Hair Replacement Surgery : Corrective Hair Transplant Surgery

Additional Topics:

-	Limited role of scalp reductions
-	Use of Propecia/Rogaine
-	Transition from a hairpiece to hair transplants
-	Temple area transplantation
-	Trans-gender Transplantation
-	About Donor Scars

Links

60 Railroad Place Suite 102 Saratoga Springs, NY 12866
Phone: 518-581-1872 Toll Free: 1-800-281-9198
e-mail: saratogahair@spa.net

“Corrective” Hair Transplant Surgery

From 1960-1990 all hair transplantation was performed using large 4mm diameter "hair plugs", which seemed great at the time and the "best we could do" for that time, but which today look very unnatural when compared with the natural results we are now able to obtain with follicular units used as 1-3 hair grafts and in pairs.

Approximately 15% of the procedures we perform in our practice involve the repair of persons who had their original hair transplant work done during those years and are now seeking to have this converted into a "softer", more natural look.

There is virtually no one who has had past work who cannot in some way be made to look much better with these corrective techniques. I will describe some of these new methods and show some patients’ results. These techniques enable the surgeon to bring about this conversion from harsh and "pluggy" and make it soft and natural.

In the majority of these formerly transplanted patients the big problem is the appearance of a “wall” of dense plugs either right at the hairline itself or just behind it, but still very detectable as being unnatural. I believe that in these patients the correction is best done using a two-prong attack.

First, by placing many hundreds of follicular unit grafts in front, using only 1-hair grafts at the very front, and then quickly going to 2-hair FU’s just behind the 1-hair ones.

Second, by using the "Lucas Technique," which is a method proposed by the late Dr. Manfred Lucas of Germany, in which 3-6 hairs are "slivered off" from a large graft, thus resulting in a smaller graft that doesn’t look so "pluggy." These hairs that are removed from the larger graft are then cut into micrografts or are moved as an intact minigraft to another space where needed. Thus, in summary, my approach is to both “break down” part of the “wall” and to soften the area in front of it at the same time. The following photos show how this was accomplished in a 39 y/o male who came to us, who had no more available donor hair to use:

(to see enlarged view of transplant patients click the desired photo)

Note "wall" of hair
at front hairline.

Small needle holes are made in front for FU's and small "cut-outs" can be seen which help break down the "wall".

After 3 corrective sessions

For additional examples of successful transplants on women visit our
Corrective Photo Gallery I and Corrective Photo Gallery II.

Sometimes these old large grafts are in places such as the "crown" or the front-temple recession, where they look terribly unnatural, without enough donor hair available to fill in the spaces of bald skin that remain. In such cases, it is often wisest to just totally remove them and use that hair to make smaller grafts, which are then placed within the front half of the scalp. In these patients, we often have to actually create a natural looking bald crown, and, at the same time, a full, but natural, head of hair on top. These restoration projects usually take two or three sessions to completely finish. If one is too aggressive and tries to do too much all at once, not respecting the limits of the scalp’s blood supply, then whatever is done will not grow fully. For this reason, it is often wiser to take two or three smaller procedures to accomplish the restoration project, so that adequate blood supply exists for all the newly planted hairs to grow. Two examples of correcting “pluggy” crowns can be seen below: The first patient is the same one as pictured in the correction of the frontal hairline above.

(to see enlarged view of transplant patients click the desired photo)
before corrective surgery	after 3 corrective procedures

This second patient had large plugs placed to fill what was then a much smaller bald crown area. However, 15 years later it is quite disfiguring:

(to see enlarged view of transplant patients click the desired photo)
before surgery	after 2 corrective procedures
frontal view of same patient before corrective surgery	after 2 corrective procedures

For additional examples of successful transplants on women visit our
Corrective Photo Gallery I and Corrective Photo Gallery II.

With the recent swing by some clinics to using 1-2 hair grafts exclusively to perform transplants, we are now seeing patients who come in complaining that their transplant result is "too thin" rather than too pluggy. In these cases, we carefully insert very small "slit minigrafts" of 4-5 hairs each into the tiny remaining spaces centrally and, at the same time, additional FU’s within the proper border FU zones, in order to increase the density of the scalp’s hair, such that the skin of the scalp cannot be seen. The following photos show such a patient who had 2 “all-FU” megasessions for a total of 3000 grafts elsewhere, and the results obtained by us with additional FU’s having been placed at the borders and small “slit-minigrafts” (double and triple-FU combination grafts) in the more central area:

(to see enlarged view of transplant patients click the desired photo)
before surgery	after surgery
before surgery	after surgery

For additional examples of corrective transplant examples
visit our Corrective Photo Gallery I, Corrective Photo Gallery II or Corrective Photo Gallery III.