Dr. Lindsey repair of hairline plug case in black man McLean VA

[Dr. Lindsey]

This really nice executive is about my age...50...so in the prime of his life. In fact he's planning a wedding in about a year. He had plug surgery in the early 90s and desires improvement in his hairline.

Now I've posted many times that plugs are not the root of all evil. They were a good technique and reliably gave good coverage. Unfortunately they often didn't appear natural, particularly is very straight hair'd folks with significant color contrast between scalp and hair. I've posted several of these repairs on the forum over the years and really, the worse they look pre-repair, often the bigger change we can get..at least at the hairline...or further, depending on donor supply quantity.

But of all the groups that plugs worked for...they were the least un-natural looking in black people. This is because there is limited skin color-hair color mismatch AND because thick, curly hair camouflages both thinness and clumpiness.

I have had lots of threads on the forums where I describe transplanting hairs as being very similar to planting trees( and I personally have planted somewhere between 2000 and 3000 trees).

Asian hair is very straight and is similar to the arbor vitae trees we have in alot of smaller yards here in Virginia. Its a good tree, but no matter how many you plant, you'll still see the ground (or scalp) and you'll still see the yard next door(areas of thinning hair further back).

Thicker european hair is like the leyland cypresses in my backyard. You plant a row of those, wait a bit, and you'll never see your neighbors and it covers great, particularly if layered or staggered...just like we do hairlines.

Many middle eastern and about half of Indians I work with have tremendous hair...almost like willow trees....plant a few of those and you can cover lots of acreage, or scalp...

But african hair, which makes up about 5 or 6% of my yearly practice, is like planting a hedge....its unwieldy and difficult for the cutters to dissect out due to the roots being almost like corkscrews, and its challenging for the placers to place gently....but man does it give good coverage!

So this fellow, had he been someone with light skin, dark hair, and limited curliness...would have been in years ago somewhere to address the hairline. As it is, he has limited hair in his first inch of hair..but since its really quite good hair, only now is he starting to want to tune it up.

We did a small strip, placed around 1200 grafts, and shown are his perioperative pictures and 1 month scar check. Note that when trimmed down, he really doesn't have much existing hair at his hairline, and that we make slits very close to, but trying not to hit, the hair he's had placed previously. His donor area is plugged scarred as is typical, and just like FUE, the scars are depigmented (whitish) compared to the surrounding scalp, but obviously of larger size. The white dermis, which curls out of the recipient slit, gives that whitish appearance the first day or so. And at a month, he's shed the new hair, and shockloss has affected much of his previously transplanted hair. That will be back around 2.5 months postop.

I expect he'll stop by before his 1 year postop date. His scar looks great, always a bit of a concern.

And I expect him to have a really nice hairline next spring. Just in time for the funeral. Wedding I mean.

Dr. Lindsey McLean VA