84 Hairline and Recipient Area Repair of Poor Previous Transplantation

James E. Vogel

Summary

Using modern techniques of hair restoration surgery, the outcome of a scalp hair restoration is generally indistinguishable from the appearance of native scalp hair. Unfortunately, older techniques of hair transplantation using large punch grafts often resulted in unnatural looks that were either pluggy, poorly designed, or did not take into consideration future hair loss. As a consequence, there are a considerable number of patients who bear the visual and psychological burden of older plugs. It should be noted that, even though modern hair transplant uses exclusively small one- to four-hair follicular unit (FU) grafts, unnatural results still occur today. Poor hairline design (too low, too straight) or not taking into consideration progressive hair loss has moved ahead of a pluggy look as the most common causes of unnatural results. Also, even with the exclusive use of one- to four-hair FU grafts, the improper placement of three- to four-hair FU grafts on the hairline, especially if at the wrong angle or direction, still creates an unnatural “grafty look,” just with smaller grafts. The focus of this chapter is to provide a useful review of the most common cosmetic problems the hair transplant surgeon is likely to encounter. A practical approach is presented.

Schlüsselwörter

hair plugs - corn row transplant - progressive hair loss - donor site scarring - corrective hair transplant

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