Doctors on Hair Loss & Hair Transplant surgery.

What are the ways to camouflage strip hair restoration scars?

Camouflaging Strip Scars

Scars in the donor area from strip harvests may be problematic for many men. They may be short or run from ear to ear. Sometimes they widen over time, occasionally to more than two centimeters, which is deforming. This is usually due to an overly tight scalp, too low a placement, or poor surgical technique. They also change the direction of hair growth below the scar, relative to above the scar, which may cause a “shadow” of the linear scar to be evident even with the hair grown out somewhat.

IN order to minimize the appearance of scars, several strategies are available. There are cosmetics such as Dermatch, which may help disguise the scar. The hair may also be grown out fairly long to attempt coverage. This, of course, may not be an option for those with an over harvested donor region.

Surgical scar revision may be attempted, often without success. This consists of excising the scar and them suturing up the wound, hoping that the resultant scar will look better than the original one. This can work in some instances; however, if the condition that led to the scarring is not remedied, then even the best revision may fail.

Grafting into the scar is another option. Because yields tend to be lower in scars, this may take more than one surgical procedure over many months to have a significant cosmetic effect. Either body or scalp hair may be used; scalp hair is generally a better choice if it is available.

Tags: dermatch, donor area, hair cycle, hair growth, hair restoration, scar grafting, scarring, strip scar, surgical scar revision

Add a Comment | Ask a Question |  Print This Post

I had hair transplant procedure a week ago and I’ve note that the hair is still growing in the grafts. Does this mean the hair has been accepted and that it will continue to grow?

Following hair transplantation hair in the grafts will continue to elongate for about 10 days. Some of this may be continued hair growth, but it also reflects a move toward anagen effluvium. In anagen effluvium the dermal sheath begins to contract and move toward the surface of the skin much like an accordion. This shortening of the dermal sheath will push the bulb of the hair shaft toward the surface of the skin. Therefore, some of the elongation of the hairs is not due to growing, but rather due to a contraction of the dermal sheath toward the skin surface.

Once the dermal sheath contracts, the hairs will either begin to shed on their own beginning in two to three weeks after the transplant. Some of the hairs will continue to rest on the surface of the skin for a prolonged period of time. Eventually the scalp skin will either begin to form a wall around the resting, non-growing hair, or the scalp will form a pustule or pimple like reaction that will eventually burst and the non-growing hair will exit the skin with the exudate from the pimple or cyst like structure.

It is probably a good idea to minimize the number of the cyst like structures that you get because they represent unnecessary inflammation. Inflammation may not always be a good thing. In theory inflammation might sometimes lead to an autoimmune response toward one’s own hair and this in turn may compromise future graft growth.

In order to minimize inflammation, we generally recommend that patients begin removing non-growing hair fragments beginning three weeks after the hair restoration procedure. The best way to manage this is to aggressively wash the scalp with soap and a wash cloth. Non-growing hair will come out easily like removing a pin from a soft stick of butter. Growing hairs on the other hand must be plucked and it takes a good bit of force to accomplish this.

Sometimes hairs do continue to grow following a hair transplant without ever going into the resting phase, but it is unlikely that you will see more than 10% go into the resting phase. It is far more likely that the hairs will shed. Occasionally hairs almost shed, but then continue to grow. We can easily recognize these hairs because they have a dark tip that is coarse followed by a narrow constriction that is of lighter color. This is followed by a gradual darkening of the hair shaft and increase in hair diameter once again. We call these hairs that exhibit signs of this trauma pol pinkus hairs and they are a sure sign of recently transplanted hairs that have continued to grow.

Tags: anagen effluvium, cyst, dermal sheath, dr. john p. cole, Grafts, hair diameter, hair growth, hair restoration, hair shaft, hair transplant, hair transplant surgery, hair transplantation, inflammation, non growing hair, patients, pimple, resting phase, scalp

Add a Comment | Ask a Question |  Print This Post

Dr. Cole, what is the C2G stand for?

C2G stands for the Cole Isolation technique to go or CIT to go. CIT is a proprietary method of harvesting individual follicular units one at a time such that there is no need for a strip harvest. Strip harvests leave linear scars and no one can predict how wide the scar will be or whether it will be pale white in color or red in color. Either way the strip harvest leaves you will a linear scar that obviates your capacity to wear your hair short and leaves you vulnerable to others suspecting you’ve had a hair transplant previously. Often patients are so concerned about their strip scar that they cease going to a barber or hair stylist for fear of exposure.

In an effort to overcome this social stigma we developed the CIT procedure. The single negative to this procedure has been the requirement for patients to shave the donor area. This can result in problems blending back into society or into one’s work place. The goal of C2G was to develop a procedure that allows patients to keep their hair long so that they can return to their normal social environment within a few days.

C2G is a procedure where only individual follicular units are trimmed and the resulting individual follicular units are then transferred to the top of the scalp after harvesting them via CIT. Only the individual follicular units are trimmed so that you have a normal appearing donor area from day one and you also have the advantage of avoiding the strip scar altogether. Now there is no reason to avoid taking advantage of all the long term benefits of CIT. This includes no linear strip scar, no prolonged strip scar pain, no prolonged strip scar tightness or numbness in the donor area, more hair per graft (more bang for you buck), and a lower follicular injury rate (transaction rate).

There was once a draw back to CIT. Now there is none. C2G is the future of hair restoration surgery.

Tags: c2g, cole isolation technique, donor area, hair restoration, hair transplant, hair transplant surgery, strip, strip scar

Add a Comment | Ask a Question |  Print This Post

What are the common used hair transplant techniques and how are they different from CIT?

Hair transplant surgery can be done using several different techniques, including old-style plugs, strip harvest, The Cole Isolation technique (CIT), and body hair transplantation (BHT). Plug harvesting is only mentioned for historical reasons; it is a very poor technique and should not be used in the modern era. Strip harvest using only two incisions became popular during the 1990’s, and is still widely used today. CIT is very new, having been used only the past 5 or 6 years, but is beginning to challenge strip surgery in some areas as a procedure with much less scarring. BHT is used mostly for adding hair to scalp hair surgeries, and in patients who have had much of their scalp donor hair removed. Scalp hair is always better, and BHT is seen as a complement to scalp hair.
Hair grows on the scalp in separate units, which are known as follicular groups or follicular units. They contain 1, 2, 3, 4, or rarely 5 or more hairs. During the CIT procedure, a special tool is used to take these hair groups out one at a time. The advantage is that no long incision or wound is made in the scalp, and therefore no long scar results. Also, there is very little pain after the surgery, and the hair grafts come out ready to place in the balding areas, with no trimming needed. Sometimes there are tiny white dots left where the hair s were taken out; these are very small and if the hair is more than ¼ inch long or so, the dots are invisible.
These hair grafts are then placed into tiny slits or holes made by the surgeon into the balding or thinning hair areas; in about 3 or 4 months the first of the “new” hairs begin to sprout and by the end of a year, the full result of the transplant will be seen!

Tags: balding, bht, cit, follicular groups, Grafts, hair transplant surgeon, hair transplant surgery, incisions, patients, plugs, scalp, scarring, slits, strip, the cole isolation technique, thinning hair

Add a Comment | Ask a Question |  Print This Post