Hair Transplant Scar Stretching Concerns

This question, from a member of our Hair Restoration Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

I recently underwent a follicular unit transplantation (strip) procedure and have a few questions regarding scar stretching: At what time period (days, weeks, months) after the hair transplant procedure is the potential for scar stretching maximal? Will leaving the staples or sutures in for a longer period of time help to minimize stretching? Is there any correlation between the amount of time the sutures are in and how much the strip scar stretches?

Scar width is generally proportional to skin edge tension. Therefore whatever can be done to reduce this helps scars. At our office, we favor long, skinny strips, so that there isn’t alot of scalp to pull together. Additionally, deep sutures can take the load off of the skin edges so that the wound doesn’t pull apart or the scar stretch after the skin sutures are removed. In general skin stitches should come out between day 6 and 10. Frequently getting doctors to agree on anything is like herding cats, and you will find no concensus on when sutures ought to come out. Just follow your doctor’s advice as he has a reason for the time frame.

We take sutures out on day 7 unless there is some issue that would prevent that. Leaving skin sutures in for an extended period will not likely keep a scar from widening if the deep layers are not holding the skin edges together, nor will they keep an incision together that is falling apart due to infection. Back when I used to do head and neck cancer surgery, we’d still take sutures out by day 10, even in necks that had huge surgeries and in tissues that had already received radiation treatments. Sutured properly, those scars were consistently a “B” and often an “A”. But if there was an infection or breakdown deep to the skin, the wound would fall apart regardless of sutures being left in.

During your evaluation process and visiting doctors, ask them their reasons and ask to see some representative scars. At our consultations we show a great scar, one that is our average scar, and often times I’ll show the worst scar we’ve had in the past few years.

That is why preop communication and education with sites like this is so beneficial.

Dr. William Lindsey

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Blake – aka Future_HT_Doc

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