suggestions needed

[worldruler]

hello

i have had two transplants. one about 20 years ago in pittsburgh by nuhart hair clinic that left me with plugs on front part of my scalp. i had another in 2001from a clinic in clearwater fl. that i dont believe did much to improve the look of my plugs. as my hairline recedes the plugs are becoming harder to hide. i have had two consultations. one doctor wants to core out the plugs and put in 2000 grafts the other wants to pack the area with 2000 grafts to camaflauge the area. both are coalition doctors. I wondered if anyone has any suggestions which would be the best way to go.

[mattj]

Both suggestions could be good ones; it depends on just how bad those plugs are. If the plugs remain and are hidden by the new grafts then they will provide added density to the final result. Both surgeons are recommending the same number of grafts so it's likely that if the plugs remain you'll end up with a thicker result overall.

 

Of course not having seen your plugs I don't know how bad they look. Some are far worse than others depending on the size of them and how well they were planted.

[NEWHAIRPLEASE]

Like Mattj said, both are good suggestions....It may be a case of excising some of the larger grafts and leaving some...

[Dr. Glenn Charles]

Sometimes partially removing the prior larger plug grafts works well when surrounding the remaining part of the grafts with smaller follicular unit grafts.

[Cam Simmons MD ABHRS]

Either approach can work in the right situation.

 

For example, if you have dark, coarse hair, light skin and big compressed plugs with 18 - 30 hairs per plug, it would be very difficult to camouflage the plugs with small grafts alone. In that case, you would need to debulk the old plugs and transplant more grafts. There are different techniques to reduce and recycle old plugs too.

 

If you have finer, lighter coloured hair and the plugs aren't too big you may be able to just fill in.

 

One more caveat: If you have already had 2 older method surgeries in the same area, the scarring may limit how densely the new grafts should be placed. Dense-packing into scarred skin can lead to poor growth.

[Cam Simmons MD ABHRS]

Here is an example, where we transplanted in front of and between punch grafts without reducing them. We could do this because he had grey hair and his old grafts weren't compressed:

 

http://www.hairrestorationnetwork.com/eve/165228-dr-cam-simmons-%96-hairline-restoration-man-old-plugs-depleted-donor-hair.html#post2299480

[Cam Simmons MD ABHRS]

Here is a patient were we needed to reduce his old grafts:

 

http://www.hairrestorationnetwork.com/eve/162633-dr-cam-simmons-%96-1-session-repair-scalp-reduction-hairline-flap-punch-grafts.html

[NEWHAIRPLEASE]

Here is a patient were we needed to reduce his old grafts:

 

http://www.hairrestorationnetwork.com/eve/162633-dr-cam-simmons-%96-1-session-repair-scalp-reduction-hairline-flap-punch-grafts.html

 

Man that is a great improvement Dr Simmons!!

[MIKIEB]

Hello i had mini graft 10 years ago,i research this alot. I think the best way is i go in-between to soften the appearance .i did try it with bernstein .its did help but i was not happy at all with bernstein. I just had a ht with dr dorin and he agrees that next ht we will go in-between the mini to soften up ht minis ..good luck