FUT in a Keloid-prone Patient

This patient came to see Dr. Arocha with a history of two previous keloid formations after some scalp procedures done by another physician. Dr. Arocha recommended that he consider doing an FUE to minimize the risk of developing a keloid with an FUT procedure. However, the patient insisted that Dr. Arocha perform an FUT procedure. Dr. Arocha complied with the patient’s request and performed an FUT to restore his hair loss. Even though this patient had the tendency to keloid, he followed Dr. Arocha’s post-operative instructions thoroughly and avoided a keloid this time around. This resulted in a fine, barely visible FUT scar.

There are factors that increase the risk of scars widening or thickening. These factors include 1) increased scalp laxity 2) the risk of keloid in people with pigmented skin (asian, indian, middle eastern, etc…) 3) failure to follow guidelines to limit tension on the wound margins post surgery. The wound requires 6 to 12 months to mature. During this time, there is an increased risk of the scar widening if tension vectors are applied to the wound margins. This can be from progressive resistance exercises like squats and shoulder shrugs, or even using a pillow that predisposes to create tension on the neck. These tension vector forces are amplified in someone with very loose scalp. Therefore, it’s vital to follow all post-operative instructions and precautions.