FUE Graft Removal

[Beneke]

Hey everyone,

Looking for general advice.

I got a HT about a year ago when I shouldn't have. I'm in my 20s and have some diffuse thinning, moderate recession. The results aren't terrible, but I am uncomfortable with how low the hairline is and the lack of density. 6 months ago, I started shaving my new hairline back to the old and it boosted my confidence a bit. That did change when I noticed some texture changes in my recipient site (minor cobblestoning). I notice it in certain lighting. I'm currently growing out bangs to cover my forehead. My goal is to make it more ambiguous as to whether I had a HT.

I'm looking for the best path forward. I'm in no rush to spend any more money on my head. That being said, I do want to help the appearance of my skin. Just having a level-headed plan helps my mental health and gives me hope. I will be seeing a dermatologist about this in a few months.

I think the best path forward is to remove all the grafts on otherwise bald parts of my scalp. I am in no way set on this. I want to see if minimally invasive scar removal treatments help first. I'm not even sure if I would bother to have the grafts replanted. I entirely understand this would create scars. These scars may be more concealed and more susceptible to scar revision treatment than the cobblestoning. I can also do a test site first and see how that heals before committing.

A few months ago, I emailed one of the forum recommended surgeons in the US and he said he doesn't raise hairlines due to risk of scarring. I see cases from Dr. Feriduni raising hairlines and would love to have results like that.

Does anyone have an opinion on this? Are there US based doctors with results like Feriduni (to save me the plane tickets)? I haven't seen any. If I go forward with this, this topic could document a legitimate way to help out others in a similar position.

 

I do want to say that the active users on this forum really have helped me by showing I am not alone and there may be things I can do to help. Thank you.

[baldfighter]

Sometimes people feel that their new hairlines are low because they are used to the high forehead. From the photos it's hard to see how low your hairline is. What is the distance from glabella to hairline.

If you are worried about scarring and you don't even care about replanting those hairs then you can consider electrolysis to kill those.

Edited June 15, 2023 by baldfighter

[HappyMan2021]

how many grafts do you want to remove? if you don't think outright killing the grafts will cause any issues down the road, then electrolysis may be your best bet. 

[Beneke]

33 minutes ago, baldfighter said:

Sometimes people feel that their new hairlines are low because they are used to the high forehead. From the photos it's hard to see how low your hairline is. What is the distance from glabella to hairline.

If you are worried about scarring and you don't even care about replanting those hairs then you can consider electrolysis to kill those.

About 3 before HT and greater than 2.5 in now. 

I would definitely do electrolysis but I am bothered by the cobblestoning / scars. I want to try something like RF microneedling before removing the hairs.

[Beneke]

34 minutes ago, HappyMan2021 said:

how many grafts do you want to remove? if you don't think outright killing the grafts will cause any issues down the road, then electrolysis may be your best bet. 

I would say there's about 1000 grafts I'd like removed. The FUE scars may be smaller than my recipient scars I currently have. IDK. I definitely want to be careful with this.

[HappyMan2021]

10 minutes ago, Beneke said:

I would say there's about 1000 grafts I'd like removed. The FUE scars may be smaller than my recipient scars I currently have. IDK. I definitely want to be careful with this.

1000 grafts may require 2 surgeries. 

Good US repair doctors are Shapiro in Minnesota and Cooley in NC. The bad thing though is, for repair patients, you are required to first visit their office in-person for a consult. No excuses. From there, you are then looking at around a 1 yr wait time for surgery. And then keep in mind if you are looking at 2 or more surgeries then this timeline will be extended. 

[A_4_Archan]

Not able to see if the hairline is looking too low or not from this pics...please post proper pics including pre op ,immediate op and 1yr post op pics...one of the reason can be that you are use to see a high hairline and thn the change which can be unacceptable sometimes...so give it sometime and you will get used to this....how many cms from glabella is your hairline ? And if you are too concerned abt this than you can consult dr Shapiro imo...

[Berba11]

18 hours ago, Beneke said:

Hey everyone,

Looking for general advice.

I got a HT about a year ago when I shouldn't have. I'm in my 20s and have some diffuse thinning, moderate recession. The results aren't terrible, but I am uncomfortable with how low the hairline is and the lack of density. 6 months ago, I started shaving my new hairline back to the old and it boosted my confidence a bit. That did change when I noticed some texture changes in my recipient site (minor cobblestoning). I notice it in certain lighting. I'm currently growing out bangs to cover my forehead. My goal is to make it more ambiguous as to whether I had a HT.

I'm looking for the best path forward. I'm in no rush to spend any more money on my head. That being said, I do want to help the appearance of my skin. Just having a level-headed plan helps my mental health and gives me hope. I will be seeing a dermatologist about this in a few months.

I think the best path forward is to remove all the grafts on otherwise bald parts of my scalp. I am in no way set on this. I want to see if minimally invasive scar removal treatments help first. I'm not even sure if I would bother to have the grafts replanted. I entirely understand this would create scars. These scars may be more concealed and more susceptible to scar revision treatment than the cobblestoning. I can also do a test site first and see how that heals before committing.

A few months ago, I emailed one of the forum recommended surgeons in the US and he said he doesn't raise hairlines due to risk of scarring. I see cases from Dr. Feriduni raising hairlines and would love to have results like that.

Does anyone have an opinion on this? Are there US based doctors with results like Feriduni (to save me the plane tickets)? I haven't seen any. If I go forward with this, this topic could document a legitimate way to help out others in a similar position.

 

I do want to say that the active users on this forum really have helped me by showing I am not alone and there may be things I can do to help. Thank you.

