Hair repair surgery. Corrective measures for improvement of older large-graft procedures and scalp scars.

BACKGROUND: Implanted hair follicles generally take and grow well. This can be desirable or undesirable, depending on the skill and aesthetic eye of the surgeon. Older methods employing larger grafts often produced pluggy, bristle brush, or "Barbie doll" hairlines that were unsightly and conspicuous. OBJECTIVE: Since patients possessing these outcomes often seek corrective measures, a search was undertaken to find effective, corrective repair methods. Unfortunately, relatively little has been published on this subject. METHODS AND RESULTS: Discussion will center on recipient site repair, donor site repair, and scar repair. Recipient sites can be improved with a combination of laser ablation, electrolysis, punch removal, and fill-in micrografting. Donor sites can be improved by reexcision, undermining, tissue expansion, and layered closure. Anterior scalp scars may be improved by punch excision and micrografting. CONCLUSIONS: Satisfactory improvement for untoward hair transplantation outcomes may be obtained with one or more corrective procedures in many patients.