Robert M. Bernstein, MD,*† William R. Rassman, MD, ‡ Nazia Rashid, and Richard C. Shiell, MBBS
Dermatologic Surgery 2002; 28(10): 873-93.
© 2002 The American Society for Dermatologic Surgery
*College of Physicians and Surgeons, Columbia University, New York, New York
†New Hair Institute Medical Group, A Professional Corporation, New York, New York and ‡Los Angeles, CA
This is the second of a two-part series. Part I discusses the most common problems encountered in surgical hair restoration and presents general concepts in corrective work. Part II addresses the technical aspects of performing the actual restoration.
PART I: General Aspects of Repair and Basic Repair Strategies
Introduction to repair
Cosmetic problems produced by poorly executed hair transplants
Major limitations inherent in restorative procedures
Basic repair strategies
PART II: The Tactics of Repair
Why Follicular Unit Transplantation is the ideal tool for repair
Specific repair techniques
Removal and re-implantation
Removal alone
Camouflage
Special cosmetic problems
Repair of the donor area
Background
As patient awareness of new hair transplantation techniques grows, the repair of improperly planned or poorly executed procedures becomes an increasingly important part of surgical hair restoration.
Objective
Part two of this series is written to serve as a practical guide for surgeons who perform repairs in their daily practices. It focuses on specific hair transplant repair techniques.
Methods
The repairs are performed by excision with re-implantation and/or by camouflage. Follicular Unit Transplantation is used for the restorative aspects of the procedure.
Results
Using punch or linear excision techniques allows the surgeon to relocate poorly planted grafts to areas that are more appropriate. The key elements of camouflage include creating a deep zone of follicular units, angling grafts in their natural direction, and using forward and side weighting of grafts to increase the appearance of fullness. In special situations, removal of grafts without re-implantation can be accomplished using lasers or electrolysis.
Conclusion
Meticulous surgical techniques and optimal utilization of a limited hair supply will enable the surgeon to achieve the best possible cosmetic results for patients requiring repairs.
