Laser resurfacing to remove graft 'cobblestones' -
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  1. #1
    Junior Member
    Join Date
    Aug 2009

    Default Laser resurfacing to remove graft 'cobblestones'

    First, I hope this post won't be unwelcome here, as my goal is to more or less undo the effects of a hair transplant done over twenty years ago.

    I have a large bald area, and a relatively small 'donor site' area. The result: sparse growth in front, and a daily routine of combing over hair over the bald area in back, with plenty of hair spray.

    I'm done! I want to just be bald.

    Of course, I could just shave the transplanted area -- but if I do, I'm gonna look pretty funny, as it's "cobblestoned" from the effect of the grafts/plugs put in.

    About nine years ago, a dermatologist told me that this area could be smoothed, through surgical treatment. I *think* this is laser resurfacing, but am not sure. And, unfortunately, he doesn't do the treatment anymore.

    Can anyone offer any advice?

    A friend with a smaller bald area had a hair transplant done, with excellent results. But my bald area is quite big.

  2. #2
    Junior Member
    Join Date
    Aug 2009


    Update, several hours later: I did some more research and found some old notes, and more or less answered my own question.

    I think that 'laser resurfacing' is the term. A dermatologist referred to a procedure with a C02 laser years ago.

  3. #3
    IAHRS Recommended Hair Transplant Surgeon Robert True, MD's Avatar
    Join Date
    Mar 2009

    Default Repairing cobblestone bumps from old transplants

    Properly performed laser resurfacing can be a very good method to repair cobblestones or bumpiness of the scalp that has resulted from old style transplants.

    Superficial resurfacing methods such as IPL, Fraxel, gentle YAG, and microdermabrasion are not adequate for this type of problem. You need to go to a qualified dermatologist or plastic surgeon who uses a CO2 laser. The CO2 is an ablative later which can penetrate deep enough to take away this kind of scar tissue. Typically 2 to 4 treatments may be required. After each treatment there will be rednesss and crusting that lasts days to weeks. If the cobblestones are dark or red in contrast to the surrounding skin, the CO2 does a good job of normalizing the color as well as flattening the skin. However, if the bumps are white and lighter than the surround skin the color is not normalized.

    When the cobblestone bumps are "sclerotic" or white color, I prefer surgical removal. Many surgoens use a round punch, but I have found that making careful elliptical excisions and closing with small sutures is better and leaves only tiny imperceptable scars. Depending on the number of grafts to be removed one or more sessions may be required.

    Another approach which could be used successfully is dermabrasion. Its effect is similar to that of the laser.
    Robert True, MD
    Member, International Alliance of Hair Restoration Surgeons
    View my IAHRS Profile

  4. #4
    Junior Member
    Join Date
    Mar 2013


    Any suggested doctors for this procedure in the Pittsburgh area?

  5. #5
    Junior Member
    Join Date
    Aug 2012


    I went to Dominic Brandy in pittsburgh and he removed my plugs with the punch. They healed pretty good. He then went over it with demabrasion. Brandy has a bad reputation on these forums, but he treated me very good, and did a VERY good job compared to the local doc I went to.

    You can read more of my story here.

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