A: Although dermabrasion can flatten elevated edges, it will not eliminate the round, white circular scars that results from old punch graft hair transplants.

The scarring in these procedures goes all the way through the dermis to the fat. Dermabrasion can only go down to the upper part of the dermis without causing further scarring.

Graft excision with suturing removes the plug as well as the underlying scar and will eliminate the tell-tale circular marks of the older hair restoration procedures.

A: This condition is often referred to as pitting and occurs when grafts are placed below the surface of the skin. It is more common with large grafts rather than small ones and is almost never seen in Follicular Unit Transplantation (FUT).

In general, visible holes can result from mini-micrografting hair transplant procedures where the grafts (and thus the recipient sites needed to hold them) are larger than approximately 1.2mm. Recipients sites smaller than 1.2 rarely leave any mark. In follicular unit hair transplant procedures, the grafts will fit into sites smaller than 1.2mm so surface changes are generally not seen (even if the grafts are not placed flush with the skin).

It is difficult to fix the holes directly with the methods you listed as fillers do not fix well defined holes and laser-abrasion and dermabrasion may destroy the surrounding hair.

A properly performed second procedure that places follicular unit grafts in the area should correct the problem.