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I have had 5 hair transplants. All were done by way of the strip method and I am very pleased with the ultimate outcome. However, the linear scar from my 4th surgery is horrible. It is very wide and red. The scars from my prior surgeries and the one subsequent surgery look fine. Because of concerns about elasticity issues, between the 4th and 5th HT I did scalp exercises to improve the donor elasticity which I found on Youtube. My Doctor said that the elasticity between my 4th and 5th surgeries was greatly improved and attributed it to these exercises. With this improvement, I am considering a scar revision with the hopes that the scar from my 4th surgery can turn out like the one from my 5th surgery. Is this realistic?

Lastly, in general would you recommend a plastic surgeon for the scar revision or a hair transplant Doctor? I traveled some distance to have my last hair transplant and don’t plan on making this trip again for a scar revision so I would look for local Doctor to do this procedure.
Thank you for your time

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Scar revisions in the hands of an experienced surgeon that deals with hair transplant scar issues on a regular basis is generally better than a plastic surgeon for this type of work. Experience is everything in this process. I don’t know what is realistic to expect, as each case is unique and I haven’t seen you.

If you want to find a doctor in your area, I’d suggest using the physician search at

Tags: scar revision, hair transplant, scarring


I had my first hair transplant in the mid 1980’s with punch grafts and over the years i have had micro grafts and more recently single grafts taken from strips. the old punch grafts were removed and then re-implanted via single grafts. My hairline looks pretty good but i am now losing a lot of hair on my crown but have very little donor hair left do i have any options?

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Donor hair is finite and many people in your situation have depleted donor supplies with significant donor area scarring. More surgeries will often make the scarring worse. I see people like you all of the time and lately I have been seeing more of them. Everyone is different and an individual assessment based upon remaining donor supply, donor area scarring, the existence of old “plug grafts”, hair color (graying is good), and hair characteristics all must be considered in the equation on what to do.

I could write a book on this, but this is not the place. I would suggest that you find a hair transplant surgeon with a lot of experience in repairs.

Tags: hairloss, hair loss, hair transplant, plugs, repair, donor hair


To many people that aren’t familiar with the advances made in hair restoration, “hair plugs” are still the norm. There’s nothing pluggy looking about today’s hair transplant procedures, but those bulky hair plugs of yesteryear were easy to point out and looked incredibly unnatural. I saw a patient that had an unusual placement of these old plugs and was looking to correct it.

This patient first came in about a year and a half ago with a large bald area and old-style transplant plugs that were placed far too low on the right side of his hairline. I suggested that he fill in the frontal area, and he also wanted additional grafts placed into his balding crown. A total of 1919 grafts were transplanted.

You’ll notice that the achieved result shown below is an uneven, but fuller looking hairline (we were limited to what could be done because of the placement of his old plugs). He recently came in to see me again lower the frontal hairline and I agreed to lower the left side a little to balance it out. I remembered how much he hated the plugs on his right side when we first met, and now we succeeded in managing the plugs with styling and camouflage. While that 2nd procedure hasn’t happened yet to even out the hairline, I’m glad he was so happy with the results thus far from the repair and he’s allowed me to share the photos here.

Before photo on left / After photo on right. Click to enlarge.


Tags: hair plugs, hair transplant repair, hair transplant


This is a Norwood 6 patient who had a hair transplant done at a clinic in Europe in the 1990s with the old pluggy technique. He wanted to shave his head, but the old hair transplant donor scar and the visible plugs were a problem for him.

This patient chose a combination of (1) SMP to camouflage his old scar, and (2) the surgical removal of his old plugs. The hairs that were in the plugs were redistributed into the crown. We also transplanted a few hundred FUE grafts taken from the donor area and used them on the top of the scalp. As he does not live in the United States, he will return at his convenience on another visit for the needed touch ups. He will likely go on to cover his entire head with SMP, may also undergo more FUE grafting into the frontal hairline, which will make it appear even more natural.

At the point I last saw him, the patient was very satisfied with removing his old plugs with FUE and having SMP done into the old scar. He can stop here if he is satisfied with the result, but I anticipate more work to be done. The after photo shows the temporary redness common just after surgery. We will keep you posted when he returns to the US.

The before (left) and after (right) photos show a work in progress. Click photos to enlarge.


Tags: smp, scalp micro-pigmentation, pigment, hair transplant, repair, hairloss, hair loss


What if my transplant is bad and I’m scarred badly?

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I really don’t have enough info about what is bad about your transplant, but since I’m sure I’ve answered questions about repairs before, perhaps another physician’s opinion would be valuable to the readers of this site. Coincidentally, I recently read a post on the IAHRS site from Melike Kulahci, MD that answers your question about corrective procedures — Is It Possible To Have a Normal Looking Head After a Bad Hair Transplant?

