Today I will discuss the effect of the old hair Transplant “plug” method on the donor region. The old hair transplant plugs have been gone for a number of years, but I still see a number of individuals who had this procedure performed years ago and need corrective work to repair their results. The purpose of this blog entry is to discuss the effect of this procedure on the donor region. The old hair transplant plugs involved taking a punch graft from the donor region and punching the same graft into the area of balding on the scalp. These plugs were harvested using punches ranging in size from 2.0mm-5.0mm. The plugs consisted of between 4-20 hairs per plug. This was in essence the same technique we use today for FUE, however with FUE today most physicians use punches ranging from .8mm-1.1mm. These much smaller size FUE punches allow us to harvest the natural follicular unit, which ranges from 1-5 hairs per follicle. As you can see from the photo, the old plugs cause a tremendous amount of scarring in the donor region and deplete the amount of donor hair that is available for future procedures. In these cases the best course of action to harvest additional donor supply is to find the least harvested region in the permanent donor zone, and perform a strip harvest procedure. In this way, we can remove some of the plug scarring and yet still obtain good donor hair. Below I have included donor photos of the patient who had large plugs and another photo of a patient 7 days after 1600 grafts were harvested via FUE utilizing a .9mm punch tool. The difference is dramatic.
All the best,
Marc Dauer, MD