Hairline repair work. Advice needed please!

[leindub]

Is it possible to have grafts from a previous hair transplant in the hairline that are either growing in the wrong direction or are 3's punched out on the same day you plan to have your hair procedure to fill out your hairline? Obviously the excised grafts will be repositioned fufther back but can new donor grafts be placed in the excised area on the same day?

 

Or is it a case were the old grafts are excised from the hairline, the area needs to heal for some days/weeks before proceeding to implant new grafts there?

[gillenator]

First of all, it really depends on the density level of the existing hairline. There needs to be adequate spacing for a new recipient site to be created between the extractions of the former grafts that need to come out. And a new graft cannot be inserted into a fresh extraction site because the extractions are more oval shaped due to the circumference of the punch as compared t a recipient incision which is more of a micro-slit.

 

In addition, once a graft is removed by extraction, there is trauma induced to the surrounding tissue and can in fact reduce the survival rate of any new grafts placed too close to them.

 

Single hair grafts can also be removed by excision and not always by extraction. This creates less trauma and I suppose a new graft can be placed in the same site of the old one being removed. The cleaner the removal and less cutting involved, the less resulting and corresponding trauma.

 

So what your surgeon can initially assess is whether to first remove the unwanted grafts, heal and then come back to add new grafts later "or" add new grafts to the area now and let them grow in. Then come back later to remove the unwanted former grafts that were mis-angled.

 

Most of the time the unwanted grafts are removed first, you heal and come back for new grafting to fill in the missing spaces where the old grafts were removed.

[leindub]

First of all, it really depends on the density level of the existing hairline. There needs to be adequate spacing for a new recipient site to be created between the extractions of the former grafts that need to come out. And a new graft cannot be inserted into a fresh extraction site because the extractions are more oval shaped due to the circumference of the punch as compared t a recipient incision which is more of a micro-slit.

 

In addition, once a graft is removed by extraction, there is trauma induced to the surrounding tissue and can in fact reduce the survival rate of any new grafts placed too close to them.

 

Single hair grafts can also be removed by excision and not always by extraction. This creates less trauma and I suppose a new graft can be placed in the same site of the old one being removed. The cleaner the removal and less cutting involved, the less resulting and corresponding trauma.

 

So what your surgeon can initially assess is whether to first remove the unwanted grafts, heal and then come back to add new grafts later "or" add new grafts to the area now and let them grow in. Then come back later to remove the unwanted former grafts that were mis-angled.

 

Most of the time the unwanted grafts are removed first, you heal and come back for new grafting to fill in the missing spaces where the old grafts were removed.

 

If we call the hairline the area and the old grafts the individual sites within the hairline area. If some of the old grafts are excised, can I take it you can implant new grafts around the sites, but on that day of surgery not in the individual tiny sites created by the extractions? They would need to heal first?

 

I ask this, as currently I seem to be getting conflicting views from different surgeons. I want all my work done on one day and will be travelling abroad. It is my opinion that excised individual sites would need to heal before re-implanting grafts precisely in there but it would be okay to implant around those sites.

Edited October 30, 2015 by leindub

[gillenator]

Allow me to clarify further. Yes, new grafts can potentially be implanted around the extracted sites where the old grafts were removed. But as I stated, the resulting trauma to the area itself can potentially have a negative impact on the yield/regrowth of the new grafts that are being added.

 

This is why many repair docs prefer to see the extraction sites heal first. Because not only do the extraction sites fully heal, the corresponding level of trauma subsides as well.

 

In addition, some docs do not advocate dense packing too tightly because of this same principle. Too many incisions or incisions that are placed in close proximity to one another can reduce the yield level.

 

Removal of old grafts is more traumatizing to the overall recipient area than simply making new recipient sites for the first time as in a normal procedure where removal of old grafts is not involved.

 

So as inconvenient as it may be of having to go back and having the repair involving a two-stage procedure, it's the end result or final result that counts. And the last thing you want is to have the regrowth of the new grafts to be poor or substandard right?

[leindub]

Thanks a million Gillenator. You've explained it concisely, I get it it now. I'm think I'm going to choose to get the new grafts placed in and around the old grafts in the hairline with the option down the road of removing some of the old bad mis-angled grafts in a separate procedure.