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Repairing Inadequate Hair Transplants

Today hair transplant surgery can achieve results that are so natural they are undetectable, even by a barber or stylist.

However, many early hair transplant techniques that used hair “plugs” or large grafts are not aesthetically acceptable by today’s standards.

Many who have had these older techniques can now complete or repair their previous hair transplants using today’s very refined hair restoration techniques. Once their previous hair transplants are updated they can typically achieve a natural look that they can style in any manner.

The below photos show examples of out dated or poor hair transplants results that have been repaired/updated with today's new techniques.

his section shows in detail the various surgical techniques available today for repairing out dated hair transplants such as masking, recycling grafts, and/or excising the hairline.

Old Hair Transplants repaired/updated.

hair transplant repair

repairing hair transplants

corrective hair transplant

Various techniques to repair previous hair transplants

1) Masking large grafts with micrografts

Some physicians will simply attempt to mask the old plug grafts by surrounding them with today’s smaller and more refined micrografts. This can be effective if the older grafts are not too close to the hairline. A patient must also have a sufficient number of micrografts available to surround and mask these larger grafts.

However, if a patient’s large grafts are too low on the hairline or if there are not sufficient micrografts available to mask them they should be carefully removed.

Hair transplant repairs

2) Removing and recycling large grafts into small grafts

Often a patient’s previous hair transplant grafts cannot simply be masked by surrounding them with smaller and more refined micrografts. These large grafts should be surgically removed and recycled into small micrografts that can then be retransplanted.

This technique is referred to as “Plug Reduction and Recycling” or PR & R.

old plug transplant repaired by recycling the "plugs"

Close up of removed plugs
Scalp after old round punch grafts have been removed by a punch.

close up of repaired area
Scalp after punch holes have been stitched closed. New micro incisions have been created for the recycled grafts.

To do plug reduction and recycling a physician begins by removing the large round plug grafts. Typically a round punch instrument is used to excise these obvious larger round grafts. This punch graft is normally the same size or smaller than the one used to originally create and place these round punch grafts.

Some times a small part of the large graft is left in the scalp, thus leaving behind a smaller graft. Often the round holes left after the round grafts are punched out are then stitched closed.

The hair plug or part of the hair plug that was removed is then carefully dissected into tiny micrografts that contain one, two, three, and sometimes four hair follicular units.

large plugs and newer micrografts Large round plugs are recycled into numerous tiny micrografts.


These refined micrografts are then retransplanted into tiny incisions around the excised punch grafts. Often a surgeon will harvest additional tissue from the donor area to create additional micrografts. When these tiny micrografts grow out they will recreate a natural and refined distribution of hairs in place of the previously unnatural “pluggy” grafts.

3) Repair of outdated and or poor graft placement using scalp surgery.

In extreme situations where the hairline was placed unnaturally low or the temple areas are blunted with no natural recession, scalp surgery may be required to raise the hairline and remove the offending grafts.

The patient shown below has a hairline that is not only “pluggy” but placed too low, with no natural recession in his temple areas. Simply removing the round plug grafts would not remedy this patient’s unnaturally low hairline because he would then have visible scarring in his forehead area below the hairline.

This patient opted to do a surgery that first lifted his hairline higher, while recreating a natural recession in his temple areas.

Scalp lift to re create a new hair line

The row of pluggy grafts that are too low are first surgically removed in one thin strip. The grafts in this removed strip were then immediately recycled into small grafts for retransplantion.

The patient’s forehead skin was then pulled upward and seamlessly sutured. This surgery raised the man’s hairline by about 1.5 cm and restored the recession in his temple areas. A rejuvenating browlift was a bi-product of this surgical hairline correction.

after having scalp surgery and new hairs transplanted

Tiny follicular unit micrografts are then placed in front of the linear incision to create a refined and feathered hairline.

Once the newly transplanted hair grew out the patient achieved a hairline that was vastly more refined and also positioned higher on the forehead in a much more natural manner.

new hairline after scalp surgery, combined with hair transplants

Hair Transplant Repair – restoring hair and restoring lives

Patients who suffer from inadequate previous hair transplants are encouraged to seek expert medical advice and correct their outdated or inadequate work. Today there is no reason for patients to continue to suffer from an unnatural and embarrassing appearance.

Understandably, many patients who have had a painful and negative experience with hair transplant surgery are reluctant to seek help. But they often get a new lease on life when they discover what can now be done to restore both their natural hair and often their normal life.

Special thanks to Dr. James Vogel of Maryland for contributing his photos and world renowned expertise for this repair section.


The original “plug” hair transplants

Hair transplants from years ago could restore a full looking head of hair - if a patient completed all planned surgical sessions.

round punch graphs
Newly placed round punch grafts.
completed plug graphs
Completed result after multiple sessions

However, a patient was typically limited in the way they could style their hair due to these large grafts.


corn row plug graphs
“Corn Row” results from outdated round “Plug” grafts.

Others found that their large hair “plugs”, which had been disguised by their own natural hair, became obvious in time. This occurred as their hair loss progressed - leaving behind only the large pluggy looking hair grafts.