Bernstein Medical - Center for Hair Restoration » Dermis

Can Dermabrasion Repair Old "Pluggy" Hair Transplant Scars?

Robert M. Bernstein M.D. — Sat, 09 Jun 2007 09:25:00 +0000

Q: Can dermabrasion help eliminate the circular edges of raised plug grafts caused by old hair transplants? Is this similar to the suturing and excision look?

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.

What Are Consequences of Trichophytic Closure of Hair Transplant and Infection of Donor Area?

Robert M. Bernstein M.D. — Fri, 02 Feb 2007 16:36:58 +0000

Q: Could you tell me in case there is an infection at the donor area following a hair transplant, will it prevent the hair to grow after healing if the donor area closed by Trichophytic Closure? What are the problems which may the infection cause?

A: Infection may cause the donor incision to heal more slowly or with a widened scar after a hair transplant. It may affect any closure, Trichophytic or not.

The risk of infection after a hair restoration procedure is made worse by a tight closure, but not necessarily a Trichophytic closure, unless too much skin was removed at the edges leaving the dermis (deeper part of the skin) exposed.

Can One Have Hair Transplant if Scalp is Tight from Prior Surgery?

Robert M. Bernstein M.D. — Wed, 05 Jul 2006 06:33:44 +0000

Q: What can be done if I want to have a hair transplant and my scalp is very tight from prior surgeries?

A: Follicular Unit Extraction is ideal in very tight scalps, provided that there is enough hair to extract without leaving the donor area too thin and provided that the follicles are not too distorted from the scarring.

With strip harvesting, undermining techniques may be helpful to close the wound edges once the strip is removed.

In undermining, the surgeon uses either a sharp instrument (scalpel) or blunt instrument (the dull edge of scissors) to separate the upper layers of the scalp (dermis and epidermis) from the lower part of the scalp (fascia). The hair transplant surgeon accomplishes this by spreading apart the fat layer of the skin or by cutting through scar tissue.

Undermining allows the upper layers of skin to literally slide over the lower layers and can significantly increase the ability to close a tight wound. However, if not done carefully, it may increase the risk of bleeding and injury to nerves and occasionally may damage hair follicles.

Undermining is usually used with a layered closure where the deeper tissues are brought together first with a layer of absorbable sutures before the surface of the skin is sutured closed with sutures that are removed.