Different Types of Repair Surgery
When a hair transplant patient has a result that makes them look worse than before they ever had hair restoration surgery it can be devastating. This has been the case since hair transplant surgery was first started. In fact, the majority of hair transplant repair cases involved clinics trying to repair the work performed during the 1970’s and 1980’s when the only procedures available were 4mm plug graft transplant surgeries, flap surgeries and scalp reduction surgeries. These procedures still show up today in hair transplant clinics around the world but the frequency which they appear is steadily declining.
Plug hair transplants – These types of procedures were considered “state of the art” for nearly 30 years but rarely did they ever look good enough to classified as “natural” by today’s standards. There are multiple ways to correct these old fashioned hair transplant procedures. The first way to correct plug hair transplant results is to perform more surgery to transplant hair in between and in front of the plugs. This can work very well but usually takes two procedures for the best result. The challenge is that the plugs are usually placed in a vertical or reverse angle making new surgeries difficult to perform properly. When natural angles are attempted with subsequent modern procedures the result can be a mix of angles and directions that is less than natural in appearance. The result may have a better appearance than the previous appearance with just plugs but having a variation of multiple angles and directions serves to create additional problems.
An alternative manner of correcting or improving plug surgeries is by removing the old grafts entirely. This is the preferred manner of plug correction as it allows for a “clean slate” to be created whereby the new surgeon can start over for the patient and not have to deal with the plugs creating surgical difficulties. There are three ways to remove plug grafts.
1. FUE – Inside of each plug are multiple follicular units. These units can be removed one by one to thin out or even complete remove all hair from the plug. This is the most common removal technique today.
2. Coring – This involves using a scalpel to completely remove the plug in it’s entirety. This leaves a similar size own wound in the patient’s scalp but these are then closed with either a suture or a surgical staple. The result is a very fine and faint scar that can only be seen upon close inspection. This not only removes the hairs from each plug but also the scar tissue that the plug creates as well.
3. Forehead lift – This is the most intrusive procedure but it is also the most effective if the patient presents with a high number of plugs and the plan is for removal of as many plugs as possible. A forehead lift involves the removal of the entire hairline in one linear excision, similar to the removal of a donor strip during FUSS. The procedure removes all of the offending plug grafts in the frontal hairline. Once healed, the resulting scar is usually not only very thin but also fairly faint. The idea is that once healed a new hairline can be constructed that will not only be much more natural in appearance but will also be placed on top of and in front of the forehead lift scar.