FUG

The reality is, most individuals can be successfully transplanted using their own existing hairs, in sufficient quantities, to create significant improvement in the treatment of hair loss. The average male patient presents with over 8000 donor grafts total (over 16,000 hairs) - a significant number that can allow for two procedures of 2600-plus grafts, then subsequent smaller procedures. 
However, given the amount of reparative work I perform, I do see individuals who, because of excessive scarring and/or inefficient transplanting techniques, have a serious deficiency of an adequate amount of hair for transplanting. While these individuals can be helped even with conservative procedures, they strike me as those who would benefit most from cloning techniques of the future that could provide much larger - potentially unlimited - numbers of donor hairs or cells to initiate the growth of new hairs.

Posted by Jeffrey S. Epstein, MD, FACS

Yes, it is true that many surgeons require the patient to have a shaved head for the transplant procedure. However, I find that most of my patients find this a significant inconvenience for it makes it more difficult to conceal the transplanted areas for the first few weeks post-procedure. Thus, while it takes a bit more time to perform the procedure with the hair left long, I am able to work between the existing hairs most of the time without requiring the shaving of the hair.
It is NOT true that shaving the head permits more accurate placement - for in fact, with the shaved head, it is more difficult to assess the natural direction as well as distribution of existing hairs. However, especially in patients with fine hairs, the procedure can proceed a bit quicker with the hair cut short (similar to how you wear it), but once again, I do not require this of my patients.

Posted by Jeffrey S. Epstein, MD, FACS

It is not a problem, given the state of the art technique I utilize, to place 70 follicles per square cm-  which translates into around 35 follicular  units (or grafts) per square cm.  The length of time to perform the procedure and its cost is dependent upon the total number of grafts transplanted-  which likely will range from 1800 to as many as 4000+, depending upon your degree of hair loss.  With a Class 3v, typically 2400 to 2800 or so grafts would be indicated, the cost which I will have a Patient Advisor from my office provide you with.  Once performed, you can return back home to France as soon as the very next day, and 3 to 4 months later the hairs will start growing in.

Posted by Jeffrey S. Epstein, MD, FACS

With FUE techniques, additional grafts can be obtained above and beyond what can be obtained with a strip procedure. When FUE is performed at the same time as a strip procedure, depending upon the donor area, FUE can provide an additional 250 to 400 grafts per procedure. In addition, stand-alone FUE procedures can provide anywhere from 600 to as many as 1800 additional grafts from areas that normally would not be included in areas of donor strips.

Posted by Jeffrey S. Epstein, MD, FACS

It is difficult to significantly change the growth of a cowlick- yes, some of the hairs can be removed and replaced with transplants at a more desirable angle, however you will lose a moderate amount of the density in the area.

Please feel free to email me some photos.

Posted by Jeffrey S. Epstein, MD, FACS

Very impressed.

I use a combination of lateral and vertical slits, depending upon the area of the hairline being worked upon. This without a doubt provides the most aesthetic and natural appearing (and fullest looking) results.

I usually use sutures- they are more difficult to apply properly, but typically result in a finer line scar as well as are much more comfortable. This is why the overwhelming majority of surgeons use sutures, and as a plastic surgeon, I prefer them.

Thanks for the compliment about my work on the children. It would be a pleasure to possibly have you as a patient.

Posted by Jeffrey S. Epstein, MD, FACS

I also have read about another doctor's approach.  Megasession + dense pack. Equal greatest amount of hair and greatest possible coverage. Is that true? And can u do that? 

Yes, I personally perform all procedures.  I typically perform 2 of these hairline advancement procedures every week-  from patients the majority who fly in from out of town.

For most patients, depending upon the amount of lowering desired, 1700 to as many as 2300 or so grafts are indicated.  This number is necessary in order to achieve adequate density and a natural appearance-  otherwise you'll just need a second procedure to achieve the sort of results with which you'll be satisfied.  Because I use such small recipient sites-  0.5 to 0.7 mm in most cases-  I am able to achieve the closest placement of grafts for the best density. 

For these cases, I see no reason to use FUE-  instead, the fine line scar from the strip (FUM or FUG) procedure is essentially undetectable unless you were to shave your head, and the number of grafts I can obtain is simply great and these grafts tend to have a higher density.

I encourage you to visit, if you have not already, the page on my website devoted to this procedure:  http://www.foundhair.com/pages/hairlineadvancement.html

Posted by Jeffrey S. Epstein, MD, FACS

Depending upon the size of the donor site, anywhere from 25 to 45 or so.  I use very small fine sutures for the most aesthetic results.  For 2000 grafts, typically 30, for 3500 grafts, typically 45.

Posted by Jeffrey S. Epstein, MD, FACS