Dear Dr Reddy,

I have had a 2300 graft strip surgery 3 months ago to the front and temple region. I am not happy with the density and also the direction of the hair. I have heard that with the specialised implanter used in H+ technique, you can achieve better density and also better direction than traditional strip procedures.

My question is can the density and direction be improved and if yes, how soon can this be done after my first surgery?

Thanks for your question. Before I start answering your question, I would like to reassure you that 3m is still very early days to determine the success or failure of your strip surgery. I do not belong to the school of thought that FUE is better than strip surgery. My belief is that both surgeries should complement each other.

Moving on, yes we use a specialised implanter pen that helps in achieving better control over the angle and direction, whilst protecting the vital structures of the graft.
With regards to density, a couple of factors influence the density. Logic says that to achieve the desired coverage a surgeon should aim to achieve 50% of the density of the donor area. Any density beyond that would not provide any additional benefits.
So the answer to your question is that we can achieve the desired density in one procedure with the H+ technique.

With regards to answering your second question, I always advice my patients to wait at least 6 months before contemplating the second procedure.
The reasoning behind this is that you have to wait 6m before you could assess the success of the first surgery and hence you can plan your second surgery better, without disturbing the healing process.

Hair restoration with FUT( Strip Surgery) has been around for nearly 20 years. Though the method of extraction has got significantly better with the use of tricophytic closure, there is very little chance of avoiding linear scarring which is visible when the hair is shorter than 2-3 mm. There are many ways by which the appearance of the scar can be reduced. One of the most recent advances is by using FUE.

In this method, Follicular units are extracted using a 0.9 mm punch. When meticulously extracted, leaving plenty of room in between grafts, FUE should leave no visible scarring even with very short hair.

One Key thing to consider is that the scar tissue is unlike normal skin in that the normal architecture is destroyed and hence the expectation level should clearly be revised in that the client should be explained that there is a possibility that some of the grafts might not be taken up.

Keeping this in mind, the surgery should be planned in such a way as to achieve the best camouflage. The results can be improved by a proper preparation of the donor scar and using sufficient tumescence. Another surgical consideration that should be pencilled in is that in order to achieve the desired result, grafts need to be placed in the healthy tissue on either side of the scar tissue.

At Cosmetic Medical Group we have achieved exceptional results with regards to scar correction following a previous strip surgery or scars induced by trauma to the scalp, eyebrows or side burns. Please pop in for a no obligation free consultation to discuss your needs with our specialist.