Q: When performing a repair on an old, pluggy hair transplant, why can’t all the grafts be removed at once?
A: We always try to do this, but it is not always possible.
If the large grafts (plugs) are spaced too close together, suturing one will put tension on an adjacent graft and make it more difficult to close. This may worsen, rather than improve, the underlying scar.
In addition, it is not always possible to remove all the follicles in a graft on one pass, as the root tends to fan outward deeper in the skin. If you use a large enough punch to remove all the follicles at once than you risk leaving a mark from the excision.
For more details, please see the following hair restoration publications:
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