I have had 2 transplants (3800 and 1500). The first left my recipient area pitted and looking like a golf ball or a pin cushion. I had the second one recently (Jan 2010) with the intent to conceal the pitting in the hailine. First procedure was with NHI (Oct 08) in Melbourne Australia the second with Dr Knudsen in Sydney. When I see your photos (and others) I almost begin to cry cause my recipient area is such that I cannot leave the house without a cap. I fear that the recent procedure will not be enough to conceal the damage. My only hope is to have another procedure (around 4000, donor area permitting) to get as much density as possible to conceal the mess as I am painfully aware that scars are for life. How long do I need to wait between procedures and is donor hair supply the only constraint on density or is there a physical limit at which you cannot place grafts together? Please help me. — S.H.

It would be best to wait until at least 8 months post-op to determine the result and plan for another procedure. If the recipient area is not able to be improved to the desired degree by the second procedure, a couple questions need to be addressed:

1. will another procedure adequately conceal the old work and create a natural enough result ?
2. will removing the old work be necessary before the next procedure to achieve the desired result ?

In many cases where the recipient area is scarred and damaged, the removal of the tissue and then later reconstruction will create the most natural hairline. There are several factors that need to be taken into consideration to determine the best approach if any for another procedure. There are too many factors to discuss here which would determine that. A clear set of photos, or better, a physical examination would be required to correctly assess the situation. For a free consultation and to upload photos, please submit a free hair loss consultation form.

While donor supply does factor into what density would be best to try and achieve, there is a physical limit as to how dense the grafts can be packed. If given a sufficient amount of raw materials (donor) to work with, many patients with otherwise obvious unnatural hairlines from previous surgeries can in the end have normal looking natural results.

— Victor Hasson, MD

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I received a previous transplant from another doctor. The result was extremely thin in appearance. The doctor spread out about 1000 grafts all over my head and they gave this very thin appearance. This is cosmetically not what I was desiring, as I would need some thickness to make a cosmetic improvement. Is your clinic able to transplant new grafts in between my old grafts from the previous transplant in order to thicken it up a bit? Are you able to transplant in between the old grafts from the previous transplant without having to remove or damage to old transplanted hairs? Thanks in advance.
— S.R.

Hello S. Yes, We can transplant between your old grafts, and yes we can do so without damaging them. To do so, we would have to shave the recipient area to about 2mm where hairs are being transplanted. Dr Hasson and I both require recipient site shaving regardless, but occasionally allow a few clients to forego the shaving for various reasons. In your case, it would be an absolute requirement. Shaving is done so that we can clearly visualize the old work and the angle and direction at which the hair leaves the scalp.

Of course, the "yes"s to the questions above come with a caveat: you must first have a consultation before the we can be definitive about your specific case. Feel free to submit your photos and complete the consultation form.

Jerry Wong, MD.

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I have had 3 strip hair transplants and one FUE hair transplant totalling over 7500 grafts. The results are poor at best. I am now left with 3 wide scars, 2 of the scars were closed via trichophytic, the other was not, honestly I can not tell the difference because they are all wide, the doctor didn’t use staples. I am worried that the doctor has depleted my donor area. I want to desperately fix the scars and complete my frontal hairline. Is that still possible to do, can I have the non trichophytic scar taken out (scar revision) and use the grafts from it to fill in the other 2 scars and complete my front hairline? — N.K.

Thanks for the question N.K.

It would be nearly impossible to give a definitive answer given the complicated nature of your experience. Some scars can be revised and improved but never to 100% satisfaction, though usually, improvements can be made. In the past, Hasson & Wong have improved donor areas of patients with wide donor scars or multiple donor scars from other clinics. We have also made cosmetic improvements to previously placed grafts. Repair patients must understand that most failed or unacceptable hair transplants cannot be repaired in one session. In order to reverse or improve the previous work it may take multiple sessions just to attain a more natural appearance. In extreme cases, complete rectification may not be possible, though improvements can usually be made. A face-to-face consultation would be required.

Best of luck.

Jerry Wong MD.

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If you are not satisfied with the hairline you got from your hair transplant, is it possible to remove the grafts and make your hairline higher so it matches the rest of your hair?

Do you know if the scars from the grafts remain visible?
Does Kelo-Cote help to minimize these scars? — BS

It is possible to remove a transplanted hairline if it has been placed too low or is extremely unnatural in appearance and difficult to make look natural by adding more grafts. In some cases, only a portion of the hairline need be removed to create a more natural appearance. In other more extreme cases, the entire first few millimeters must be removed creating a higher hairline. Sometimes, just removing the unsightly hairline can be enough for a cosmetic improvement, but in other cases a second hair transplant procedure is required to rebuild a new hairline. If you are referring to whether scars remain after the removal of the old grafts, the answer is probably "Yes". If the old grafts presented no scarring to begin with and are removed with electrolysis or laser, minimal if any scarring should remain after grafts are removed. If, however, the grafts to be removed created scarring, pitting, or any surface irregularities, the entire tissue must be removed via strip. This excision will leave a fine linear scar running along the front of the hairline. This scar usually heals fairly well and if the hair is strong behind it, some patients would find this acceptable and a great improvement over what was there. In most cases, as mentioned before, some grafting in front and into the scar (rebuilding a new hairline), blending into the existing hairline, gives the best aesthetic result.

If you are considering a repair procedure, please send photos via the Hasson & Wong online consultation page.

I can’t comment on the product Kelo-Cote. Sorry I can’t be of help there.

— Jerry Wong, MD

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