Should I Remove Old Plugs Or Work Around Them ?

[Torn]

I'm considering whether or not to remove my plugs or work around them. What are some of the pros and cons of each procedure ?

 

If I decide to remove them what would be the best way to go about it ? Should the plug be removed as a whole unit, or would FUE be the better approach ?

 

What are some of the better documented cases here good and bad of both approaches to these procedures ?

 

I have a limited amount of donor left btw, of approx 1600 or so I'm told.

 

 

Torn

[Al - Moderator]

It depends on a lot of things.

How large are the plugs and how much hair is growing from each one? Large plugs with lots of thick hair growing out of them are best removed or some hairs FUEed out and placed elsewhere. Thinner or smaller plugs may be better camouflaged with additional grafts placed around them.

 

How much area do the plugs cover and how much more area are you trying to cover. You say you don't have much donor left, so this will matter.

 

Are the plugs placed an an area or a way that they need to be moved? For example is the hairline too low and need to be raised? If so, then just remove the entire plug and they will cut them into multiple grafts and place them where needed.

 

Pictures would give a better idea of your situation.

 

I had many plug type grafts done years ago, ranging from 2.5mm to 3.75mm in size, but they have thinned out some and there are a lot of them all over, so for me I feel it's better to just fill in around them to get a more full appearance.

[Blake Bloxham]

Torn,

 

I think happy's advice is spot on. Can you share some images of the plug grafts? We could probably offer more helpful advice if we could see the actual grafts. Look forward to your reply!

[Torn]

The plugs are not that large, the amount of hair varies though. Certainly not as thick as they were. Hopefully the photos should help in judging both size and density.

 

The plugs are scattered throughout but mostly concentrated in the top frontal area. Given what I have I'd like to cover the frontal third region (not sure of the proper term) it is approx 7 sq inches or 45 sq cm. Running from the hairline to about two inches back. That should hopefully help conceal the see-thru look. I would love to go 3 inches back from the hairline (approx 10 sq inches or 64 sq cm) but I don't believe I have enough donor to give it the proper density. As I was told I only have about 1600 donor left. This is not counting FUE though if that would be possible after all 'strip donor' is exhausted.

 

Surprisingly, I think the placement is not that bad. The hairline is a high, but not necessarily a problem. I'd love to lower it but don't believe I have the donor to do so. Wish I could but I have to be realistic.

 

I wear my hair Caesar style which helps conceal the high hairline. Id love to lower it as I said but that would just eat up more hair that I can't spare.

 

My situation sounds somewhat similar to yours BeHappy in that my plugs have thinned out somewhat and are placed all over. With lose of native hair over the years I now have an overall thin see-thru look that I hope to correct if at all possible.

 

Torn

[wylie]

You shouldn't remove anything, but you need to soften that hairline a bit.

 

Another thing: You shouldn't get a strip for 1600 grafts, in my opinion, you shouldn't get a strip at all, you are only adding another scar. You can also likely harvest more grafts with a competent, experienced FUE doctor.

 

You might also consider using some beard hair as a filler in lieu of scalp donor. Your precious scalp donor is likely going to be wasted if you use it behind the hairline. It should be preserved for hairline.

 

You might be able to harvest more than 1600 grafts, but rethink getting another strip scar. I was tapped out completely for scalp donor thru strip surgery, but FUE from the back and sides yielded me 1500 grafts, all of them used at the hairline.

[1978matt]

I think you may have posted a couple of months ago and I may have responded the same.

 

If your hairline is high then I don't see why any grafts need to be removed. Just work in between existing hairs in the frontal 1.5cm with those 1600 grafts FUT or use FUE to increase density.

 

The only really pluggy looking area is that linear row of grafts at the front. You could get a 'mini' widows peak in front of that to disguise it. It just depends how that would fit in with your facial features but it should be an improvement.

Edited April 11, 2015 by 1978matt
picture added

[Spanker]

I think you may have posted a couple of months ago and I may have responded the same.

 

If your hairline is high then I don't see why any grafts need to be removed. Just work in between existing hairs in the frontal 1.5cm with those 1600 grafts FUT or use FUE to increase density.

