The current method for big plug correction is to use a punch to remove the large plug partially or entirely and then dissect the plug into smaller grafts before transplanting them back.
Our method is different. We often do not punch the old plugs, unless the location is very inadequate. We transplant many small grafts in the surrounding area of the old large plugs. The idea behind this method is to have the same density so the old plugs are no longer visible. When you punch out the old plugs you may damage a lot of hair and consume time suturing the punch hole.
The patients’ goal is to have natural looking hair with good density. They have invested a lot of money for the prior surgery therefore, as long as we can cover up the appearance of plugs, we don’t see any reason to remove them. (Please see cases and video clip to see our results with the Natural Hair Plug Correction).
Please read our study Surgical Correction of ‘Plugginess’ in Hair Transplants, published in Hair Transplant Forum International, 2006.