Pluggy hairline removal / donor restocking, 2 repairs with Dr Ball (Maitland Clinic)

[Paul_]

Hello everyone,

I hope this post will help some of you that are going through the same stress and discomfort as I suffered.

Background:

• I am a NW 3/4, with a very obvious bald crown and an odd receding hairline “gulf” right in the middle of the hairline
• After several years of using topical minoxidil, which helped somewhat, I took an emotional decision to get a hair transplant, after having done relatively little research. I had it done in Malaga, Spain, in a “good value for money” clinic, in Feb’23
• They did an awful bit of work on me, including not listening to what I asked of them – I ended up with about 1200+ grafts hairline “reinforcement” they strongly recommended, which did NOT cover my balding areas in front well, plus I had nasty multi grafts in front, pitting and ridging. And the crown with thinner coverage, 1300+ grafts added (so they said, it turned out to be much less). The worst part is that I was overharvested on the sides of the head. I always kept my hair short on the sides and at the back, and having to hide it under a messy, no-shape hairstyle now was killing me

Options for repair

• All the research I did not do before my surgery, I did afterward – to my relief I discovered that hairlines can be removed and donor areas repaired, by very experienced FUE surgeons
• I discarded SMP on donor as that is not the best long term option, for me at least
• I checked with the most renowned clinics in Europe about removing the implanted hairline grafts and restoring my donor with them, and got all kinds of answers
• From the positive answers, after much due diligence and a detailed talk with David Andersen (senior advisor at TMC, who helped me out a lot, guided me and put up with my nervous questions) and Dr Maitland Ball himself, they thankfully confirmed they would take my repair case

My two repairs with Dr Ball / TMC

• 9 months after my first botched transplant, I flew to the UK and met with Dr Ball the night before surgery for my final check-up
• He was kind and empathetic (same as the first time we talked), answered all of my questions about the surgery, we discussed risks, technique, equipment, steps, team. He is extremely knowledgeable and it shows. We agreed on a 2 step surgery to remove the densely packed implanted hairline and reuse the grafts to fix my donor
• The first step removed 759 grafts, as long as the extraction punches do not overlap and fixes the left side of my donor (most damaged).
• The second step (659 grafts, out of which ~50 from my crown) was 4 months after, once the skin had healed
• The days of surgery involved Dr Ball assisted by 6 (yes, 6!) Technicians (most clinics use 2, cutting cost and taking shortcuts at your expense). They had clearly been trained by Dr Ball, and had many years of experience
• Dr Ball did the extractions himself, with the most senior technician assisting him, and the grafts were carefully placed in a protective solution, with the rest of the techs carefully cleaning and dissecting them accordingly (e.g. a 4-hair graft was split in 2 x 2-hair grafts, so we could use them better for restoring the donor)
• The extraction was not simple, the grafts were badly angled and placed. I even had “piggybacked” grafts, which were placed one on top of the other. Dr Ball effectively did complex mini-surgery on me, opening up the skin over the grafts, removing the one on top and the one growing under the skin, one hair/root at a time. I would have developed cysts and infections and would have needed such surgery later on, had it not been for Dr Ball’s keen eye
• Once that was done, the next step was creating the sites where to place the grafts in my donor area where I had bald extraction spots, which Dr Ball did with a blade.  I had multi-extractions one next to the other, it looked patchy and moth-eaten
• The last step was done by the techs under Dr Ball’s guidance, where they used all the different types of grafts by hair count (1’s, 2’s and 3’s, “strong” and “fine” types) to best fill the holes in my donor area. The level of coordination and focus among them was outstanding
• Both surgeries took ~8h

Now (6 months after left side repair, and 2 months after right side repair)

• Healing quite nicely along the hairline, and my donor looks normal again, thanks to Dr Ball & team’s technique. I followed the post-op instructions fully, and am using a silicone based anti scar cream now as well in addition
• While my hairline looks as messy as it did before, I can tell you the relief I am feeling is tremendous. My skin feels normal again, without ridging and pitting. I can cut my hair short and go outside without getting odd looks

I hope this will help some of you here. It’s a terrible feeling to go through a botched HT, but thanks to amazing people like Dr Edward Ball, David Andersen, and the entire technician team, such abuse can be mended. I am grateful to them, and hope they will be able to help more people in the future. I would not let anyone else touch a single hair on my head now

Photos tagged along the different stages

Initial hairline 

 

After first botched HT and pre-op with Dr Ball (first repair) - awful hairline with multis in front and spaces behind

 

Hairline post-op first repair / extractions with DR Ball

 

Hairline pre-op 2nd extractions/repair with Dr Ball (4 months after 1st repair)

 

Hairline post-op 2nd extractions with Dr Ball

 

Hairline today (15 months after initial botched HT, 6months after 1st repair  and 2 months after 2nd repair)

 

Left side (overharvested after 1st HT)

 

Left  side pre-op, 1st repair with Dr Ball (shaved)

 

Left side post-op with Dr Ball (1st repair)

 

Left side today (6 months post-op)

 

Right side pre-op 2nd repair (shaved)

 

Right side post-op with Dr Ball (2nd repair)

 

Right side today (2 months post-op)

 

All the best,
Paul

[Al - Moderator]

Hi. Welcome to the forums. It sounds like you've been through a real mess. It looks like Dr Ball basically removed all of the first transplant and placed those grafts back into the donor area, essentially reversing the original hair transplant (more or less). But now you are left with nearly the same hairline you started with. Do you have a plan going forward to re transplant the hairline?

