Is It Possible To Repair a Bad Mini-Micrograft Hair Transplant From 2005?

Written by Raymond J. Konior, MD on June 10, 2008

I am 36 years old and had a mini-micrograft hair transplant in 2005. My hairline looks extremely unnatural and I have heard more than my share of jokes and comments made by co-workers and friends. I am writing you today to find out if this can be repaired, and if so how would that be accomplished? Are the grafts removed or is more hair transplanted around the existing grafts?
- - - - - - - - - - - - -

The adverse effects of a poorly performed minigraft hair restoration procedure can be improved upon using contemporary repair techniques. The manner in which the repair is performed depends on a variety of factors which include: 1) hairline location - i.e. is it too low or does it have an aesthetic shape and height; 2) graft direction and exit angle from the scalp; 3) graft appearance - i.e. severity of plugginess, presence of pitting or cobblestone formation; and 4) the availability of donor material for supplemental grafting. Some of the methods that are used to repair an unnatural minigraft hairline include: 1) complete removal of the objectionable grafts; 2) removing selective portions of the objectionable grafts; 3) adding follicular-unit grafts to the minigraft region.

Grafts may have to be completely removed if they are located below what is considered a natural hairline location. A hairline that is too low may look unnatural and can consume excessive donor supply. Removing the low grafts in this situation will restore a more natural looking hairline. The removed grafts can then be “recycled” into follicular-units to assist in completing the repair process. Total graft removal may also be necessary if the grafts have severe pitting, angling or directional abnormalities which cannot be camouflaged by adding additional follicular-unit grafting into the problem area.

Grafts that exhibit too severe of a pluggy look, but have proper angling and direction, may benefit from a selective reduction. Follicular-unit extraction (FUE) can be used when a minor volume reduction is indicated in the problematic grafts, while a more traditional punch excision can be performed when the objectionable grafts require more volume reduction than FUE will provide.

The most common method for improving an unnatural minigraft hairline is to perform high quality follicular-unit grafting within and in front of the problem area. Natural looking follicular-unit grafts provide density and refinement so as to improve the overall look of the unnatural hairline. The ability to utilize supplemental follicular-unit grafting depends, of course, on having adequate donor material to complete the repair.

Photos
Konior Hair Transplant Patient