Q: I had several prior hair transplants that left me with a pluggy look, I was hoping to re-utilize the removed hair and re-implant it, perhaps in the front as a new, more recessed hairline. It is possible?

A: The hair from the excised grafts is always re-implanted.

The grafts that are removed are dissected into individual follicular units and then placed back in the recipient area in a more natural distribution and angle. See this patient’s hair transplant repair in the Hair Transplant Repair Photo Gallery on the Bernstein Medical – Center for Hair Restoration website.

 

Q: Can I have plugs removed by FUE (follicular unit extraction) which would probably result in less scarring – but would probably take more time and be more expensive.

A: Follicular units in a plug are already compressed and scarred down. Trying to remove them individually will result in a worse cosmetic outcome as the underlying scar tissue will not be removed.

In addition, extraction of individual follicular units from scar tissue is more likely to cause damage to the hair follicles. Removing the entire graft is generally better for these reasons.

 

Q: I had an old hair transplant and I’m hoping to remove these plugs and of course am concerned how much additional scarring would result. I’m wondering if removal of the total hair plugs (which are perhaps 2 or 3 mm in diameter) by coring them out would result in a lot of additional scarring.

A: It will significantly reduce the scarring.

The reason is that the round disc of scar tissue at the bottom of the graft from prior plug hair transplants will be removed and the normal skin edges will be brought together resulting in a barely perceptible fine line scar.

See the Graft Excision in Hair Transplants page on Bernstein Medical – Center for Hair Restoration website.

 

Q: I’m male, early thirties and in the early stages of hair loss, too early for hair transplants. I am experiencing extreme shedding. I took Avodart for 6 weeks, but because of the shedding I stopped. Now, it still continues as strong as ever. I’ve been losing about 200 hairs every day in the shower. 3 months ago I had so much more hair, what is going on? I heard that shedding can happen, but not like this. Could this have caused telogen effluvium, or something else?

A: Since Avodart (dutasteride) is a more potent medication than Propecia (finasteride), the shedding (telogen effluvium) may be more dramatic. If you have made a decision to use Avodart, then you need to tolerate this short-term effect. It should subside within the first 6 months on the drug.

 

Q: I stopped using Rogaine for my hair transplant, when can I start using it again? And would it be any different with the new Rogaine foam.

A: I would wait at least 7 days to use Rogaine (minoxidil) in either liquid or foam.

The foam has less alcohol and can be irritating when applied to open wounds, but should be fine one week post-op.