This following article was written by recommended hair restoration physician Dr. William Lindsey and posted on our Hair Restoration Social Community and Discussion Forums.
I had the old style “plugs” back in the 90’s and had some repair work years after (2 sessions) but the hairline was not natural. Then, I had a plug reduction in 2007 by a well known hair restoration doctor. I still have some plugs on each side that are noticeable that I would like reduced as well as to add some grafts via follicular unit extraction.
None of the grafts that were taken from the reduced plugs grew in all the areas where the plugs were broken down but I noticed some grew in the virgin parts of the scalp. Also, when looking at some old pics, I could swear that I lost some of the other transplanted hairs in the area. So, I am wondering if the trauma to the scalp caused the old transplants to fall out as well as the new ones not to grow. Could this be due to a lack of blood flow?
Depending on how big your plugs are, taking them out via FUE, excising them, or even including them in your new hairline are all options to be discussed. I often favor the latter and just pack hair around the plugs. While not “virgin scalp”, this hair transplant technique has been very reliable for me.
I’m not a fan of excising a plug, sewing it up, and then grafting above it as I do think the blood supply could be an issue leading to poor hair growth. In those cases, I’d excise on day 1, put those hairs somewhere well away from the site of surgery and then plant around the plug site 3 or more months later with a different surgery.
Dr. William H. Lindsey, MD, FACS