Hair Transplant Repair: Can I Have My Old Hairline Grafts Removed and Placed In The Scar Area?

Written by Raymond J. Konior, MD on July 30, 2009

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. A cobblestone appearance is corrected when the graft is removed and the skin edges are reapproximated back in the normal skin plane. Following the extraction phase of the repair the grafts are further dissected and refined using stereomicroscopy to produce high quality follicular unit grafts. These grafts can then be used to refine the hairline or to help camouflage the donor site scar.

The extraction sites often stay pink for several weeks following the procedure. Fortunately, with time the vast majority of patients heal very nicely when either excision technique is used. Follicular unit extraction leaves a very small opening that typically heals with a barely recognizable scar. Punch excisions that are performed meticulously often leave nothing more than a fine scar line remaining at the excision site. You may be an excellent candidate for selective graft removal and it is advisable that you discuss this option in detail with your surgeon.

Raymond J. Konior, M.D.
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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