Best Doc for old plug repair

[rodfl]

I am hoping to get some response on the best Doc to remove old plugs in the hairline and replace them forming a new hairline---I am currently have an appt with Dr Hasson in a few weeks--but am also hearing good things about Dr.Feller,Burnstein,Shapiro,Cole---any help would be appreciated and personal experiences even better : )

[rodfl]

I am hoping to get some response on the best Doc to remove old plugs in the hairline and replace them forming a new hairline---I am currently have an appt with Dr Hasson in a few weeks--but am also hearing good things about Dr.Feller,Burnstein,Shapiro,Cole---any help would be appreciated and personal experiences even better : )

[stumper]

There all good were are you from?

[rodfl]

I am from virginia----have u had the same experience?

[tisab]

I read somewhere on this forum where feller did repair work on a person who flew in from UK.

 

this was done several months ago so u wont see the full results.

 

what i suggest you can do is use the find feature and hopefully get some hits

[nobuzz4me]

Rodfl,

 

I just had a recent repair HT with Dr. Vogel in Baltimore. Feel free to pm me or check out my photos under my name in photo albums. You may want to check his website, it has extensive repair patients photos.

[stumper]

Yes I have in a way I got 1200 mini micros and it looked bad.I flew from NY to Dr Shapiros in Minn.and he fixed me up.Im now six months post op and it looks great,and I still have six months of growth.good luck.

.

[stumper]

Ohh and Id like to add I seen Dr Feller and I liked what he said but he was not on the colition at the time so I went else were.If I were to go again I would go there the guy is damn good and cheap.

[TheHairLossCure]

There are many ways to contend with poor graft and plug work. Depending on where the hairline was placed, you can attempt to camouflage the work with follicular unit grafts. You can also remove the grafts (via scalpel or other utensil depending on graft size) and then suture the incisions. A variation on that idea would be to selectively remove natural follicular units within the grafts (via FIT/FUE), thus thinning them and hopefully softening their appearance.

 

It should be interested to hear what the various doctors are recommending for your case. Good luck!

 

By the way, are the grafts you are concerned with the result of open donor harvesting or strip harvesting?

[rodfl]

The graphs are from open harvesting---I met with Dr Hasson this past week and he feels my best bet would be to reomove the strip of plugs along my hairline and suture up and then replant them---then return in 8 months to finish up work on the hairline.

[rodfl]

Rose,

 

I met with your office last year to inquire about a scar that was very low on my head/neck area--during my visit another guy happend to be there concerning the same issue--I was wondering if you guys have had any luck with repairing these difficult scars and if so--what techniques have u used

Thanks,

R

[TheHairLossCure]

rodfl,

 

Dr. Rose has had great success with scar repair and has developed and refined several techniques that can be applied to this very process.

 

The Ledge closure is method where the epidermal edge of the donor incision is trimmed while leaving the growing part of the follicles intact. The wound is then closed with a single layer under minimal tension. The objective is to get the finest possible scar so that the hairs that have been trimmed of epidermis may grow through the scar line to camouflage it. This technique can be an effective method of scar removal and subsequent revision.

 

FIT (Follicular Isolation Technique) is another procedure Dr. Rose has developed over recent years. This surgery, like the Ledge closure, can be effective in scar management and repair. As you probably know, FIT/FUE is a method whereby follicles are harvested from the donor region one by one with a tiny punch or needle. Grafts can be harvested and planted into scars to conceal the tissue.

 

In some repair contexts, the Ledge closure and FIT can be used as complimentary procedures. A strip can be harvested to removed prior scar tissue and then the wound can be closed via the Ledge to create the best strip scar possible. Once healed, any areas of scar that may require additional coverage can be addressed via FIT grafting.

 

There are multiple ways to improve donor scars. The best approach is largely informed by the extent of the scarring as well as the location of the scars within the donor zone.

[Bill - Seemiller]

theHairlossCure,

 

Excellent descriptions.

 

To summarize for those who are familiar with the Tricophytic scar, the Ledge closure technique is a specific variation of the Tricophytic scar.

