Keloid Scar for FUE?

Question

I am a 30 year old African American male considering 2000 grafts FUE. I have a history of keloid formation on my sternum. I did a test of 15 grafts 1 year ago and did not scar. I am however still concerned about the chances of scarring with 2000 grafts. Any suggestions? Should I stage the procedure? maybe 500 at a time?

Jae Pak, MD · Answer

If you have concerns about scarring after surgery such as keloids, it is best to discuss this with your surgeon.  Anyone can give you a general answer but the actual outcome is your doctor's responsibility.

Alan S. Feller, DO · Answer

Keloiding and hypertrophic scarring can occur anytime to anyone. If you have a history of it than the chances are obviously higher. FUE is usually talked about in terms of small scars. It is true. But there are MANY MANY small scars produced by FUE that is not talked about and they coalesce into one large fibrotic sheet. This could set off a significant keloid or hypertrophic scar reaction. I personally would not do a hair transplant on a patient with your history. It's like throwing the dice.

John Peter Cole, MD · Answer

I have seen only a single case of hypertrophic scarring from FUE in the African ancestry patient.  I have never seen keloid scarring from FUE in this ethnic group.  While keloids are common in both Caucasian and African sternum areas, they are unheard of in the scalp donor area.If you are still nervous, try 100 grafts next.  Work your way up to confidence.  Chances are very good that if you did well on 15 and well on 100, you will do fine with more grafts.  Even then you can gradually do the process with 500 grafts per session.  FUE is just as efficient when you do 10 grafts as when you do 3000 grafts in terms of the impact on the donor area.  With strip harvesting, you larger sessions are more efficient.  This is not the case with FUE.

Anthony Bared, MD, FACS · Answer

I believe you are going about this in the best and most conservative manner.  Given your history of keloid formation, the most prudent approach would be a staged procedure as you are considering.  It is impossible to know if you would keloid from a procedure.  A staged approach with close post-op follow up with your surgeon would be the best approach.  Close follow up is important to combat the first signs of scar formation if one does happen to appear.

Omeed Memar, MD, PhD (license suspended) · Answer

I have not seen keloid formation after fue procedures but it is a possibility.  I think your conservative approach makes sense.

William Rassman, MD (retired) · Answer

keloids in the sternum  in some people are not common but keloids for FUE are almost unheard of. You have done the right thing by having some test grafts and with no keloids in the test area, you should be comfortable going forward. I belong to a group of 55 hair transplant surgeons and I recently polled them on this very subject. They all agreed that the test grafts alone wlll be sufficient testing.

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