Hair Transplantation for hair loss
Surgical hair restoration
Hair transplant is an elective, usually cosmetic but sometimes reconstructive surgical procedure that moves individual hair follicles from one part of the body, known as the donor site, to a different part of the body, known as the recipient site.
Once moved, these transplanted hairs will continue to grow. In most cases, the recipient area is an area of hair loss or a receding hairline, but it can also be the eyebrows or the beard. Similarly, in most cases the donor area is the scalp– usually, the back and or sides where the hairs are typically genetically programmed to be permanent, but it can also be other areas of the body in what is called body hair transplants, such as the beard or chest. The result when transplanted into the scalp is permanent, natural-appearing hair restoration.
Note that, in surgical hair restoration, the donor hairs must come from the same individual to ensure that the hairs will not be rejected. These are typically painless procedures that take one day to perform, with recovery periods of one to seven days depending on the type of work performed. Each hair is transplanted in the form of a graft, consisting of one to four, most commonly two or three hairs, as per the natural grouping of hairs as they grow in the scalp.
A Hair Transplant Specialist
Dr. Jeffrey Epstein
Since 1993, during his facial plastic surgery fellowship, Dr. Epstein has focused his aesthetic surgery practice on the treatment of hair loss in men and women. As a specialist in the field, Dr. Epstein is able to offer the full scope of medical and surgical therapies, all of which are described on this website for the Foundation for Hair Restoration.
Dr. Epstein has evaluated in consultation in person as well by webcam and photo reviews well over 100,000 with hair loss and other hair issues, and this includes more than 15,000 on whom he has performed hair procedures that include scalp and eyebrow and beard transplants, reparative procedures, and hairline lowering surgeries. These patients from all 50 United States and over 85 countries have put their trust in knowing that they will be treated with the best approaches, whether preventative or restorative.
Working with Dr. Epstein is his business partner of 9 years, fellow board-certified facial plastic surgeon Dr. Anthony Bared. In addition, he works in consultation with his wife, European board-certified plastic surgeon Dr. Gorana Kuka Epstein who like Dr. Epstein is a Voluntary Assistant Professor at the University of Miami’s Philip Frost Department of Dermatology and Cutaneous Surgery, as well as the Department of Otolaryngology. Dr. Kuka Epstein specializes in the evaluation and treatment of hair loss in women as well as the use of fat and other cell-based cutting-edge therapies for the treatment of hair loss, and who performs procedures in her Belgrade, Serbia office.
Learn more about hair transplants in the links below.
- Hair Transplants
- Surgical Hair Replacement Process
- Receding Hairlines
- Bald Spot Treatment
- African American Hair Treatment
- Procedures for Women
- Tissue Expansion
- Facial Hair Transplants
- Eyebrow Transplants
- Read About the Procedures
Aesthetic FUE results as demonstrated in this patient after 1700 FUE grafts.
One day after a no-shave FUE procedure of 1700 grafts. With the no-shave, patients are fully presentable the very next day.
Hairline advancement photos
* All patients are unique and individual results may vary.
Most common technique
Follicular Unit Extraction
The most common technique for hair transplantation is Follicular Unit Extraction or Excision (FUE), a technique for which Dr. Epstein and his team of assistants and fellow doctors are recognized for their expertise in achieving the highest rates of regrowth (typically 90% or greater) with minimal donor site scarring.
This expertise is reflected in not just the consistent results, but also in the popularity of Dr. Epstein’s and Dr. Kuka Epstein’s FoundHair training course, which trains hair transplant surgeons in the use of several of the most sophisticated FUE systems including the WAW-oscillating system with a hybrid blunt punch (developed by a Belgian colleague) and the Trivellini oscillating system also with a hybrid punch (developed by a Paraguayan colleague), as well how to achieve aesthetic-appearing results. The other much less common technique is Follicular Unit Transplantation (FUT, also known as the “strip” technique) which is still occasionally performed in women primarily.
How do hairs get transplanted?
Up to 2,500 grafts in a single session
We are able to transplant hundreds to as many as 2,500 grafts (each graft typically contains just over two hairs) in a single, typically painless procedure lasting three to as many as 10 hours. Larger procedures or those performed using a no-shave FUE approach will sometimes require a second day of surgery.
Each procedure is performed in our accredited Miami office, procedure suite that helps assure a sterile, safe, comfortable experience. Because it is accredited as a surgical facility, we are able to provide if desired twilight sedation for the procedure administered by our anesthetist, although most patients choose oral sedation to go along with local anesthesia for their procedure. The all full-time team of assistants who work with the doctor includes three Nurse Practitioners, two Registered Nurses, and additional hair technicians who average more than 13 years working with Dr. Epstein and the Foundation.
Numbing up the scalp
While the notion may hold that a hair transplant is a procedure that does not utilize or require anesthesia, it is important to remember that a hair transplant is indeed a surgical procedure and that it may be painful to undergo without completely numbing up the scalp so that nothing gets felt at all.
Administering anesthesia before a hair transplantation procedure is similar to what one might experience at the dentist’s office- although the overwhelming majority of our patients tell us that it is much much less uncomfortable than the dentists. The patient is typically awake and conscious and can be given a light sedative, such as Ambien and Valium, to keep them calm and rested throughout the entire procedure. A local anesthetic is normally given, through a series of injections into the patient’s scalp, administered by the Wand, a computerized device that slowly injects the anesthesia below the threshold of sensation, where the donor site for the hair follicles is to be extracted. By using a local anesthetic, the patient will feel nothing, and thus not need to undergo IV sedation. That being said, patients do have the option, should they choose, undergo twilight sedation, a form of IV sedation administered by an anesthetist. At this level of sedation, the patient remains asleep for a period of time, until the procedure is complete. Twilight sedation is not commonly chosen for hair transplant procedures, but is a viable option at an additional fee, should the patient choose. Due to the risks involved, this form of sedation is not offered beyond six hours, and in preparation, the patient must not eat or drink for 8 hours prior to the procedure.