 

For those that are new, please understand that FIT is, at best, a variation of the FUE technique and is nothing new in itself. The only difference that I have concluded between FUE and FIT is the instrument used to extract the follicles. One is not superior over the other.

 

As a side personal note, I still have a personal problem with clinics using the term FIT since FIT is exactly the same technique as FUE. Notice you will only see me use the term FIT when I'm responding to someone who uses it first

 

Bill

[TheHairLossCure]

That is correct - FIT is NOT a new procedure.

 

There is a reason Dr. Rose refers to his strip-free donor harvesting method as FIT. And it is not to imply superiority over another method or clinic.

 

Dr. Woods was the Aussie physician who opened people's eyes to possibility of strip-free donor harvesting (years ago). The results were met with skepticism though, since Woods was so secretive about his work. Wood's procedure was not called FUE. I believe it was initially marketed as the "TOP-UP Procedure," then later referred to as the "Woods Technique."

 

Later, Dr. Rassman published a paper where he described his version strip-free harvesting as FUE, or Follicular Unit Extraction.

 

Dr. Rose was one of the first physicians in North America to really examine the possibility of the strip-free harvest. He called the procedure FIT, or Follicular Isolation Technique. Since this was back in 2002, there wasn't a generic name for strip-free harvesting. Apparently, over time, the term "FUE" emerged as the generic and over-arching name. I do not think there is any particular reason for that.

 

I assure you Dr. Rose was not trying to reinvent the wheel only to call the something else. At the time, the procedure really did not have a widely accepted name. I personally feel that Follicular Isolation is a better description of the method. Ultimately, it is name we have lived with for a long time.

 

Hope that clarifies the history a bit. There really is no pretense in the naming. But for the sake of clarity, I will try to refer to the procedure as FIT/FUE.

[PLEASE GROW PLEASE]

Dr Ron Shapiro removed 15 minigraft from my hairline and redistributed them,with no sign they were ever there. You cant wrong with any of those docs ,but I would contact Dr Shapiros office

[rodfl]

What technique did he use?? Did he do the browl lift incision technique--or did he just reomove the plugs and replant them?

 

R

[Bill - Seemiller]

TheHairLossCure,

 

Thanks for giving more insight into the FUE/FIT naming issue. I agree that it really doesn't matter which one refers to it as...as long as it's referenced similarly. Whereas I know Dr. Rose and some other reputable doctors intention is not to use any term as a marketing tactic...unfortunately, there are some out there that do. I have witnessed discussions (though not in this community) where FIT was promoted as a superior technique to FUE, yet the very same people arguing such points could not (or would not) state the difference between the techniques, at least, not very convincingly.

 

I think it is safe and appropriate to refer to FIT with your definition. I just have strong reservations about that term because of many discussions I've witnessed where "FIT" seemed to be a way to market something "new", even though it has already existed for some time.

 

Bill

[PLEASE GROW PLEASE]

He just punched them out

[TheHairLossCure]

Rodfl,

 

If you have a hyper-dense row (or rows) of plugs in the front line, a brow lift can be a fairly efficient option. With this approach you can remove a lot of bad grafts as well as scar tissue in a single long and narrow strip. You will be trading your old grafts for a linear scar though so, yes, a follow-up session will be needed to cover over the scar and build a nice, natural hairline. Individual graft removal might be an option too.

 

Please Grow,

 

Did you find that your old grafts were widely and irregularly spaced? If so, it would make sense that the grafts were removed one by one. Glad your repair experience was positive.

 

Bill,

 

Your observations are largely on point.

[PLEASE GROW PLEASE]

YES, THEY WERE MIXED IN WITH ONES AND TWOS ALL THROUGHOUT.

[the B spot]

I am against brow lifts, due to the uncertainty surrounding their immediate and long term effectiveness.

 

In addition, the margin for error in the immediate hairline is nil, not to mention if excessive scarring occurs, transplanting into the scar tissue may not completely disguise the problem as well.

 

While it may be applicable as a last resort for some, removing old plugs or disguising them seems to be the best option.

 

Of course, it is up to the patient, but just trying to give another perspective here.

 

Take Care,

J