Corrective Hair Transplants
In the 1950’s hair transplants were first introduced into use as we know it today. The first transplants were large round grafts containing 8-12 hairs per graft and these were placed into large round holes in the scalp. This is now known as the “pluggy” transplant appearance. But in those days it was all that was available. In this section options for correcting previous transplants in need of repair are presented. This is a sub specialty for Dr. James Vogel and he has had extensive experience with these difficult problems. Dr. Vogel is particularly well qualified and experienced for this type of repair surgery because of his training as a plastic surgeon.
In addition to the information provided you are encouraged to read several articles and text book chapters Dr Vogel has written on Corrective Hair Transplant Procedures.
- Article on Correcting Problems in Hair Restoration Surgery
- Hair Restoration Complications: An Approach to the Unnatural-Appearing Hair Transplant (NEW!)
- Book Chapter (In Recent Textbook)
Corrective Hair Transplants Patient Story
Briefly, the problem with the pluggy appearance is the large round plugs and the limited donor hair available. Thus two fundamental approaches are usually taken to improve the appearance of the pluggy look. The first is plug reduction and hair recycling and the second is linear excision of the hairline and hair recycling. Both of these techniques directly address the plug as a culprit for the undesirable appearance and recycle the plug hair respecting the precious and scarce amount of available donor hair.
Plug Reduction and Recycling
In this technique the large round hair plugs are reduced by approximately 80-90% and the removed hair plug is recycled into follicular units. These (recycled) hairs, now small and natural appearing grafts, are placed at the hairline to soften the appearance. The reduction of the plug also greatly contributes to the softer and more natural appearance.
Recycling of the hair plug is essential because there is a shortage of donor hair and every follicle that is usable must be re-used. Recycling the hair also decreases the amount of hair needed for harvesting from the donor area (i.e. back of the head)
No matter which option is chosen the patient must be realistic about what can be achieved and be aware that several procedures are needed to achieve optimal results. Dr. Vogel will spend time explaining the options and details about which procedure is best for you as well as the goals, likelihood of success, alternatives and risks.
Corrective Hair Transplants Video Review
Linear Excision of Hairline
In some cases, the best option for improving the hairline is to directly remove (excise) the entire front hairline. The name for this procedure is Linear Excision of Anterior (i.e. front ) Hair Line. The reasons for choosing this corrective technique include an extremely intense pluggy hairline, a low placed hairline that needs to be elevated for better facial balance, and an extreme limitation of natural donor hair. The first step is to remove the front hairline and re-cycle this hair into usable grafts. Grafts are then placed in front of the stitches during the first session and subsequent transplants are typically placed again at the hairline and behind during another session. This technique is illustrated by the photos in this box. What is shown here is a patient who underwent linear excision of his hair line and the stitches are seen. Hair grafts were then placed in front of the stitches during that initial procedure and subsequently during another session as well. The results are seen 8 months following the completion of the second session. Below you can see additional examples of this technique and how it helped to solve the unsightly appearance for quite a few patients.View More Before & After Photos