Side note: I have met Melike Kulahci, MD at the various physician meetings and she is clearly one of the outstanding doctors in this field today. We have shared some stories from time to time and we agree on most of the clinical issues before us.

Tags: hair transplant, corrective procedure, hairloss, hair loss


This patient came to see us in March 2007 for 1004 grafts and then for a follow-up procedure in May 2009 of another 1045 grafts. All of these grafts were placed into the hairline to cover up old plugs. On his recent visit to the office, I couldn’t even find the old plugs… and when I told him that, he smiled ear to ear. Click the photos to enlarge.





Tags: hair transplant, hair restoration, repair, hairloss, hair loss, hairline


This is a follow-up to our post from earlier this month: Scalp Lacerations Required Staples — Will Hair Regrow There?

Thank you for responding so concisely to my query regarding hair regrowth surrounding a scalp laceration closed with staples.

The orientation of the wounds seems to be almost perfectly aligned with the Langer lines (the wounds are located upon the occipital protuberance and are titled stightly from being perfectly horizontal). From your commentary, I find this encouraging.

Also, to remove the guess work of assumption, the wounds were stapled about 1 hour after initial injury, the wounds were created by the fist of a criminal assailant, and no infection has henceforth appeared. I even went so far as to have the staples removed by a plastic surgeon so as to avoid further damage caused by clumsiness.

I gather, from your comment, excision is contra-recommended. How many follicular hair units am I looking at to fill the described area via hair transplant if there is not satisfactory hair regrowth?

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The size of the wound and the character of your hair will dictate the number of grafts. If the infrastructure of the skin is intact, one session should be adequate, but if there is no infrastructure (can feel the skull) then sometimes two smaller sessions are needed.

There is no substitute for a direct examination, which then relies on the judgment of the surgeon and his/her experience.

Tags: scalp surgery, injury, laceration


Hi Doctor. Thank you for having this great site!!

About 25years ago I had a HT using the hobby drill method. Now I have 3 rows of white plugs. I am like most of the others on this site and want to shave my head. I was wondering if you have ever considered a procedure to re-drill the plugs and suture them closed similar to the way you show it being done to patients for the top of their heads. I have spoken to other doctors and they want to cut the entire area out and suture it closed. They also state that it would take two or three procedures. Why can’t someone just re-drill and suture shut the area?

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We have done what you described — taking each of the old style hair plugs out one-by-one and suturing each wound closed. We have also cut out the entire row and sutured it all closed. And we’ve even done a combination of both. Here’s a step-by-step story of the process one man took to repair his pluggy hairline. It took multiple surgeries to complete his repair, with the first procedure being a removal of a row of plugs, and the second procedure being individual removal of some of the remaining plugs.

My point is, everybody is different and every treatment plan for each individual is unique. In the end, find the doctor that you trust and ask to see some before after results of these repair procedures. You may even ask to speak to their former patients or meet them. Good luck.

Tags: hair plug, repair, hairloss, hair loss, hair transplant


Snippet from the article:

Darren Hope, 40, finally found “W****R” on his scalp when he shaved his head.

A surgeon left the two-inch capital letters across the back of his nut by removing tiny hair roots. But the word was hidden by the new locks he implanted.

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Transplant plug scarsRead the full article — A hair transplant patient had a swear word branded on his bonce for 19 YEARS without knowing.

Well, that is unfortunate. As if the scars left from the old large plugs weren’t bad enough, he justrealized they removed the plugs to look like a word. If the clinic is long gone and he’s so emotionally scarred by this (or at least upset), I wonder why he took it to the press and allowed his name and photos to appear. Seems it would just generate unwanted attention.

It’s difficult to see the word in the photos, but I think the word is “wanker”. Apologies to UK or AU readers that are offended by that word, but it’s rarely used here in the States.

Tags: hair transplant, scarring, hairloss, hair loss


I had a hair transplant in Australia nineteen years ago…the hair transplant was so bad…it looks like a doll head…can I repair my hair transplant in NHI? How much it will cost? Is it the same price or different price? Thanks

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RepairAt New Hair Institute (NHI), we perform corrective surgeries for patients who have had bad hair transplants (including the old doll hair looking “plugs”). You can see the before and after results of our repairs here. We’ve also created a complete step-by-step of one patient’s journey to fix his ugly hair plugs — see Dean’s Story. That’s Dean at the right before his repair procedures began.

If you would like a private consultation, please email us with detailed information (including pictures, if possible) or call us at (310) 553-9113 US.

The cost of a hair transplant and repairing old plugs generally ranges from $3000 to $10,000. As you can see with this wide range, each and every case is very different. There is usually no special fee to repair old plugs, and we charge the surgeries as in price per graft. Our fees are outlined here.

Tags: repair, hair transplant, hair plugs, hairloss, hair loss


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