Hair Transplant Specialist Miami
Hair transplantation is a surgical procedure which restores hair to thinning or bald areas of the scalp- and if desired, the beard, eyebrows, and even chest- using the patient’s own hair. Hair can be taken from the back and/or sides of the scalp to serve as donor hair, and in the occasional patient, the donor hairs come from the chest and or beard. This hair is genetically programmed to be permanent and is not susceptible to the hair loss process. Hair transplant surgery represents the only proven way to permanently restore hair to bald or thinning areas. We hope that sometime in the next 10 year or so, our research work with stem cells will provide a more permanent solution, but until then, transplants remain the gold standard- proven to provide long-term results, something Dr. Epstein has seen in his years of performing these procedures.
There are two different techniques currently available in hair transplantation today: follicular unit extraction or FUE, and follicular unit grafting or FUG. The best technique will depend on the individual patient, his/her pattern and degree of hair loss, as well as the patient’s personal desires. With over 23 years devoting himself to the hair restoration field, Dr. Epstein is considered one of the world’s experts in performing both of these procedures, not only technically but all importantly aesthetically, able to create natural appearing hairlines. FUE, using the E-Fue System custom-designed by the Foundation, is the most common technique we perform, due to the outstanding results and the absence of any linear donor site incision. When performed properly, both FUE and FUG are capable of creating truly aesthetic natural appearing results. This is where the skills and aesthetic eye of the surgeon are so important, for it is the surgeon who ultimately is responsible for determining the naturalness of the procedure.
Candidates for Hair Transplant Surgery
Hair transplant surgery is most commonly performed for individuals with male pattern baldness or female pattern baldness. It is generally not advised for individuals with diffuse hair loss, because sufficient donor hairs from the back and sides of the scalp must be available for transplanting. Individuals with thin or missing eyebrows, mustaches or beards, as well as those with hair loss due to scars, injury or prior surgery- including previous hair transplants- are also appropriate candidates. Good health and realistic expectations are also important, which will be explained by your surgeon in consultation. Hair transplants can be performed on individuals of a wide range in age, from the early 20s to the 70’s and beyond. In general, most men are best treated with the follicular unit extraction technique using our custom-designed E-Fue System, since it avoids the making of a linear donor site incision scar. A particular technique Dr. Epstein has developed is the Hybrid approach, whereby a relatively small donor site incision is performed in the back of the head for FUG grafts, which are then combined with FUE grafts – the main advantage being the absence of a need for shaving the entire head yet obtaining as many as 2000 or more grafts. For patients who already have had a prior FUG procedure, this technique may be the best approach, however this will be discussed in consultation.
Techniques in Hair Transplantation: FUG and FUE
The most common technique in hair transplant surgery today is known as follicular unit extraction (FUE), due to its main advantage being the absence of a linear donor site incision. Instead, the individual follicular units are extracted one at a time directly from the scalp. There are a variety of ways for obtaining the grafts- Dr. Epstein utilizes a combination of the most sophisticated devices, relying primarily on our custom-designed E-Fue System. Note that the NeoGraft® company routinely sends doctors to Dr. Epstein’s and Dr. Kuka’s FoundHair Training Course, for training in state-of-the-art FUE as well as recipient site creating techniques. When performed properly, FUE grafts have excellent regrowth. While the entire back and/or sides of the head needs to be shaved in order to allow more than several hundred grafts to be obtained (with smaller procedures, only narrow areas of the scalp need to be shaved allowing overlying hair to cover over these donor areas), these sites tend to heal up in a matter of days, allowing patients to be presentable without the wearing of a hat. Because of the additional work and expertise involved, FUE is a somewhat more costly procedure, but for most patients represents a small additional investment to assure the best long-term outcome and maximum satisfaction.
The other hair transplant technique is follicular unit grafting (FUG), sometimes referred to as strip harvesting or the strip technique. With FUG, a single donor site strip, ranging in length from 5 to 25 cm, of hair-bearing scalp is removed from the back or sides of the head. From this strip are dissected hundreds to more often several thousand tiny grafts containing anywhere from one to three, sometimes four hairs each. These grafts are then implanted into tiny slit incisions in the bald or thinning area where they can then grow after several months just like normal hair. This procedure is typically performed with local anesthesia and oral sedation – although the occasional patient chooses twilight sedation, something that the Foundation is able to offer in our certified operating rooms- and may take anywhere from three to eight hours to complete depending on the number of grafts involved. In order to get the best result with the donor site in FUG, Dr. Epstein and Dr. Bared are able to utilize plastic surgery closure techniques.
In order to assure an aesthetic result with any hair transplant, whether FUE or FUG, the key step is the making of the recipient sites- where the surgeon can determine the pattern, distribution, and angle of hair growth to achieve the most natural appearance. Here is where a surgeon, particularly a surgeon who is board certified in facial plastic or plastic surgery and passionate about hair transplantation, can utilize the necessary aesthetic skills to make the difference between an excellent and a truly outstanding result.
Other techniques in hair restoration include surgical hairline lowering, also referred to as forehead reduction or hairline advancement, most commonly performed on women but also on the occasional man with a stable frontal hairline; repair of prior scalp reductions and other scalp scars; beard and eyebrow hair transplantation; the repair of scarring from prior plastic surgery; and hair transplant scar repair.
Recovery & Results
There is little downtime or recovery associated with hair transplant surgery. Most patients are able to return to work and other normal activities within just one to two days, though strenuous physical activity needs to be postponed for five days. Occasionally, patients develop some swelling in the forehead, and there are tiny crusts at the site of each graft that fall off by seven to eight days. The transplanted hairs typically fall out at three weeks, then will start to regrow at four to six months. After about six to nine months, as the hair continues to grow, it takes on a fuller look, and will continue to so for the next year. Depending on the patient’s goals, occasionally a second procedure is desired to achieve more coverage, which can be performed a year or more later.
Dr. Epstein is one of the world’s most renowned leaders in the field of hair transplantation and hair restoration, and has personally helped develop the techniques utilized by his partner Dr. Bared, as well as Dr. Kuka. Over 70% of his patients travel from across the country and the world to be treated at our Miami or NYC clinics. You can schedule a consultation by calling the office at (305) 666-1774 in Miami or (212) 759-3484 in New York, or by contacting the office through our online consultation form or email [email protected] We are here to assure that you have not only the best outcome but also the best possible experience.