Hair Transplant Repair: Reconstructing a bad hair transplant
As has already been discussed, the discipline of surgical hair restoration has high aesthetic significance in the modern cosmetic surgery. Hair transplant repair is thus an important part of reconstructing bad hair transplants.
Apart from hair loss treatment for male and female pattern baldness (androgenic alopecia,) hair restoration surgery can successfully be used for hair transplant repair and reconstructive surgery of the face and scalp.
There could be several reasons for someone to have a bad hair transplant, but the state-of-the-art surgical hair restoration techniques like hair transplant repair try to rectify all types of bad hair transplants by giving them a more natural look.
Plug grafts: Perfect examples of a bad hair transplant
Hair restoration surgery with plug grafts (3-4mm diameter pieces of scalp skin consisting of 12 to 20 hairs each), was the main form of hair transplantation in the 1970s and early 80s. However, the plug grafts often produced aesthetically unpleasing unnatural results. The primary reason for this was that the hair follicles in the center of the graft didn't get enough nutrition because of the poor or no blood flow after transplantation. The follicles died leading to the appearance of a hole in the middle of the grafted hair plug where no hair growth occurred. Moreover, as the baldness progressed in such patients the rear or side margins of the plugs were easily seen by the casual observer.
The cosmetic and aesthetic problems such as the 'plug like look', 'the doll hair look', or the 'tooth brush look' are the perfect examples of bad hair transplants caused by the plug grafts which were considered to be standard grafting method until the year 1980.
The introduction of micro-grafts (one- to two-hair grafts) and mini-grafts (three- to four hair grafts) in 1981 was a major breakthrough in the history of hair restoration surgery.
The modern hair transplant surgery based on micro and mini grafts is now extensively utilized for hair transplant repair , especially for repairing bad hair transplants resulting from plug grafts or any larger grafts consisting of more than 4 hair follicles.
Unnatural Hair Line: Another Category of Bad Hair Transplant
An unnatural hair line in the front, a visible posterior, or "rear" hairline caused by progressive balding around transplanted hair follicles, and the transplanted hair growing in a different direction than normal, are the result of bad hair transplants done by an inexperienced hair transplant surgeon.
The natural hair line is of utmost importance for the look of a person and always has indistinct and variable existence. A truly natural hair line is never an abrupt, extremely dense, or regular look as given to it by some bad hair transplant clinics.
A natural hair line should consist of a very thin line of single hairs to serve as a "transition zone" between the hairless forehead and the hair-covered scalp. The transplanted hair follicles may be distributed slightly unevenly to mimic a natural hair line, but not so unevenly as to look abnormal. Making a hair line look natural requires a surgeon with considerable experience and aesthetic eye. Hair transplantation is not just a surgical procedure, it is also and art form. Unnatural hair lines made by a hair transplant surgeon are nothing but bad hair transplants. An unnatural hair line may be the result of using larger sized grafts or through faulty design of the hair line with no consideration for the direction of the hair growth.
Hair transplant repair in such cases is easily possible through state-of-art hair transplant surgery performed by an experienced hair restoration surgeon. An innovative hair transplant surgeon can place single follicle units or 2-4 haired micro grafts in front of a straight hairline or the bad hair transplants to give it a more natural look and a softer transition from bald forehead to haired scalp. Adding a few single hair transplants in among the previously transplanted follicles is another technique which a hair restoration surgeon generally uses for hair transplant repair of an unnatural hairline.
Hair transplant repair: Camouflaging the Scars of Previous Surgeries
As discussed earlier, there are hair restoration techniques other than the transplantation of hair follicle units which can be used for hair loss restoration.
Scalp flap surgery involves the moving of hair-bearing "flaps" of skin tissue from one area of the scalp to another. Typically, a strip of scalp from the non-bald temple is brought towards the bald frontal hairline. A small area of the flap is always left attached to the parent area in such surgeries in order to preserve the blood supply to the tissue. But at times, the blood circulation to a portion of the flap may be compromised leading to death of the skin and hair follicles in this area (a process called tissue necrosis). The dead part of the hairless skin flap becomes visible as a scar. Sometimes these scars can be quite large if the tissue death is extensive.
Another type of hair restoration surgery known as the scalp reduction surgery effectively reduces balding by cutting out an area of the bald scalp and pulling the hair bearing sides of scalp closer together. Though the surgery gives dramatic results in some people when conducted by a hair restoration surgeon with extensive experience in the technique, in others, when the procedure is conducted by an inexperienced surgeon, it can actually lead to more hair loss and scarring in and around the site of surgical incision. The hair loss is a form of telogen effluvium and sometimes scarring alopecia rather than androgenic hair loss.
In both the above mentioned cases, hair transplant repair of the affected area is a good option to consider. The hair transplant repair of the affected area not only helps in hair loss restoration caused by the effluvium and scarring, the restored hair also helps in camouflaging the scars of previous surgeries.
Advantages of Mini & Micro-Grafts for Hair Transplant Repair
The micro-grafts and mini-grafts used for hair transplant repair have lower metabolic requirements due to their small size. The other significant aspect of hair transplantation repair by these micro-grafts and mini-grafts is that they are able to grow in areas of fibrosis and burn scars and over skin grafts and flaps, including split-thickness skin grafts. The survival rate and the hair growth of these mini and micro grafts used for hair transplant surgery is excellent (85 percent as compared to 95 percent on unscarred, healthy tissue).
The hair transplant repair with mini and micro grafts can often be performed in a single mega-session using 1000-1500 mini and micro grafts. A second small-session may occasionally be required to make for a more aesthetically natural look. The separation of mini and micro-grafts is a tedious process and requires a great deal of patience from both the hair transplant surgeon and his assistants. A good hair restoration surgeon not only has patience and diligence, but also knows that the direction of hair growth is of great importance, when planning and actually performing the surgery. He takes a great care to insert the scalpel and/or needles in the desired direction of hair growth when he makes an incision for implanting the follicles. The finer details of natural hair growth are all the more important while performing a hair transplant repair surgery.
Whether it is the reconstituted eyebrow or a full skin graft on previously melanoma affected skin, a reconstituted cleft lip or hair restoration on burnt skin, all are the ultimate feats performed by the hair transplant surgeon whose hard work and diligence is a great service to human-kind.
1. Alfonso Barrera, M.D. : ‘ The Use of Micrografts and Minigrafts in the Aesthetic Reconstruction of the Face and Scalp’, Plast Reconstr Surg , September 1, 2003.883-890
2. Dominic A. Brandy, MD: ‘The Art of Mixing Follicular Units and Follicular Groupings in Hair Restoration Surgery’, Dermatol Surg, 30:6:June 2004, 846-856