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This patient is a 57-year-old gentleman who came to me after a failed hair transplant elsewhere in the Northwest. He stated that 2 years prior to my initial evaluation, he had a transplant, which did not achieve the desired result. In fact, he had problems with an infection throughout his scalp and an area in the left mid-scalp turned black. It took almost a year to fill in with scar, which is shown on the close up.


On initial evaluation, he had many 4-mm areas of “white scars” which represented plugs that failed and had no hairs. There was an area in the left mid-scalp which was white and thin where the skin died (necrosis), and a white scar eventually replaced it. There were several areas of plugs that were very unnatural appearing. (See photograph with diagrams). The donor scar was wide and unsightly.


We were able to perform 2 procedures on this patient with a total of 3570 grafts, with repair of the donor scar. Our goal was to repair the prior transplant by placing grafts where he lacked them, and thicken the entire scalp region with new transplants. We also wanted to make it look natural. I was not sure if the grafts would grow in the prior necrotic area, so these were placed very conservatively in that area to make sure there was adequate blood supply.


The postoperative photographs are 3 year after the procedures. The entire scalp has been filled in and he has a very natural appearance to the hairline and scalp.









Steven Gabel, MD, FACS, FISHRS

Diplomate, American Board of Hair Restoration Surgery

Diplomate, American Board of Facial Plastic and Reconstructive Surgery

Diplomate, American College of Surgeons


Gabel Hair Restoration Center

Portland, Oregon


Email Dr. Gabel directly at drgabel@gabelcenter.com

Dr. Gabel's Website


Dr. Steven Gabel is a member of the Coalition of Independent Hair Restoration Physicians.

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Dr. Gabel,


This would be an impressive result on a virgin scalp and is even more impressive given the it is a repair. I'm sure you have exceeded this patient's expectations. He must be very happy.

David - Forum Co-Moderator and Editorial Assistant


I am not a medical professional. All opinions are my own and my advice should not constitute as medical advice.


View my Hair Loss Website

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