Optimal Repair

[NervousNelly]

After coming across a few different repair cases lately, I was wondering why sometimes the doc elects to conceal with grafts in front of old work and other times by placing grafts in behind. Is it a case by case scenario? I am assuming that it is, and in cases where the hairline is high enough and there is plenty of donor they would almost always elect to place both in front and behind. Am I corrent in my assumption?

[NervousNelly]

After coming across a few different repair cases lately, I was wondering why sometimes the doc elects to conceal with grafts in front of old work and other times by placing grafts in behind. Is it a case by case scenario? I am assuming that it is, and in cases where the hairline is high enough and there is plenty of donor they would almost always elect to place both in front and behind. Am I corrent in my assumption?

[flyby]

Hi NN,

 

Not sure about other cases but in my case I think the dr. felt that we could achieve a soft/natural hairline by transplanting additional grafts into the existing hairline and I really didn't want to lower my hairline unless needed. There's tons of 1's there blendid in that you can't see cuz of the shitty resolution in my pics. I guess only time will tell but I'm expecting to see some nice natural results. If not then I've got tons of donor to go back and do some work on the hairline. My front 1/3 has about 1000 grafts from bosly blendid in with native hair.

[wylie]

flyby, I'm following your progress and have an appt. with Dr. Alexander in January.

 

As far as the question, definitely a case by case basis. My best hope in repairing my previous work is that I wished to keep my original receding hairline, I shudder to think what I'd look like right now had I have gone with a low hairline. As it stands, its easy to conceal the work at the hairline, but it needs grafts behind the hairline to fill in and I may not have the donor available.

 

Most surgeons likely want to do both types of graft placement (inside and outside the hairline) but are limited with resources in repair work

[omy]

I feel it is on a case by case basis . Sometimes a case will imply that density will always equate to naturalness , other times we see a nice soft hairline and it looks un-detectable .Repairs should never be a one way only procedure .

This is where the artistry of the procedure coupled with a skilled team is evident .

 

Doctors and patients must make sure they are communicating well in order to achieve a mutually acceptable result .

[TheHairLossCure]

If you can place several rows of single hair units in front of old work I think that is the best way to go. In some cases the hairline is already build too low and there is risk in lowering it further (or there is just a limited donor supply). Another option that has not been mentioned is partially removing the front row and rebuilding it with follicular units.

[TheHairLossCure]

Nervous,

 

I noticed, in your signature, that you got some work in '89. Did you do some camouflage/repair work in your recent surgery (if you don't mind me asking)? I am sure you posted about that, but I must have missed it.

[NervousNelly]

TheHairlosscure,

 

Yes, I had a procedure when I was 22. I have to commend the surgeon even though it was old school work. Thank God he went high enough in the hairline and used strip as opposed to punch. I was fortunate enough to maintain some native hair for many years so I believe (unless people are too kind ) that it was essentially undetectable. However, it was definitely starting to become visible as I aged and prior to surgery it was in my opinion, quite evident.

 

That has been my sole reason for seeking out this site and why I narrowed things down to Dr. Ron Shapiro. I have plenty of donor and in my case we were able to place grafts in front to camo the old work. I could have lowered hairline more but chose to just hide and seek out density. I am blessed that it looks like at 4 months things are going to be awesome.

[Bill - Seemiller]

NN,

 

In most cases of camoflauging, I would suspect that adding follicular unit grafts in between and around (including in front of) the old grafts is idea - though HLC is correct. In some cases where the old plugs have been placed too low - it may not make sense to place follicular units in front of.

 

One thing for sure is that there is no "one size fits all hair transplant" which includes hair transplant repair cases.

 

Good topic of discussion!

 

Bill

[nobuzz4me]

I was a lucky repair patient in that my old plugs were not to placed too low. I did however, elect to have them partially removed and thinned some.

 

I think camo works well if the plugs are not too thick and stalky (like a lot are!). Putting a few singles around are sometimes no match for those thick stalks and can still show thru. Like Bill said, its kind of a case by case basis, type of hair, placement of the old hairline, amount of donor you want can commit to that area, etc. are all factors which you need to go over with your doctor.

 

I personaly chose to thin out the plugs some and refine and soften the hairline vs trying to dense pack a lot of fu's in there. Dense packing in the area would hide the plugs but in my case would not leave enough for me to hit the central core and mid scalp harder. That IMO will look more natural than a wall of hair in front and thin behind it.

 

Good topic!