hair transplant repair

I had my first hair transplant in June of last year and I hate it. I stupidly made my decision to go with my surgeon based on price and a sales pitch from a consultant who said that the reason their prices are so low is that they don’t need to advertise so the savings are passed onto their customers. I had it done in south Florida, where I know there are a couple of good doctors after reading your site, but I just thought that all the doctors where the same and I wanted to save money. Well I guess I got what I paid for and now I’m in need of help. What percentage of people are in my situation and can I eventually look like I have a normal head of hair even though I think I wasted 1200 hair follicles and $2800. The new hair is growing in different directions and is almost impossible to to style unless I use a lot of gel. Can this be corrected and improved upon if I go to a respectable hair transplant surgeon this time? – Mark
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Dear Mark,

Thank you for your question. Among hair restoration surgeons, hair transplantation has a well-deserved name for being an art rather than a science. Many of us have studied not only the surgical side but also the aesthetic side of this procedure. Read the Story

I had a hair transplant when I was 20 and would prefer now to just have a buzz cut. I have a straight scar in the back of my head that is very thin but if I buzz my head it will definitely be visible. My doctor did not take the extra step of stitching or cutting the skin so hair would grow through the scar. Is there anywhere in the Miami area, where I currently live that I can go to get the scar fixed to become hard to see? – Patrick
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First of all Patrick, you bring up a very good case in point as to why young men (those under the age of 25 or so) should not be readily treated for their hair loss with a transplant procedure. Certainly, anyone at that age, I am going to recommend the most conservative approach, most likely Propecia, possible laser light therapy, and conservative follow up. For those men under the age of 26 or so, FUE is essentially the only procedure I would consider, for it does not leave the problem of a visible donor site scar.

With your donor site scar, I have found that the first step should usually be the excision of the scar with plastic surgery closure. While there is no guarantee that this will improve the appearance of the scar, it makes sense to try this first, for it does have a reasonable chance of scar narrowing, and perhaps if there is enough laxity, for the allowance of hair growth through the scar using the HITS (trichophytic) technique. A variety of techniques can be used for scar revision- most commonly it involves the use of deep sutures to help hold the tissue together, with superficially placed skin sutures as well. Read the Story

I had a hair transplant back in 2001 that left me with an unsightly scar in the back that goes practically from ear to ear. I have to grow my hair at least two inches to cover it, and when it’s wet it look horrible. I’d like to see if this could be corrected. What should be my next step and can this be accomplished?
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There is always hope that a less than ideal donor scar can be improved. The best method for correcting an unsightly scar in the donor region will depend on several factors including: 1) the width of the scar; 2) the location of the scar with respect to how high or low it was placed in the donor region; 3) the elasticity of the surrounding scalp; and 4) the baseline follicular-unit density in the region immediately adjacent to the scar.

There are two basic modalities available for correcting the scar. One can undergo a scar revision at which time the scar is excised and the remaining incision is meticulously repaired. An open scar revision like this will depend on the width of the scar and the elasticity of the surrounding scalp. A tight scalp may preclude this option since there needs to be some redundant scalp available to stretch into the defect which is left following removal of the scar. Tension is one of the single greatest contributors to the creation of a wide scar following a strip harvest procedure. You will have a high risk for developing another wide scar if the revised incision is closed under tension. Read the Story

I had a transplant in 1995 that I am unhappy with. It left me with a strip scar and frizzy hair. Now all I want to do is to be able to buzz my hair short. I’ve had the scar partially filled in with FUE, and am satisfied with the result. Now I would like to remove the old hairline grafts, splice them, and have them transplanted into the scar to camouflage it some more. Also the old hairline grafts have caused cobblestoning, so this needs to be repaired (I guess with the removal it is?). Is it possible to achieve what I am looking for?
Many thanks,
Adam
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It is definitely possible to correct the appearance of unsightly grafts that are too big or that have been placed with poor direction, angle, depth or location. Unfortunately, many of these repair cases require multiple sessions to achieve maximum improvement since there is often a limit to how many grafts can be removed at any one time. There are several options available for removing the offending grafts. Follicular unit extraction techniques may be used to remove smaller grafts or to selectively reduce the density within a plug graft. Thinning out a large plug can improve its appearance by making it look less “pluggy”. Large grafts that would not benefit from thinning with follicular unit extraction may require complete extraction with a standard skin biopsy punch. The punch is used to first core out the offending graft from the recipient site. The residual defect is then sutured closed or left to close via secondary intention healing, i.e. leaving the wound open and letting it close down on its own. Read the Story

I’ve had two poor hair transplants in 2003 and 2004 and I am at my wits end. Unfortunately, I did not do enough research and have just found your organization. I am hoping to repair my hair line to make it look more natural than it does now. I still have a lot of donor hair but definitely need a touch up to make things appear less obvious. Where do I go from here?- Ted
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Dear Ted,

Much has changed since 2003 and 2004 in respect to hairlines. Correct hairline creation is based on anatomic markers and artistry. Every head is shaped differently, however the anatomical apex and temporal points are consistent. Once consistent anatomical markers are found then the hairline is created. To look natural, the hairline is gradually thickened by a technique called feathering. Single hair grafts are used to outline the front hairline and thicker grafts are blended behind this front border. The hairline is not created straight and rounded but irregular-what some call a snail tract. Even the differences in the hair shaft thickness is utilized in proper hairline creation with the most thin hairs placed in the very front. Read the Story

Hair transplant surgery is one of the most demanding cosmetic procedures performed today. Unfortunately, many physicians performing hair transplant surgery do not do so to state of the art standards. For various reasons, some physicians who decide to enter the field are either unwilling or unable to  learn how to perform this labor intensive, artistic procedure the right way.

Performing hair transplant surgery well involves several factors. First and foremost, it requires a surgeon to be highly skilled and meticulous. You can not cut corners when it comes to hair transplant surgery and this includes the physician’s staff.  A hair transplant practice must have the infrastructure to accommodate the equipment and staff requirements necessary to perform a procedure that can last between eight to ten hours. Each staff member plays an integral role in the final outcome of each hair transplant procedure and as practice is only a strong as it’s weakest surgical staff member. Read the Story

All cosmetic surgery leaves scars, there’s no ifs , ands or buts about it. However, a skilled surgeon can greatly reduce the visibility of scars my utilizing specific techniques that either strategically place the scar in a less visible area of the body or camouflage the scar all together.

Hair transplant surgery is unique in that most scars, even the less than optimal ones, can be hidden within the hair, if in fact the patient has a sufficient amount above the scar.

Patients should expect a donor scar to be no more than 1-2mm in width on average. In some cases, even in the best hands, the donor scar can be wider. If a patient’s connective tissues are weak, or if he happens to fall into the hands of an unskilled surgeon the scar left behind can become a serious aesthetic issue. Read the Story

I had one hair transplant procedure some 12 years ago which has left me with a lengthy single incision scar from the donar area, to me the worse decision I have ever made. I now keep my hair clipped short leaving the scar very visible.

I am constantly depressed and do not know if there is anything that can be done to correct my scaring. I live in the UK and wonder if there is a reputable person/organization where I can seek help and advice. – Andrew
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Dear Andrew,

You say it was the “worst decision you made”, but I am not clear if you are happy or not with your transplanted hair. Also your email clearly shows you are unhappy with your donor scar, but you do not describe whether it is the normal and expected variety or a widened scar. Having your hair very short obviously exposes the scar and if you do not wish to have further surgery then I recommend a slightly longer hair style. You need to appreciate that hair transplant techniques when done according to today’s incredible standards and in the right hands is a million years away from 12 years ago. Read the Story

Ten years ago I had 300 round circular plugs taken from the donor area and placed on the middle and crown area. I have 100 round “white” circles on the crown, but what is worse are the indentations. They appear to be “crater like” scars on the middle of the scalp. Is there any method(s) to correct the craters and smooth out the skin? The donor area is too thin for future use and I would like to just correct the scalp issue and be able to live without wearing a baseball hat in public. I tried a hairpiece but the thinning hair on sides could not hold it in place. Your insight is appreciated! Thank you for your time and consideration. ~Dante
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Dante

Unfortunately large plugs become very detectable when they are located in the middle of a large balding area. Indentations suggest that the grafts were placed too low in the scalp. Improper graft placement results in a cobblestone appearance when positioned too high and in a crater or pit-like appearance when positioned too low. The “white” circles you describe suggest that there is little or no hair growing out of the grafts. The combination of a white plug and no hair means that the graft did not survive the original transplant procedure. What you are now seeing is the residual scar tissue that has replaced the once healthy plug tissue. Read the Story

I had a hair transplant seven years ago and have never been happy with it. It is constantly on my mind and has destroyed my social life. The main concern I have with my hair transplant is the resulting cobblestone appearance, it looks shocking when exposed to light ie sunlight. I would like to have another procedure to improve the density, but I am still concerned with the pitting. Nobody ever discusses treatments for scarring/pitting to the donor area, is this because there are none? I’ve often thought creams or laser treatments similar to that used in acne scarring could be used or would these treatments damage or kill the hair follicles. Surely with all the skin treatments available there must be something to rid or improve the pitted appearance. ~Tony
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Tony, I am very sorry to hear about the position that you are in. Cobble-stoning in the recipient area could be due to particular healing characteristics of your skin but could also be due the grafts placed too shallow in the slit i.e. the slits being not deep enough. Read the Story