The following thorough response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member and lead medical tech and surgical manager for the Shapiro Medical Group, “Janna”.
My first hair transplant surgery was ten years ago and I’m considering doing another one with a reputable surgeon. One issue I’ve spoken to various top hair restoration physicians about is improving my hairline which, if you look at it very closely, looks pretty pluggy due to the mini-grafts used. What I’ve discussed with some of the surgeons is the idea of removing them and planting them further back to blend with newer transplanted hair, or to place grafts around them to minimize the look. Has anyone had luck with this? Also, when mini-grafts are simply removed is there a pinhole or scarring left in their place or can they be pretty cleanly removed?
Either removing the mini-grafts or transplanting around them are both viable options when revising an older procedure. Generally, there really isn’t much of a scar remaining after a punch out session if done correctly. Which course to take depends on several factors, such as, the size of the mini-grafts, how prominent they are in the hairline and how high or low the current hairline is. If your hairline is low, the recommendation will likely be to remove as many mini-grafts as possible and replant them further back. I would imagine you’ll still need some fine single hairs to make it look natural.
If your current hairline is high, then planting follicular unit grafts around the mini-grafts will likely be favored. The existing grafts will help with the density. Make sure you have good “before” pictures to send for thorough consultations if the consultations are not in person.
Best of luck!
Lead Medical Tech and Surgical Manager
Shapiro Medical Group