Hair Transplant Repair Methods Explained by Dr. Cam Simmons

This question, asked by a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. Cam Simmons:

I have had two hair transplants. One was about 20 years ago in Pittsburgh that left me with plugs on the front part of my scalp. I had another in 2001 from a clinic in Clearwater FL that I don’t believe did much to improve the look of my plugs. As my hairline recedes, the plugs are becoming harder to hide. I have recently consulted with two hair restoration physicians. One doctor wants to core out the plugs and put in 2000 grafts. The other wants to pack the area with 2000 grafts to camouflage the area. Both are Coalition doctors. I wondered if anyone has any suggestions which would be the best way to go.

Either approach can work in the right situation.

For example, if you have dark, coarse hair, light skin and big compressed plugs with 18 – 30 hairs per plug, it would be very difficult to camouflage the hair plugs with small grafts alone. In that case, you would need to debulk the old plugs and transplant more follicular unit grafts. There are different techniques to reduce and recycle old plugs too.

If you have finer, lighter colored hair and the plugs aren’t too big you may be able to just fill in.

One more caveat: If you have already had two older method surgeries in the same area, the scarring may limit how densely the new grafts should be placed. Dense-packing into scarred skin can lead to poor hair growth.

Cam Simmons MD ABHRS

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