This fellow had a couple of plug cases in the mid to late '80s. He asked if we could help him; and fortunately he had sufficient donor scalp, mostly free of scar on the sides, to allow us to shoot for 1800 grafts. He had done scalp exercises, and was really much more lax than I had expected; and so we got more grafts than our initial goal; and were able to fill in all of his plugged region.

Periop and 1 week pics are shown. He'll followup in a few weeks for a scar check and then at the holidays.

Dr. Lindsey McLean VA

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William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

This was my surgery. Dr. Lindsey and his staff, particularly Wendy and Debbie, from initial consultation and throughout the surgical procedure and followups were professional, friendly, and above all highly skilled in this procedure. There were no surprises and the surgery and post-op went off without a glitch. I am entirely pleased with the outcomes and confident that in the months to come I will be more than pleased with the results and regret that I did not go to Dr. Lindsey sooner. I would not hesitate to recommend Dr. Lindsey and his staff to anyone who is considering hair restoration. Dr. Lindsey's terms of payment were extremely easy and he made himself available to my schedule. I am looking forward to posting more photos in the months to come because I am confident that the results will exceed my expectations. Also, I found it gratifying that Dr. Lindsey would only entertain and perform the surgery that was absolutely necessary to achieve the results that were best for me. If you are thinking about hair restoration surgery or any similar procedure and find yourself considering your options more than once a day then the time for you to visit Dr. Lindsey and his staff is now.

Dr. Lindsey,

Looks 1000X better than it did before for sure. Did you remove the plugs or just addd hair around them. The reason I ask is because it appears the plugs were removed but the hairline still has some 2 and 3 hair grafts.

I was wondering why you didn't have some of the lumpy old plugs taken out?

it does seem that removing some of the more prominent plugs and replanting further back would of give an overall better result

Dr. Lindsey,

Thanks for posting this case. And congratulations to you Patient 1179.

I'll be interested to see how these results turn out. I'm sure it will look much better than it did previously. Is there any particular reason why you didn't want to remove and re-distribute any of the old plugs? Do you think 1800 grafts will be enough to camouflage it?

Thanks for your contributions and input.

Bill

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Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

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To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

I rarely remove old plugs. I am kind of a simple guy who grew up farming in rural Virginia and apply alot of my farm lessons to all facets of life including surgery. Using my Christmas tree farm analogy that I have used in lots of other threads on this site, this guy had a poorly maintained Christmas tree farm on his forehead. It was regular, had lots of areas with no trees (unlike some old plug cases which really don't look too bad except for the regularity and the anterior most hairline itself) and had trees growing at varying angles. But, there were trees growing in that field and given a finite donor area, I'd say plant around the existing trees...thus you have less to plant and can take advantage of preexisting hair to give coverage. So we simply plant lots of single and double trees randomly around the existing trees, particularly at the fence line (hairline). As the hair grows, the regularity of the previous procedure is replaced by randomness which tends not to catch the human eye(great at recognizing patterns of almost anything).

And, why don't we simply excise old plugs and refine into singles and doubles? 2 reasons. First, I do worry about the blood supply to the recipient area getting disrupted and then getting a major reduction in transplant growth. And second, each of those 1cm circles would have to be excised, converted to an elipse(circles don't close tension free--lots of wound tension studies on that) and then a 2 layer closure on each elipse is required.

I'll excise plugs if they are significantly out of the planned new hairline, but otherwise I just leave them.

Dr. Lindsey McLean VA

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William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

Dr Lindsay,
I like the analogy.Your patient is going to be very happy come Spring.

Mick

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Patient coordinator for Drs. Bessam and Nilofer of the Farjo Clinic in England

I agree. He skipped his scar check last week saying things were fine. I'll put up pics the next time he shows, likely New Years.

Dr. Lindsey McLean VA

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William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians