever come across cases like this?

I am due to revisit my doctor at the 12 mth stage but i'm not sure what h would actually do for me. I can hardly imagine him admitting fault and give me any type of refund or re do for free , so maybe i'm stuck with the failed procedure . what do you think?

 

[Kevboy]

Do you have better quality pictures? If it is only the hair that can be seen that has grown it is a very poor result And you have the necrosis scarring to contend with. What are the clinic saying?

 

[Keith]

Do you have better quality pictures? If it is only the hair that can be seen that has grown it is a very poor result And you have the necrosis scarring to contend with. What are the clinic saying?

I'm going to the clinic next month for a check up. Not quite sure what you mean by better quality pics? You can see the full grafted area with the little hair growth from most of the grafts but they have not grown much. I'm not sure what the clinic will say or suggest yet which is why I'm asking this forum and BigMac wanted an update

 

[Kevboy]

To show your scalp more clearly because it has what appears to be a brownish colour covering it.

 

[Keith]

there is no brown coloured covering It looks shaded somewhat because of the SMP micro scalp pigmentaton I had done years ago. However if you zoom in you can clearly see the hairs in the grafted area ( further up in the thread you can see my scalp on the initial days after the procedure which clearly shows what area has been grafted)

 

[Bigmac]

To show your scalp more clearly because it has what appears to be a brownish colour covering it.

Hi Kev. The colour is the SMP fading. It looks grayish/blueish as it fades.

 

[Bigmac]

Hi Keith. I’m sorry to see your HT has produced a very low yield. I think you’ll need to have your scalp checked by a dermatologist for any underlying conditions and possibly a scalp biopsy. Suffering the Necrosis and this poor yield may suggest poor surgical procedure. It’ll be interesting to hear what the doctor advises when you have your appraisal.