Remove transplants

[Approach]

"In theory" can a doctor remove all transplanted hair on top of head without creating crazy devits, uneven skin etc?   Can he sort of smooth-out the skin after removing the transplanted hair?  For ex, if I shaved my head, would my head look like a ton of tiny holes? A battlefield.  The Hair on top of head is all transplanted.

[Berba11]

This is basically a duplicate of your other thread. But yes, in a word, you can have grafts punched back out and if it's done well, it will heal very nicely (usually with very little to no visible scarring). But for such a good outcome, you do need to select a top repair specialist. It will often take at least two surgeries because you cannot extract everything in one go without causing excess trauma. Normally this is done when someone wants their hairline fixed or taken up a bit, so the extracted grafts will be placed further back and cases range anywhere between having a couple hundred grafts removed and in one case I'm thinking of, 1,300 grafts.

Your case would be a bit different as there's questions as to where you'd put all of those grafts (some into your FUT, obviously), and different parts of the scalp heal differently. The back tends to scar more easily (hence most FUE patients have quite visible dot scarring when their hair is buzzed very short). Extractions from the frontal hairline area tend to heal much, much better and often won't leave visible scarring (again, if the work is really good). As for the very top of the head... I honestly don't know (I've never such a case). It seems a little risky to me and I think you'd be better just addressing your FUT scar and rocking a buzz cut.

[baddecisions]

Yes

Dr. Lorenzo: you can search two videos on youtube "Scar and donor repair with recipient extraction to recover a normal Male Baldness Pattern1454/2015" and "1645FUE Grafts.Scar & donor repair w/ recipient extraction to recover a normal MPB pattern1454/2015"

Dr. Epstein: one video on youtube "Immediately after FUE removal of 1500 prior placed hair grafts"

Dr. Ball: on a different forum and I am aware I am not allowed to share the link, the patient himself is sharing his experience.

In this forum there are many cases involving punching out different number of grafts and on this, other forums and youtube many cases of donor repair can be found as well. 

I am sure you can find even more.

 

"

[Approach]

1 hour ago, Berba11 said:

This is basically a duplicate of your other thread. But yes, in a word, you can have grafts punched back out and if it's done well, it will heal very nicely (usually with very little to no visible scarring). But for such a good outcome, you do need to select a top repair specialist. It will often take at least two surgeries because you cannot extract everything in one go without causing excess trauma. Normally this is done when someone wants their hairline fixed or taken up a bit, so the extracted grafts will be placed further back and cases range anywhere between having a couple hundred grafts removed and in one case I'm thinking of, 1,300 grafts.

Your case would be a bit different as there's questions as to where you'd put all of those grafts (some into your FUT, obviously), and different parts of the scalp heal differently. The back tends to scar more easily (hence most FUE patients have quite visible dot scarring when their hair is buzzed very short). Extractions from the frontal hairline area tend to heal much, much better and often won't leave visible scarring (again, if the work is really good). As for the very top of the head... I honestly don't know (I've never such a case). It seems a little risky to me and I think you'd be better just addressing your FUT scar and rocking a buzz cut.

Your response was very, very helpful.  My posts are a bit confusing.  1) Specifically:  I would like to fill in the FUT scars and rock a buzz cut.  However, I have some pitting, and uneven scap tissue, it feels like.  Ie, if I buzz my head, will every little imperfection show-- or just mild imperfections? (Pls assume I will use a great doctor including repairs.)  Also, 2) Keeping in mind I wish to Buzz my hair (not shave), Do you recommend the following:   First fill in as much of my scalp as possible with my remaining donor and as much beard hair as possible?  I realize beard hair has different texture.  In this scenario, cutting my hair extremely short may make it much harder to detect beard vs scalp hair.  

[Berba11]

2 hours ago, Approach said:

Your response was very, very helpful.  My posts are a bit confusing.  1) Specifically:  I would like to fill in the FUT scars and rock a buzz cut.  However, I have some pitting, and uneven scap tissue, it feels like.  Ie, if I buzz my head, will every little imperfection show-- or just mild imperfections? (Pls assume I will use a great doctor including repairs.)  Also, 2) Keeping in mind I wish to Buzz my hair (not shave), Do you recommend the following:   First fill in as much of my scalp as possible with my remaining donor and as much beard hair as possible?  I realize beard hair has different texture.  In this scenario, cutting my hair extremely short may make it much harder to detect beard vs scalp hair.  

Ok so that's useful in so far as clarifying what you'd like to achieve.

