Can the long term results be revised after a Juri flap?

Question:
I had a Juri flap procedure in the mid-80’s when my hair was a lot thicker. Now, as I’ve aged, I have noticed more thinning around the flap, and it is beginning to look odd. I have also noticed thinning behind the flap and in the crown. I would like to consider hair transplantation to blend this in and give me a more natural look. Can this be done and what is your best estimate of how many grafts it might require? Also can this be done with just one surgeon or does it require more assistance?

Answer:
This is not an uncommon occurrence after having a Juri flap, but it can certainly be improved with hair transplantation. As more of your natural hair is lost around the flap, the abrupt edges of the flap become more noticeable. The goal would be to create a transition zone around the flap to make it appear more natural. This can be done with follicular unit transplant grafts. This type of procedure is very tedious and labor intensive, especially since grafts will need to be placed among existing hair and the angulation gradually changed especially in the front. One surgeon could not perform such a procedure alone and would typically require the assistance of at least 4-5 individuals including a registered nurse and hair technicians. I personally perform the donor site harvesting and design and create the recipient sites along with my assistant surgeon. In the meantime, the nurse and hair technicians are busy cutting the tiny grafts. My assistant surgeon and I both start the placing of grafts and trade off our positions as the techs, who place grafts admittedly quicker than the doctors, finish the case. I would hope to be able to perform between 2000and 3000 grafts.

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