Revision Surgical Hair Restoration: Repair of Undesirable Results

In 1999, Dr. Jeffrey S. Epstein wrote an article discussing the management of unfavorable results in hair restoration surgery, which were often due to obsolete techniques, technical errors, poor planning, and complications. He presented several cases where he used various methods to correct these results, including adding more grafts, redistributing previously transplanted hair, removing transplanted hair, scalp reduction, and scar revision. However, Dr. Alfonso Barrera, who discussed the article, disagreed with some of Epstein's methods and philosophies. Barrera argued that poor hair growth was primarily due to poor technique of graft dissection, traumatic handling of the grafts, and graft desiccation. He also believed that using small slits to create recipient sites was more efficient and allowed for a greater number of grafts in a single session. Barrera preferred to address unfavorable results with the use of micrografts and minigrafts, if sufficient donor hair was available.