1. Pitting, uneven tissue etc... Will this be visible with a buzz cut? Depends how bad it is, and how much buzzed hair you have to hide the scalp. In most cases, you're probably fine. If you have any particularly offensive cobblestoning, pitting etc, usually this can be remedied by punching some of those grafts out and it will smooth things over, but this may not be necessary in your case. We're our own worst critics remember, so what seems obvious to you probably isn't to others.

2. Attempting to achieve a credible buzz cut look across your areas of hair loss might be tricky in your case; you have a lot of scalp to cover and not a lot of donor (do you have any photos with your beard grown out to a decent length that adequately conveys how dense/thick it is?) to utilise. Of course, if the intention is to keep it tight and trim, you can throw the kitchen sink at it (scalp, beard, chest, armpit, pubic hair!), but you still need to be aware that you won't get anywhere close to a dense buzz cut, and you might not be able to cover the entire scalp. If you went down that route, you're going to likely need to compromise somewhere, meaning you may only be able to address the frontal third and get that looking decent. The challenge then is making sure that the areas that aren't covered still look like a natural balding pattern. You don't want a dense patch in the frontal third and then literally nothing behind it.

What you really need to do is get some in person assessments where possible from top surgeons who can do a thorough assessment of your donor resources. I think you might struggle to get enough coverage even if the plan is to buzz it down, but I'm only guessing based on the donor pictures you've provided. If I were you, I'd start with the FUT scars only. Get them filled in and then buzz down what you have and see how you feel. If you're happy with how the FUT scars look, then you could see about throwing the kitchen sink at the recipient area. In that scenario, the worst case outcome is that your FUT scars look better and your recipient stays the same as now (your bank balance will thank you, too). What you probably don't want to do is go all in and be left disappointed.

[Approach]

3 hours ago, Berba11 said:

Ok so that's useful in so far as clarifying what you'd like to achieve.

1. Pitting, uneven tissue etc... Will this be visible with a buzz cut? Depends how bad it is, and how much buzzed hair you have to hide the scalp. In most cases, you're probably fine. If you have any particularly offensive cobblestoning, pitting etc, usually this can be remedied by punching some of those grafts out and it will smooth things over, but this may not be necessary in your case. We're our own worst critics remember, so what seems obvious to you probably isn't to others.

2. Attempting to achieve a credible buzz cut look across your areas of hair loss might be tricky in your case; you have a lot of scalp to cover and not a lot of donor (do you have any photos with your beard grown out to a decent length that adequately conveys how dense/thick it is?) to utilise. Of course, if the intention is to keep it tight and trim, you can throw the kitchen sink at it (scalp, beard, chest, armpit, pubic hair!), but you still need to be aware that you won't get anywhere close to a dense buzz cut, and you might not be able to cover the entire scalp. If you went down that route, you're going to likely need to compromise somewhere, meaning you may only be able to address the frontal third and get that looking decent. The challenge then is making sure that the areas that aren't covered still look like a natural balding pattern. You don't want a dense patch in the frontal third and then literally nothing behind it.

What you really need to do is get some in person assessments where possible from top surgeons who can do a thorough assessment of your donor resources. I think you might struggle to get enough coverage even if the plan is to buzz it down, but I'm only guessing based on the donor pictures you've provided. If I were you, I'd start with the FUT scars only. Get them filled in and then buzz down what you have and see how you feel. If you're happy with how the FUT scars look, then you could see about throwing the kitchen sink at the recipient area. In that scenario, the worst case outcome is that your FUT scars look better and your recipient stays the same as now (your bank balance will thank you, too). What you probably don't want to do is go all in and be left disappointed.

Hey thanks.  I'm happy you understand what I'm thinking.  Fyi, I met with Jerry Cooley, MD recently.  His advice is:  Don't aim for a full head of hair.  Unlike other doctors, he said he is good at creating 'illusions' of a fuller head-- for Nowood 7 kind of guys like me. He suggested he use up my remaining donor hair and place it toward frontal region / hairline.  He will do as many tricks as he can with the angles of hair, etc for illusion.  Then, consider a 2nd surgery using beard hair for the crown.  *The aim though is Not full thickness on the crown.   It seems like a realistic plan.  I keep getting confused though--- how are some doctors able to do megasessions on Norwood 7 guys like me?  Dr. Cooley never suggested it.  Ultimately, I will go with a conservative approach than to experiment with 10k body hairs.  Are you a fan of megasessions on Norwood 7 guys like me?  Assume the best doctor and best body hair, etc characteristics.  "If" someone like Cooley believed in megasessions, then it seems to me he would do them.  There are plenty of Americans willing to pay him any amount.  This is what makes me scared of megasessions.  Fyi, I have thick beard and tons of body hair.