 

[Paul_]

Thanks Al

It wasn't pleasant indeed

I made several mistakes: didn't do enough research, grossly underestimated the complexity of HTs, and trusted the first clinic to do a light hairline reinforcement where I had gaps (instead they just packed my hairline needlessly)

After going through all that, I'm not going to retry the hairline. Just care about keeping my donor healthy, and the thin-ish crown grafts are good enough 

I'm just thankful that there are extremely skilled and empathetic surgeons out there like Dr Ball who can remedy such damage

[RTC]

Wow

This is brilliant stuff, they have done a great job.

I was considering going to Dr Ball and met both him and David Anderson. I was impressed with their approach and honesty.

[Melvin- Admin]

Fantastic 👏 

[laverita]

Congrats..Dr.Ball is a good man and David also. 

[baddecisions]

To me, this is the best repair surgery I have ever seen.

[Dsly]

Congrats,great results. I’m in a similar situation and considering different approaches. So basically this was a hair transplant reversal ? Did all the grafts take into scarring?

[donpizmeov]

Sorry to hear about your botched first HT, hopefully that is a warning for other newbies to, as you rightly say, do your due diligence before HT… Otherwise that is a fantastic repair made by Dr. Ball and you must be stoked with the final outcome. The scarring is second to none - out of curiosity, which healing cream were you instructed to apply post OP?

[Paul_]

Thanks everyone for the kind words. All credit goes to Dr Ball, David and the team at TMC

5 hours ago, Dsly said:

Congrats,great results. I’m in a similar situation and considering different approaches. So basically this was a hair transplant reversal ? Did all the grafts take into scarring?

Yes it was. This is something I discussed in depth with Dr Ball, I wanted to keep my goals fully achievable and think long term now. And the best way to restore my donor, allow short haircuts and avoid the risk of further hairloss needing more HTs in the future (hence more donor damage) was to revert the first HT

I can't say if all the grafts took, but many certainly did and didn't even shed. As dr Ball instructed, I ran PRPs in the donor areas for a few months prior to the repairs as well.

Dr Ball estimated that in my case, with the PRPs + soft scarring in the prev FUE extractions + good aftercare, I should end up in the 90s range

I'm 6 months post-op on one side and 2 months on the other so still a long way to go, but it's already looking better than i expected

 

2 hours ago, donpizmeov said:

Sorry to hear about your botched first HT, hopefully that is a warning for other newbies to, as you rightly say, do your due diligence before HT… Otherwise that is a fantastic repair made by Dr. Ball and you must be stoked with the final outcome. The scarring is second to none - out of curiosity, which healing cream were you instructed to apply post OP?

Thanks! Technique from Dr Ball played a big role here, he explained how he chose the punch sizes to fix pitting etc, and then it's aftercare

I used Vaseline as recommended by Br Ball for the first week to prevent scabbing. Afterward switched to silicone gel (Stratamed) 2x day

It's discreet enough to use on hairline and did wonders in my case. Here's a sunny pic, you can't even tell there's a thin layer of gel over it

Edited May 31 by Paul_

[donpizmeov]

Thanks Paul for the information - I was purely interested due to the fact currently a few similiar cases with Bisanga repair patients and to see how their approach differs. I am sure they would all love a similiar outcome to yours!

[BaldReaper]

wow, one of the most impressive repairs I have ever seen

[Dsly]

Any chance you could message me ? I have a few more questions to ask I have a similar case to yours 

[Paul_]

On 6/1/2024 at 3:42 AM, Dsly said:

Any chance you could message me ? I have a few more questions to ask I have a similar case to yours 

Hi, we're both new to this forum and there is a policy for new members blocking this I think

Best talk to one of the admins to allow it

[Berba11]

World class repair. Amazing!

Dr Ball is a top doctor. I'm really pleased that you've managed to overcome that bad first surgery now. Great write up and documentation - will help a lot of people for sure.

[Al - Moderator]

On 6/2/2024 at 6:32 AM, Paul_ said:

Hi, we're both new to this forum and there is a policy for new members blocking this I think

Best talk to one of the admins to allow it

 

Once you get to 10 posts, private messages is unlocked. It's a bit of a pain for legitimate new members, but it's put in place to stop spammers from messaging members.

 

[Paul_]

51 minutes ago, Al - Moderator said:

 

Once you get to 10 posts, private messages is unlocked. It's a bit of a pain for legitimate new members, but it's put in place to stop spammers from messaging members.

 

No prob, thanks Al

[Paul_]

Quick snap, 7 months post-repair, left side (most damaged)

Hair longer, 1 month since last haircut so probably ~2cm, photo taken in strong light + flash

Edited June 19 by Paul_

[Paul_]

Hi, quick update after haircut (guard 2, 5mm)
Looking at my previous snaps, I still feel I haven't shed much after either repair. Maybe it's the oral minox + well vascularized area?

Right side (3.5 months post repair)

Left side (7.5 months post repair)