I had a session of about 1600 graphs about 4 years ago. I have thin hair, and it had receded to about a grade 5 baldness. Because my hair is thin, and maybe because I didn’t get enough graphs, I’ve never really gotten the thickness or coverage that I was hoping for, and I am now considering having the transplants removed entirely. Have you had much success with laser removal of transplants? How much scarring is typically visible? I am concerned about having a bald head with little holes all over it.
Your question comes right after I met a fellow in my office today who asked about the same subject, removing his transplants completely and going back to his normal balding state. You are correct to worry about the deforming issues if the grafts were anything but today’s modern follicular unit grafts with skin trimmed down when they were transplants. There are many things that an examination will show a good doctor and they include (1) the presence of cobblestonning of the skin along with other surgical scars in the recipient and donor area, (2) the number of grafts we are talking about removing and what type of grafts that was transplanted, (3) The distribution of the grafts, etcâ€¦. With that information, it would be easier to discuss this approach, but generally removing the grafts involve removing both the hair and the skin, each producing its challenges. The patient I just saw was more specific in his questions, so I am going to reference my letter to him reflecting the visit he and I had. This particular patient did not want another hair transplant, even though it is the only good option for him to become normal looking.
This is what I wrote:
You had previous hair transplants with another medical group many years ago and scarring is present both in the donor area and in the recipient area. Your focus was not to repeat the transplant, but rather to try to wipe the slate clean, removing the cobblestonning in the skin at the hairline area and elsewhere which were spread out widely in your head. It is interesting to note that the transplants that you had (three sessions) was largely a failure from a growth perspective and this means that the hair plugs are not very obvious leaving you more with skin abnormalities that are a real management problem for both of us.
You asked about the following subjects:
- The use of lasers to treat the cobblestoning of the skin and the hair in the front balding area. Lasers have a side effect, they depigment the skin. I have seen the skin become white in color after laser treatments for smoothing down the skin. For that reason, I am not excited about their use in the areas you want to address.
- Dermabrasian is another option that I am not excited about. It often leaves obvious different scars which will call attention to the areas that were treated.
- Excision of the grafts and cobblestoning area: This is a technique we have used extensively. Your cobblestoning and plugs are not as bad as most of the people I see, and although scarring is often acceptable, a bald head will call ones attention to any scar you get in this area. If this was considered with a thinning look hair transplant, then I would consider this option with more enthusiasm than I have at this time.
I talked about choices. You are looking for solutions that may not be out there and could be stepping off a cliff again with more bad choices like the one you made when you had this work done in the first place. I have suggested that you come to one of our open house events where you can meet other people like you that had the old type of transplants repaired by us. In this setting, you can assess the value of the various approaches and then set up another appointment with me to discuss it further.
I know that we did not see eye to eye today, but I am concerned that I want you to make the type of decision that you will be happy with, not another one which you will regret. Let’s spend more time together to see if we can come together on a plan that suits your needs and my comfort zone.
My suggestion for you, like this patient reference above, is to visit one of our open house events and see the results of the repair process in patients we have repaired. If you are not near on of our offices, I suggest that you review our website which also shows many examples of the repairs we have done. We have written the classic articles on repair, which are available at newhair.com.
Fixing your thin look may be the best way to approach the problem.