Hair loss is not exclusive to any one ethnic group, and certainly people of African and Caribbean ethnicity will have hair issues. Sometimes this is a genetically high hairline, other times it can be thinning or receding of the hairline or other areas of the scalp due to genetics or traction. In addition, there is a higher incidence of certain types of “scarring” alopecias which need to be first diagnosed properly, then treated medically prior to any hair restoration that can possibly be indicated.
Hair transplant surgery is an effective permanent way to restore hair growth, but many people of African or Caribbean descent are concerned about getting good results from a transplant procedure- this is for good reason, given that these procedures due to the typical curliness of the donor hairs, can be more challenging and many surgeons do not have sufficient experience or technical skills for successfully working with these hairs. There are certain considerations that must be taken when performing hair transplant surgery with black hair. Given the years of experience, Dr. Epstein and the team at the Foundation for Hair Restoration have an excellent grasp of the common concerns and challenges facing this ethnic groups of patients in dealing with hair loss, and it is possible to produce excellent results for patients with hair transplant surgery. This includes not just the use of certain devices for FUE graft harvesting, but also the aesthetic aspects of hairline design, graft planting, and more.
Overly high genetic hairlines can be effectively lowered with hairline lowering/forehead reduction surgery. This is a one-step procedure, one of which Dr. Epstein specializes in, in which the hairline can be lowered by as much as one inch or more. Finally, using modified transplant techniques, eyebrows and beards can be aesthetically and safely restored.
* All patients are unique and individual results may vary.
Common hair challenges and hair loss problems for african and caribbean patients
Hair Loss and Thinning Hair
Both men and women can benefit from traditional hair transplant surgery, with a few special considerations. FUE, or follicular unit excision or extraction, is most commonly used as the technique for obtaining the donor hairs. This involves the removal of individual grafts containing from one to four hairs, avoiding any linear incision scar and allowing most of our patients to even shave the back and sides of their head without any problem. In some women, the FUT, or follicular unit transplantation, approach is used, whereby a narrow strip of hair is taken from the back of the scalp which typically heals as a fine line scar. In either technique, the hairs are dissected under a microscope to assure they contain the ideal number of hairs. These hairs can then be carefully placed into recipient sites made by the doctor, following the pattern and direction of growth as he determines.
ABSENT OR THIN EYEBROWS
The eyebrows are an important facial feature, and overly thin or completely absent eyebrows are a problem for some African and Caribbean patients. The transplant procedure is very delicate, with hairs taken from the scalp requiring perfect placement into half-millimeter incisions. Hairs must be placed at the right angle for a natural appearance so that they grow normally following the procedure and need to be trimmed once every 10 days or so. These procedures range in size from 100 to as many as 350 grafts per side, depending on the existing hair and the desired appearance. Note that consideration will be taken as to the curl of the donor hairs, such that the finest, softest curled hairs are typically used for eyebrows.
OVERLY HIGH HAIRLINES IN WOMEN
Hair transplants for Afro-Caribbean women is one way to lower overly high or receded hairlines, which can occur due to genetics, traction, hair breakage from chemical treatments, or female pattern hair loss. Another highly effective way to lower the overly high hairline, provided it is stable and not receding but rather present at birth (a common ethnic feature in women from certain parts of Africa in particular) is hairline lowering/forehead reduction surgery, also called the surgical hairline advancement (SHA). This is a 90-minute procedure performed under anesthesia, that can bring the hairline forward by an inch or more, with unsurpassed density and instantaneous results. Most patients after the hairline lowering surgery are presentable a day or two after, and sutures get removed at one week. To learn more about this procedure, please visit.
Some patients are concerned about preserving an intricate hairstyle, weave, or relaxed hair during the procedure. An experienced surgeon can work between these styles, avoiding the need for cutting off locks or braids in most cases. It is recommended that relaxers not be used on the hair for the first month after a procedure, as these harsh chemicals can damage all hair.
Are You a Candidate?
Dr. Epstein has treated a large number of patients of African and Caribbean ethnicity. Having practiced in Miami since 1994, his patients are from not only throughout south Florida and the Caribbean, but also he regularly treats patients who travel from cities such as Atlanta, Charlotte, Boston, Washington DC, LA, and more, as well as patients from London, Amsterdam, and throughout the African continent.
Consultation with the doctor can be done by webcam or by photo reviews, allowing patients to travel to Miami for a procedure that requires just a two or three day stay. In consultation, your individual case will be evaluated and recommendations provided, so you can be assured that you are an appropriate candidate and receive the best procedure for your situation.
Your Hair Transplant Consultation
During your consultation- in the office or by webcam- you will have the opportunity to discuss your goals for the procedure. Dr. Epstein will evaluate your hair loss pattern and recommend treatment options that will work best for meeting your goals. Your consultation is the time to get to meet the doctor, ask questions and express any concerns you have about the process. If you’re concerned about the possible results, be sure to take a look at Dr. Epstein’s before and after photos to see the natural restoration results that can be achieved.
The Hair Transplant Procedure
Hair transplants to the scalp, beard, and eyebrows are usually performed under local anesthesia with oral sedation. On the morning of your procedure, the area to be worked on will be marked out, with your input. The donor hairs are then harvested one at a time using FUE techniques, then the hairs placed under the microscope to assure they are the ideal size and contain the wanted number of hairs. Once the recipient sites have been made by the doctor (the most important aesthetic steps that determines the pattern, direction, and angulation of growth), the grafts are then placed one at a time, leaving no visible scarring once healed. The use of the smallest possible recipient sites- typically 0.5 to 0.7mm- assures the quickest healing and essentially no scarring. A procedure typically takes four to seven hours to perform.
