Stretching Wounds and Scars

How will these new wound closures you discussed in this blog impact people who have scars that stretch? I have scars that stretch every place I have had a surgery, including my hair transplant scar.

A trichophytic closure will not work if the wound widens more than 2-3 mm, because the hair growth from the trichotomy will only grow up to 2-3 mm from the edge of the wound where the trichotomy was done. The stretching may be helped by a sub-fascial closure below the occipitals muscle fascia. The tension reduction of such closures has value in reducing the wound size, but not necessarily in obliterating it. You might have some form of Erlos Danlos Syndrome (see here, here, and here), which comes about from defective collagen by its very nature. The story of EDS is not black and white, for I believe that some people have small amounts of this defective collagen and these people are the ones that may get stretching of the scars. In such situations, even the sub-fascial closures will not work, because eventually the body must heal the wound and as the sutures dissolve, the value of the sutures that hold the wound together will decrease over time.

Scars are at times a price one pays with surgery. For strip harvesting, this could be a price you will pay. If you have FUE harvesting (Follicular Unit Extraction), then this stretched scar problem should not become an issue with regard to your healing, as there is no large line scar to stretch.

Now with that said, putting the scar issue in perspective, the scar only exceeds 3 mm in about 5% of cases. If that happens and it bothers the patient, then I make this my problem as well and we work to solve the problem with whatever it takes.