Combined Method

Combined repair involves the removal of large grafts (or “plugs”) and the re-implantation of the hair dissected from these grafts, followed by additional camouflage procedures using hair obtained from the donor area. A combined repair is the most frequently performed hair transplant repair technique in our practice.

In the mid- to late 1990s, we performed most of our corrective work with camouflage alone. However, after performing hundreds of repairs it became apparent that the patients in whom we achieved the most natural results were the ones who had the most aggressive graft excision prior to the camouflage steps. This is particularly important when the problem grafts are large, are located near the frontal hairline (or are in the crown), and have hair that is pointing in the wrong direction.

The combined repair procedure is customized for each patient’s specific situation, but consists of the following basic steps:

I – Graft Excision

Unnatural looking grafts from bad hair transplant are excised (removed)
Resulting holes are sutured closed
Excised grafts are placed under stereo-microscopes and dissected into individual follicular units
Individual follicular unit grafts are transplanted back in the scalp (usually behind the frontal hairline)
Sutures are removed at 7-10 days
If necessary, the graft excision is repeated at 8 week intervals, until all of the problem grafts have been removed

II – Camouflage

Additional hair is removed from the donor area via a strip (Follicular Unit Transplantation (FUT)) or by removing individual units directly from the donor area (Follicular Unit Extraction (FUE))
This hair is used to create a more natural hairline, to add coverage to the front and top of the scalp, or to improve the appearance of the crown
If a second camouflage session is required, it is performed 8-12 months later (after the hair from the first session has grown in) so that results of the first session can be appreciated