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Hair transplantation is a surgical procedure which restores hair to thinning or bald areas of the scalp using the patient’s own hair. Hair can be taken from the back and/or sides of the scalp to serve as donor hair. 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.
There are primarily two different techniques currently available in hair transplantation today the FUG and the FUE procedures. The best technique will depend on the individual patient, his pattern and degree of hair loss, as well as the patient’s personal desires. Dr. Epstein is considered performing in FUG and FUE procedures, capable transplant of as many as 3,000 or more grafts in a single sitting. Most importantly, when performed properly, this procedure is capable of creating truly aesthetic natural appearing results. While hair transplantation is often associated with male pattern baldness, surgery can be performed to restore facial hair, including the eyebrows, beard and moustache, and on areas of the body like the male chest.
Hair transplant surgery is appropriate for individuals with male pattern baldness or female pattern baldness. It is generally not advised for individuals with diffuse hair loss, for 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- may also be candidates. Good health and realistic expectations are also important. 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, men under the age of 28 – or any male who likes to keep his hair short – are best treated with the follicular unit extraction technique since it avoids the making of a linear donor site incision scar.
The most common technique in hair transplant surgery today is known as follicular unit micrografting (FUM/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 – although the occasional patient chooses twilight sedation, something that Dr. Epstein’s office is able to offer- and may take anywhere from three to eight hours to complete depending on the number of grafts involved.
In order to assure an aesthetic result, two key steps are required perhaps more than any other in the strip procedure. The first and perhaps most important 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, such as Dr. Epstein who has performed more than 10,000 hair procedures, can utilize the necessary aesthetic skills to make the difference between an excellent and a truly outstanding result. The second is the donor site closure technique- where plastic surgery methods are able to help minimize the visibility of this incision.
Follicular unit extraction (FUE) is the other commonly employed technique in hair transplantation, one that over the past five years has significantly grown in popularity amongst Dr. Epstein’s patients due to its 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 the SAFE SCRIBE® drill system supplemented by manual punch techniques. This is a bit of a more time consuming technique, but in Dr. Epstein’s hands it provides grafts the highest quality. Also, having several methods for obtaining grafts assures that different hair and patient characteristics can be accommodated for.
The advantage of FUE over FUG is that FUE does not result in a fine line scar in the donor area, allowing the hair to be worn as short as desired. Instead, FUE typically results in many tiny dot scars on the scalp that in around 70% of patients are undetectable even with the head shaved. 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 quite quickly, allowing patients to be presentable in just a few days. Because of the additional work involved, FUE is a somewhat more costly procedure.
Other techniques in hair restoration include surgical hairline lowering, also referred to as forehead reduction or hairline advancement, usually used only for women; repair of prior scalp reductions; facial and eyebrow hair transplantation; and hair transplant scar repair.
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 should 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 ten 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 required 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. Over 70% of his patients travel from across the country and the world to be treated by him. Contact him today for 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.