Hair Transplant Recovery
Recovery from hair transplant surgery is usually quite easy, and patients can go back to normal activities as soon as the day after surgery, except for strenuous activity, which should be held off until the 6th day. There will be visible signs of the procedure for about a week, with tiny crusts appearing at the site of each graft before falling off. The transplanted hairs fall out a few weeks later but will begin to grow back permanently about four months later.
African & Caribbean ethnic hair transplant FAQs
In the past, a linear scar following hair transplant was a problem for male African American patients. Now, with the FUE (follicular unit extraction) method, this is avoided. Instead of a strip of tissue, follicles are removed individually, resulting in tiny dot scars typically unnoticeable. In the case of a patient with a prior old linear donor site scar, its appearance can be improved using either scar repair, hair transplantation, and or SMP or scalp micropigmentation.
Hairline shape and design is an important factor in your overall hair transplant satisfaction, and Dr. Epstein will solicit your input on this before the procedure to ensure you are on the same page about your desired hairline. African American Hair transplant photos can help give you an idea of the possible hairlines and can serve as points of reference for your consultation.
That all depends on your degree of hair loss and your desired results. Typically however, because the hairs are curly and achieve greater coverage, a smaller number of grafts will be required to achieve the same result on a patient with straighter hair.
Hair transplant surgery is very safe these days when performed by an expert, but there are always small surgical risks to consider. Rarely, reactions to anesthesia, bleeding, unfavorable scarring, or poor growth of hair follicles can occur- fortunately these are very atypical risks in our hands. Because of the way the hair grows in African American and Caribbean patients, there is also a small chance for ingrown hairs or folliculitis, which can be easily treated if they occur. A history of keloid scarring does not seem to be a risk factor for any complications with hair transplantation. Even in the beard areas, Dr. Epstein has achieved excellent, complication-free results with hair transplants, an area that was at one time a concern of his but with a number of cases performed he has learned that such concerns were not warranted.
The use of minoxidil and growth factors both seem to work in certain men and women to slow down or even reverse some hair loss, while laser light therapy results are not as clear. Finasteride can be an effective therapy but should only be used in men. The use of growth factors at the time of a transplant certainly accelerates healing and may be used ongoing as another potential way to slow down future hair loss. We are also investigating the use of fat therapy- using an individual’s own fat- to help treat a variety of scarring alopecias. This is all investigative therapy but seems to hold tremendous promise as we continue with our research. Your candidacy for these different therapies will always be evaluated by Dr. Epstein.
Below is a review of the most important hair challenges and hair loss problems in African-Americans and Caribbean patients and information on how Dr. Epstein may be of service in addressing and solving these common occurrences.
Dear Dr. Epstein, clinicians and all staff members of FHRPS
I would like to thank you all for being apart of my hair restoration journey. To begin with, I researched FUT and surgeons who specialize in African American hair restoration for approximately 2 yrs to ensure that I would make the right choice and you all have proven that to be true. From first contact till this very day, Dan (my pt advisor) has been very efficient in responding to my constant questions. On the actual day of my procedure, I felt extremely comfortable and tended to by all of the team. Kyle and another young man came in to greet and prep me (jokingly asking me to put on a “Prada” hospital gown).Linda, administered the local anesthetic so gently I didn’t feel any real pain, during this time, Vivian was kind enough to sit with me to help me remain calm. During the actual implanting of the follicles, I had Jose working on my L temple and Elsita working on my R temple simultaneously and the friendly banter between those two was not only a source of relaxation but comical relief. Throughout the entire procedure, we engaged in conversation which made the 8hr procedure seem shorter and the whole process seem so casual. Dr. Epstein, perhaps the most sincere display of the day was when everything was complete and all 1600 grafts were transplanted, you examined my hairline and was unsatisfied with the placement of 12 grafts. 12 out of 1600 seems so minute, yet you bought me back to the chair and replanted them to your liking. That definitely demonstrates great work ethics. Lastly, I want to acknowledge the gentleman (Carlos, I hope I remembered his name correctly), who not only patiently explained post-op care and medication but also organized a cab service to take me back to the hotel, he was kind enough to stabilize my gait as I walked from the office to the car. The following day I returned to the office to wash my hair. Alicia was pleasant as she thoroughly explained how to wash my recipient site and gently cleansed my hair around the sutures of the donor site.I know my description might sound rather odd, but as far as surgeries go, this experience was actually exciting. I felt very well catered to by the warm and friendly staff.Its only been 10 days since my procedure, my donor site is still tender which makes it difficult to sleep and workout but that’s to be expected. My recipient site (temples and hairline) alternates between numbness, tingling and extremely itchy but i think that’s all part of the healing process so its something i’m learning to deal with. Thank you all so much for your time, patience and energy. I have no doubt that this has been a life changing gift.
An Expert in Afro/Black Hair Transplant
When choosing between African American/Black hair transplant doctors, many patients seek out Dr. Epstein for his expertise in fighting hair loss and his extensive experience in providing effective surgical and non-surgical solutions for African American and Caribbean patients. Dr. Epstein’s patients visit him from all 50 states and over 75 countries for expert hair restoration. If you’d like to learn more about hair restoration in Miami (305-666-1774), call our office today to schedule a virtual or in-person consultation.