Revision of the Unfavorable Result in Hair Transplantation

ABSTRACT

Analysis of the unfavorable result in hair transplantation can be analyzed as either an error in judgment or an error in technique. One of the most common errors in judgment is ignoring the fact that hair loss is progressive. Other errors in this category include transplantation at too early an age or ignoring the normal contour of the frontotemporal angle. The other major category involved in the unfavorable result is that of an error in technique. Historically, the unsightly plug grafts used in past were the greatest source of problems. Even with today’s technique using small natural appearing grafts of one to three hairs, errors in technique can create an unnatural result. These include improper angulation of the grafts, poor graft preparation, poor donor site closure, and poor design of the transplanted hairline. The key component of a successful hair transplant is creating a natural appearance, and thorough knowledge of the components of a natural hairline is critical for a successful outcome. However, once an unfavorable result does occur, a logical approach to revisionary surgery is important as options are often limited. This discussion will present specific options that are available to these patients in an attempt to improve their results.

KEYWORDS

Progressive hair loss - frontotemporal angle - unfavorable results - follicular units - plug grafts

REFERENCES

• 1 Bernstein R M, Rassman W R. Follicular transplantation: patient evaluation and surgical planning.  Dermatol Surg. 1997;  23 771-784
• 2 Bernstein R M, Rassman W R. The aesthetics of follicular transplantation.  Dermatol Surg. 1997;  23 785-799
• 3 Uebel C O. Micrografts and minigrafts: a new approach for baldness surgery.  Ann Plast Surg. 1991;  27 476-487
• 4 Barrera A. The use of micro grafts and minigrafts for the correction of the postrhytidectomy lost sideburn.  Plast Reconstr Surg. 1998;  102 2237-2240
• 5 Barrera A. The use of micrografts and minigrafts in the aesthetic reconstruction of the face and scalp.  Plast Reconstr Surg. 2003;  112 883-890
• 6 Juri J, Juri C, Arufe H N. Use of rotation scalp flaps for treatment of occipital baldness.  Plast Reconstr Surg. 1978;  61 23-26
• 7 Elliott Jr R A. Lateral scalp flaps for instant results in male pattern baldness.  Plast Reconstr Surg. 1977;  60 699-703
• 8 Vogel J E. Correction of the cornrow hair transplant and other common problems in surgical hair restoration.  Plast Reconstr Surg. 2000;  105 1528-1536
• 9 Epstein J S. Revision of surgical hair restoration: repair of undesirable results.  Plast Reconstr Surg. 1999;  104 222-232
• 10 Nordström R E, Greco M, Raposio E. The “Nordstrom suture” to enhance scalp reductions.  Plast Reconstr Surg. 2001;  107 577-582
• 11 Fisher J. Discussion: correction of the cornrow transplant and other common problems in surgical hair restoration.  Plast Reconstr Surg. 2000;  105 1528-1536