Old graph technology removal

[B's_Fan]

What is the survival rate of removing old plug graph transplanted hair and re-transplanting it. I had a repair back in 2002 and I am not sure that all the transplanted hair took.. I am now going for another HT and I would like the Dr to remove some of the old graphs at my hair line and re-transplant them..

[CIT_Girl]

The survival rates of dissected plug grafts remains unknown but are most likely lower than with virgin grafts. It will also vary by case as some plugs tend to be very difficult to remove and involve more scar tissue and less blood supply than others. This is definitely something you want to approach cautiously- and perhaps have a smaller test case before proceeding with a large, expensive procedure. To achieve the best results, you will probably also want to have some more hair transplanted from your donor region (if you have a large enough donor supply) to create additional coverage and a more natural look.

[B's_Fan]

Thank you for the information CIT_Girl..Some doctors I interviewed talked about
pairing down some of the graphs..(coring out some of the hairs to leave only a couple of hairs) Some of my graphs are 8 hairs. I would like to either have them removed (only at the hair line) and re-transplant them....Would this not be the same as an FUE or is it because it was already transplanted before the scare tissue would be an issue???

[CIT_Girl]

The possibility of scar tissue and/or less blood supply with the already-transplanted grafts is what could create a less-than-optimal survival rate when redistributed. This is not necessarily the case, however, as we've seen plenty of cases where patients were able to have pluggy grafts redistributed with high yields.

Your best bet would be to consult with a physician who is experienced in repair cases and maybe even have a small test procedure done to see how easy the grafts are to remove and if they are in adequate condition for re-distribution.

[gillenator]

I agree with many of the points stated here. Over the years I have and continue to talk with a fair amount of repair patients. I see lots of pics. Every case is different and most are very complex. Open donor work (plugs) from several decades ago have such varying results with re-growth and scarring.

The cases that involve pitting, cobblestoning, raised scarring, redness, stretched scars, all are extremely difficult to remedy. I know of a past HT surgeon in my area by the name of Jeff Weidig from Bethesda, MD. He has since retired. So far, 100% percent of the cases I have seen from his past patients have extremely good yields and the plugs are in good shape and growing like carzy. IMO, there are a lack of cosmetic appeal in every case yet the potential to thin the plugs in most are very good.

Doctors who do not perform FUE have no other options really other than to excise the larger grafts and dissect them into smaller and more appropriate FU groups. The problem with this as a stand alone approach is that many lateral scars are left unless the area is filled in with new donor to disquise them. Some of the larger sites involve 1-2 sutures after the plug(s) are removed.

Doctors very experienced with FUE can potentially "thin" healthy growing plugs with extractions and hopefully re-implant those FUs elsewhere in the recipient area. I also agree that in most cases, additional donor taken from elsewhere (occipital and parietal zones) to blend in will make a huge difference in aesthetic appeal. But there is little to no boring or destruction of the existing hair within the plugs. That's the benefit of an experienced FUE surgeon when the plugs are in good shape and prime candidates for extraction. Very little visible scarring is left behind. A talented FUE surgeon can extract donor from areas that strips cannot or should not be considered.

In many cases, the plugs are compacted and sometimes pitting mostly due to the sites being larger than the plugs when they were originally placed. Then the doctor may elect to excise and dissect and still save some and ideally most of that hair. Obviously excision and not extraction (FUE) would be more practical.

This is why finding a long term doc who is skilled and experienced in BOTH strip and FUE is essential having as much experience as possible with repair.

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