Can Old Plug Grafts Be Removed?


Older style techniques for hair transplantation could leave an unnatural pattern of hair growth, commonly known a plug grafts and given derogatory names such as dolls hair and tooth brush look

The look was achieved because too many hairs were placed together in one large slit or recipient site; they could not be placed close enough together and stood out; if within existing hair they could be hidden but in the hair line there was no hiding

Hair Transplant repair Surgery Requires Technical Skills & Ability

Hair Transplant repair Surgery Requires Technical Skills & Ability

As hair loss progresses the pattern of hair growth becomes more extreme and unnatural; this also affects the donor hair supply as the plug method would waste a great deal of hair and leave large scarring in the donor making future hair transplant difficult

There can be a number of solutions to hiding the old plugs; some are dependent on the quality of the donor hair and as with any hair transplant repair priorities need to be made to achieve a successful natural looking resolution

Dependent on the position of the plugs it may be possible to camouflage them; by placing smaller follicular units in front of and around the plugs can soften the look but if the placement of the plugs is too low on a hair line or temporal area this solution will not be suitable

In some cases it may be better to remove the old offending plugs and design a new hair line; although this option may take two procedures to complete it can give a better and more natural solution

Dependent on the size of the plugs there are two options for excising, strip or FUE; either making a micro strip cut around the grafts and then suturing the strip, or using an FUE punch to encompass the graft and then extract with the wound healing over a short period of time

Either extraction method will need to properly heal before hair can be placed in or near the same area; if the plugs are below the new recipient area then restoration can be continued otherwise restoration will need to be continued in a second procedure

When removed it is common that some impairment to the skin will remain, small scarring or ridging to the skin surface; some treatments can reduce the visibility of this and some resurface the skin but can take time to show positive results

The extracted plug grafts are quite strong and durable due to their size and the amount of tissue surrounding them; dependent on how easy they were to extract and the trauma caused some can be saved and still used

The grafts needs to be examined under magnification, cleaned and divided into smaller hair grafts, probably one to three hairs, the damaged, transected hair follicles need to be disregarded as the possibility is they will not regrow when transplanted

Once the plug grafts have been divided and cleaned they can either be used back into the recipient area or in some occasions placed back into the donor area to help conceal any scarring that remains

Hair transplant repairs can be delicate procedures, psychologically as well as technically; the patient will have undergone a great deal of stress and sometimes depression and their trust has often been eroded

Technically full restoration is very unlikely and the goals should be to get back to as natural cosmetic situation as possible; goals and priorities need to be addressed and mutually agreed upon for the best well-being of the patient


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