That's quite a lot of grafts you want removed, so I'd really recommend not having them zapped to oblivion but to seek out surgeons who can remove these without visible scarring and reuse them. I know you said you're not bothered necessarily about reuse, but that might be something you regret long term. To avoid noticeable scarring you need to use the smallest possible punch and ensure that the extraction sites remain distinct from one another (so as not to turn two separate extractions into one larger one). Usually it might be done over the course or two or three sittings as well so as to not only minimise trauma in the area but to also allow the surgeon to gradually as soft singles into the newly raised hairline.

I think the very best surgeons in the US are a bit more expensive than the best ones in Europe, so you might find that actually the cost of a flight to Belgium (for example), actually doesn't work out more expensive in the long run. Plus you'll get a little holiday!

[HappyMan2021]

18 minutes ago, Berba11 said:

so you might find that actually the cost of a flight to Belgium (for example), actually doesn't work out more expensive in the long run.

the 25% Belgian VAT tax and additional European travel costs levels out the cost between the good American docs and the Belgian docs

Also, since OP is looking for a repair, this unfortunately makes multiple surgeries likely, and so OP would have to factor in paying the VAT tax and burdensome travel costs 2x

[Berba11]

2 hours ago, HappyMan2021 said:

the 25% Belgian VAT tax and additional European travel costs levels out the cost between the good American docs and the Belgian docs

Also, since OP is looking for a repair, this unfortunately makes multiple surgeries likely, and so OP would have to factor in paying the VAT tax and burdensome travel costs 2x

True, but one option would be to have the bulk of the extraction done by someone like  Feriduni, and then the smaller remaining portion in the US to lessen the extra travel costs/VAT considerations. 

[Beneke]

Thanks everyone! I'm very impressed by Feriduni and for something like this, added travel cost and multiple surgeries is definitely worth it. I agree about taking it slow. I'll reach out to Shapiro and Cooley too. I haven't seen their work on raising hairlines yet but I'll keep looking.

Yea, I'm also worried about cobblestoning on any grafts they replant. I'm not saying it would happen and my hair would probably benefit from it short-medium term. I just don't want to make my hole deeper lol

[Al - Moderator]

May I suggest only removing a few hundred in the very front and placing those grafts just behind that. This will give you a slightly higher hairline while also giving you a bit more density in the rest of the transplanted area. You also won't have a large area of scarring, so there is less chance of that being noticeable. You would be getting a little bit of everything you want. Higher hairline, more density, low amount of possible scarring.

 

[BaldReaper]

I would check this post, it has a lot of usefull information.

 

 

Edited June 16, 2023 by BaldV

[Beneke]

@BaldV That's an extremely insightful link, thanks for sharing! It seems Feriduni is unmatched when it comes to reducing scarring from removal.

@BeHappy I don't necessarily think that's a bad idea, especially if I was older. I don't know how long finasteride will preserve my hair and I don't want to rely more on it than I am. The way I see it, I have scars now and I want to reduce them the best I can. I want to explore that approach as much as I can before looking into hiding them. 

 

I may post more informative pics at a future date if I have anything new worth sharing

[Beneke]

I recently talked to a cosmetic dermatologist. He said the following:

- Scar revision techniques likely won't help (due to limitations with scar revision and I'm dealing with skin grafts, which are tougher)

- Graft excision could lead me with worse scars

A forum recommended surgeon that wasn't mentioned here yet said laser hair removal "often" removes the skin texture issues and is a much more conservative approach (I don't know if I should mention his name, so I won't). If I'm not happy with the texture afterwards, I can try scar revision.

So, I've gathered a lot of conflicting information over the last 6 months. Every option I have, (except for doing nothing) has a risk of a permanent, negative result. I am still of the opinion that graft excision is the way to go.

If I get the grafts removed, it may be over a year before the procedure is done. In the meantime, I may try RF microneedling. I know it may not help, but there is testimony on this forum that suggests it could. It is low risk and could save me the procedure all together. I will have a test site done to see how my skin reacts to the microneedling and later FUE punches. If I react well to FUE, I will have them removed over two to four sessions. I know this is a big time/money investment, but if I am careful to minimize risk, I think I will be in a much better place. Both in regard to my head appearance and for my mental health.

I am looking at more repair surgeons that have not yet been mentioned. There's videos/testimonies of Dr. Bisanga from Belgium, Dr. Epstein from Miami, and Dr. Gabel from Oregon as surgeons who remove grafts. Would they be good surgeons to work with?

[braun453]

@Beneke I got unwanted transplanted hair in my beard transplant removed with virtually no scarring (not all of it but most, at Eugenix, India). I'm much more happier with my beard line now but the first clinic transplanted many doubles and triples, I can not grow it out because it looks very weird even with a more natural contour.

I'm shaving it all off everyday and it looks ok to me, but the recipient skin is damaged. I want to reduce the small bumps/cobblestones how much ever I can. My dermatologist suggested to go for LHR to reduce the transplanted hair thickness and CO2 fractional laser or RF microneedling to reduce the bumps by 30-40%. I'm happy with that number and planning to get this done.

Beard transplant was a mistake, thanks Eugenix for repairing whatever they could. I'd say get a patch test done, not everyone scars with the small punches they use to extract bad hair.

 

[Beneke]

Thanks, @braun453! Good luck with your work. I suggest you be careful with LHR. Who knows how it can react with scar tissue. Definitely do a test site if you decide to follow through with it. 

As for an update with me, I'm holding off on booking an appointment for as long as I can. If my hair is long enough, and worn forward, it looks inconspicuous. I'll eventually recede my hairline and follow up with RF microlending if needed. I'm between a rock and a hard place. All I want is to not draw unwanted attention towards myself. I'm there right now. I just want to remain there. I hope that one day, if I bald farther, I can shave my head and not look too odd. 

[KUPNIK]

Hi bro have you tried microneedling, laser or graft removal. If yes how did it go?