How are mis-angled hairs repaired?

[Jeff Smith]

Having started back in the 1990s with HTs, many of my transplanted hairs seem to angle up at an unnatural angle.
Have you had any experience having this corrected, or are there methods to address this?

[Spex]

Hi Jeff,

Theres a few ways and all depends on the nature of the grafts. You can bulk up the area with further work and completely camouflage them or FUE them out, refine them and relocate them.

Regards
Spex
https://spexhair.com

[JoeTillman]

Having started back in the 1990s with HTs, many of my transplanted hairs seem to angle up at an unnatural angle.
Have you had any experience having this corrected, or are there methods to address this?

I had the same issue myself. There are two two ways, that Spex mentioned. The removal process is probably the best route to go in if the grafts are placed too low. If they are high enough on the hairline then they can be camouflaged. I had this approach myself and it worked quite well.

[Jeff Smith]

Thanks, Spex.
Thanks, Joe.

It is good to know there are options, and especially good to know that this includes removal and re-use. Years ago I think I had read that this wasn't successful, and the relocated FU would not grow.
Makes me curious what new tools or techniques made it possible to re-use the extracted FU, and also how wide spread this is, i.e. can most of the better HT docs do this now?

[Sean]

Sorry to hear this. Hope you get out of this mess soon. One of the many issues I have to figure out how to get out of. Ive heard scoring/extracting those misaligned grafts will probably be more beneficial. But to a certain degree. Best of luck

[Spex]

Makes me curious what new tools or techniques made it possible to re-use the extracted FU, and also how wide spread this is, i.e. can most of the better HT docs do this now?

FUE extraction and correct use of correct size punch - by a skilful and experienced surgeon.

Regards
Spex
https://spexhair.com

[Jeff Smith]

The removal process is probably the best route to go in if the grafts are placed too low. If they are high enough on the hairline then they can be camouflaged.

Mine are placed high enough, but there are so many that are mis-angled and there is so little donor left that I don't know how well camouflage would work in this case.
Many are somewhat big, and so one tentative plan would be to target these. Remove and re-use at the proper angle. Does this sound like a good approach?

[Jeff Smith]

FUE extraction and correct use of correct size punch - by a skilful and experienced surgeon.

https://spexhair.com

What yield would typically result from the "re-used" FU versus a standard FUE process from standard donor area?

[JoeTillman]

Mine are placed high enough, but there are so many that are mis-angled and there is so little donor left that I don't know how well camouflage would work in this case.
Many are somewhat big, and so one tentative plan would be to target these. Remove and re-use at the proper angle. Does this sound like a good approach?

Reusing the grafts is a gamble, only in that it depends on the quality of the grafts as many times they won't be of the same quality as grafts that have come straight from the standard donor zone. If they're not of the highest quality in the recipient area they may have scar tissue around them or be compressed (usually noted by a wirey kinkiness to them) and they can have trouble surviving once they're transplanted a second time. If first time FUE has a 95% survival rate, I'd place second placement at 75%.

Mine were overly large as well, which some having six to twelve hair each and they were angled vertically. 2406 grafts were placed in the hairline and the top to give me coverage and that could have been good enough. I can't speak about your donor as it is now but to the original question; is your idea a good approach? It really depends on what you have to work with and what your expectations are.

[Jeff Smith]

If they're not of the highest quality in the recipient area they may have scar tissue around them or be compressed (usually noted by a wirey kinkiness to them) and they can have trouble surviving once they're transplanted a second time. If first time FUE has a 95% survival rate, I'd place second placement at 75%.

I can't speak about your donor as it is now but to the original question; is your idea a good approach? It really depends on what you have to work with and what your expectations are.

That is very interesting that the wirey nature of some FU hair is an indicator of quality. I wasn't aware of this, but it makes sense that they are under some stress, and hence not functioning normally.
And the surgeon could perhaps choose which to use (or not) based on this sign?

Unfortunately donor is severely limited. When talking to a number of doctors 10 yrs ago, one even recommended not doing anything more. Then I had a session in which 1,800 were harvested via FUT.
FUE taken from below the rear donor scar lines might be usable now. Perhaps this is called the "nape" hair? If I recall correctly, some surgeons leave this in tact as a safety supply, after a point of final hair loss is reached? Maybe I am there now.
If these "nape" hairs are available, they would go towards refining the hairline and transition to (bald) crown. Beyond that, BHT might help fill in the top some .. among the older grafts. Maybe this yields a good final result?