Procedure: Hairline Advancement
Procedure details: At just one day after an FUE procedure, when performed properly, healing has already begun.
* All patients are unique and individual results may vary.
Hair transplant recovery
Return to work after procedure
After the procedure, patients leave our office without any bandage, with most able to return to work and most regular activities two to three days later, although for discreteness our patients may want to take five to seven days out of the public eye. With the no-shave FUE patients are typically presentable the next day. Resumption of full exercise is permitted on the sixth day. The transplanted hairs typically fall off at two weeks, leaving the patient looking essentially unchanged from before surgery, then start to regrow four months later. Occasionally patients will return a year or two later for further filling in to achieve greater density or a wider area of coverage, but in others, a subsequent procedure is only performed years later if there has been more hair loss.
Because in most cases hair loss is progressive for the rest of an individual’s lifetime, our patients are advised on preventative therapies that may include laser light, finasteride, and or minoxidil either orally or topically, Growth Factors, and other therapies as they become available.
Repair a previous hair transplant
Choosing to repair a previous hair transplant can be a big step for some patients, although once taken, can be extremely gratifying. As hair transplant techniques have improved over the years, along with technology utilized in the procedure, so has the quality that has been available to patients seeking a hair transplant procedure. Therefore, reparative procedures can increase the natural appearance of previous to repair previous, sometimes inferior results.
For many patients, the result of the initial hair restoration is a “pluggy” look. Should the patient choose, the old hair plugs can be completely removed, and a new procedure can be performed utilizing the latest methods of treatment that were previously unavailable.
There are many treatment options currently available for patients seeking revision hair transplantation. The first is Surgical Hairline Excision, which involves the removal of a portion, if not the entire frontal hairline to begin anew. The scalp is then sutured back together through plastic surgery. Tissue expansion is another method used in some cases where the skin of the scalp has become tight and must be stretched out so that the entirety of the scar that has formed from the previous surgery can be excised. Another option is Endoscopic Ridge Reduction, a method personally developed by Dr. Epstein, which was designed to remove the ridging (thick tissue) commonly found along the hairline where plug-grafts were inserted previously. Like the Surgical Hairline Excision, the Endoscopic Ridge Reduction is a very simple procedure with a quick recovery time of about 2 to 3 days.
Ready for your Consultation?
Plan your entire procedure and other treatments through a virtual consultation with the doctor, or through a review of your photos. Please complete the contact form or you can contact the office directly [email protected] or call our office:
Hair Transplant Cost
Hair transplant prices can vary dramatically. One patient may require fewer than 1,000 grafts while another may require more than 4,000 grafts transplanted. Without a one-on-one consultation with a particular patient, quotes for hair restoration prices can be misleading.
You can, however, get an idea of average hair restoration prices by looking at statistics. According to the American Society of Plastic Surgeons (ASAPS), the national average surgeon fee for hair transplants in 2005 was $4,755. The American Society for Aesthetic Plastic Surgery (ASAPS) quoted a slightly higher surgeon fee of $5,033 for hair transplantation in 2005. It’s important to note that these are surgeon fees only and do not include additional expenses such as those for the facility, the anesthesiologist, and so on.
Frequently Asked Questions
After a certain number of days, it will be okay to resume blow-drying your hair after a hair transplant. We do suggest not doing any blow drying over the first several days, two to three days in other words, after the procedure. The very next day after the procedure, most patients do return for a quick check-up and hair wash at each of our doctor’s offices to ensure that everything looks good and is healing well. But, before using a blow dryer please contact and speak with a nurse or doctor at your specific doctor’s office to ensure that it is safe.
After a few days, a hairdryer can be used without heat and on a low setting and, of course, care must be taken not to damage the follicles. Toward the end of the first week, once the grafts have healed up nearly 100%, normal blow drying can resume, again, with little or no heat. Please contact your doctor or nurse specifically to find out exactly when they feel in your specific case you would be ready to continue using a hairdryer or blow dryer.
Over the last several years, hair transplant procedures have become larger and larger with it possible to transplant as many as 4,000 or more grafts in a single procedure. The factors that determine the greatest amount of grafts include, of course, the need for such a large number of grafts, i.e. more density of hair loss, the donor supply with more dense donor scalp being able to donate more grafts, and lastly the proficiency of the surgeon and of his team, for hair transplantation is clearly a team effort requiring an extensive amount of work by a lot of individuals. Typically for most patients with male pattern hair loss, procedures of 2,200 up to 2,800 grafts are most common and for women, the procedures more typically are 1,600 up to 1,800 grafts, although this number can go lower and higher. The degree of hair loss is an important determining factor for how many grafts can be safely transplanted because if too many grafts are placed in too small of an area or into an area that already has existing hair, there can be a risk of poor regrowth, especially if the trauma to the scalp is increased by the use of large incision blades and also due to shock loss of existing hairs. An experienced surgeon can counsel the patient and avoid these complications.
Hair follicles typically grow between one and three hairs per follicle and sometimes four hairs, although very rarely.