 

The only really pluggy looking area is that linear row of grafts at the front. You could get a 'mini' widows peak in front of that to disguise it. It just depends how that would fit in with your facial features but it should be an improvement.

 

I agree with this. Strip out in the area above then fue better density in the frontal third. If your plugs thinned out then it's likely your donor is thinning too.

[gillenator]

Torn,

 

Your situation looks like it has a lot of potential because most plugs are in much worse shape than yours. And it also looks like you healed very well with very little scarring.

 

IMHO, there is enough space between the hair shafts to thin them out with FUE extractions however you want to make sure that the FUE surgeon of your choice is very experience with this type of repair. Magnification (Loupe) will enable the surgeon to minimize transection and the grafts should be singles and then placed between the others. IMHO, excising them out (cutting) can potentially show too much scarring when those large grafts can be thinned out by extraction methods.

 

The work that you had done looks more like larger than normal mini-grafts verses plugs (open donor) and the commencement of your hairline should all be single hairs, not the doubles and triples, etc. That will make a huge impact in producing a more natural and aesthetically appealing hairline.

 

It also appears that you have some stragglers, single hairs that are below your hair line. They look miss-angled and can be removed as well.

 

Lastly, you can always have some fresh FUE single hair grafts taken from softer area donor areas which will also soften the commencement of your hairline and will make a huge visual difference. "Don't use beard hair on your hairline!" Beard hair is usually much coarser and can also grow out with a wave or even curl and you would have a much larger problem than you have right now. You don't want hair that is visually much coarser mixed into your hairline when you are trying to soften the look.

[Torn]

Thanks for all the comments and advice guys. There's a lot of insightful information here.

 

Torn

[Raiden76]

My procedure involved planting in between old grafts and fueing the loners in the front of hairline or where the hairline once was. Your results should turn out great.

[GreatPelo]

You don't have a terrible pluggy look. Frontal hairline can be softened with fine one hair grafts and then give you density behind hairline. Also, someone above mentioned you should do FUE because the strip will give you another scar??? Wrong! You already have a linear scar. An experienced hair surgeon will take the new strip above or under the current one, remove the old scar...and leave only one scar. I also don't believe you only have 1600 grafts left as donor. Maybe you can only harvest 1600 on your next surgery...but you do seem to have more for the future if needed.

 

Best of luck!

[Torn]

My procedure involved planting in between old grafts and fueing the loners in the front of hairline or where the hairline once was. Your results should turn out great.

 

 

Raiden, did you have any problems with scaring when you fued out the hairs left over from your original hairline ? I have the same situation but would be concerned about scaring considering they are in front of the hairline and very visible. Would you have any photos you could share ?

[GreatPelo]

If you're scared of scarring, you can always look into lasering them so you kill the follicle but don't leave scars behind. Just another option...

[hairthere]

Torn, I had lots more multis in my hairline from my first hack job of a surgeon. They are no longer visible because Dr. Feller just planted singles in front and around them. As has already been suggested, I'd leave as is.

 

1978Matt, nice hairline design!

[Torn]

GreatPelo, I'll probably just leave them be. I was curious though as to if there was any scaring since it was done in front of the hairline. Though Raiden76 seems very happy with his results. I'm glad things went well for him !

 

Hairthere, Yes most likely I'll also be planting singles in front and around the plugs as well. I was just referring to the single native hairs in front of my plugs (circled in photo). They are my native hairs that surprisingly never fell out. I believe that is what Raiden76 was referring to when he spoke of fueing out single hairs.

 

I'm glad to see there are successful repair stories out there !

[WHTC-7706631290]

Torn.

 

I might go for a test of plug removal so that you know what to expect. You need an in-person consultation to determine what the ideal treatment should be. Do not get only one consultation at a proven corrective hair transplant clinic. Many doctors can't actually perform repair to the degree that you need. The end result may require a combination of both removal and camouflage and not necessarily in one specific order. Consider the loss of density if you do pursue removal. Remember that you need to decide whether you want a more natural appearance and or possibly having less density should you require a small degree of plug removal.

 

What are your goals for working around them? What are your primary goals? Do you have available donor resources if regrowth becomes a factor in your hair transplant journey?

 

Thanks for sharing your story.