Video: Hair Plugs And Hair Transplant Repair At Bernstein Medical
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May 15th, 2014

Plug procedures, popular in the 1960s and 1970s, often resulted in an unsightly “pluggy” or “dolls head” look. In the past we tried to work around the plugs with fine grafts in order to camouflage them, but this proved ineffective. At Bernstein Medical, we now find it best to totally remove the old plugs, put them under a microscope, dissect them into smaller follicular units and then re-implant them. This process is called Combined Hair Transplant Repair. In this way, many of the cosmetic defects created by hair plug procedures can be partially or completely reversed.

Here is a more detailed summary of the video:

Dr. Bernstein: Plug procedures, popular in the 1960s and 1970s, gave hair transplants a bad name because they used large grafts which resulted in a “pluggy” look, often called a “dolls head” or “cornrow” look.

Unfortunately, the hair from those procedures continues to grow and people that had cosmetic problems from those procedures still have them today.

To correct these cosmetic problems, we’ve tried a number of solutions. For example, for many years we tried camouflaging them, that is, as we developed new hair transplant techniques with smaller grafts, we tried putting these smaller grafts in front of the larger plugs to soften them and make them appear more natural. The problem was that the larger plugs still remained visible through the newly transplanted hair.

So rather than try to hide the plugs, we tried instead to decrease their size by converting them into smaller grafts, but this also proved ineffective because most of the large grafts were placed in clumps that not only contained too many hairs but they also grew in the wrong direction.

So we finally decided that, when possible, it was best to totally remove the plugs.

There are two advantages of removing the plugs. One, you can reuse the hair. Two, there are no remnants of the plug that have poor hair direction. Equally important, because the plugs are sitting in scar tissue, once the plugs and underlying scar tissue are removed, you can close the defect — the little hole — with skin on either side that is normal. This converts lumpy cobblestone-looking skin into a much more normal appearing skin.

We reuse the hair that we get from the plugs by putting them under a series of microscopes and dissecting the follicular units out of them (as we would from a normal donor strip). We can then convert that plug into one-, two- or three-hair grafts and use those finer grafts in the areas of the old plug.

Generally, to repair unsightly plug procedures, we’ll use the hair obtained from the plugs and place them in the central part of the scalp as a filler. We do this because the scar tissue around those plugs can make the hair we get from the plugs wavy and unnatural. We then take fresh hair from the donor area to recreate the hairline. All of this makes the hair transplant soft and natural.

In summary, in the old days we tried to work around plugs and camouflage them. Now we find it best to totally remove them, put them under a microscope, dissect them into smaller follicular units, and then re-implant them in the way that hair naturally grows.

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