Miami’s and NYC’s Recognized Male Hair Transplant Expert
Interested in learning more about male hair transplants? 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- a technique called BHT or body hair transplantation. 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 eight to 10 years, the research we and some of our colleagues are doing 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. In nearly every male patient, FUE is the technique of choice, and thus explains why over 95% of the procedures performed at the Foundation are done by FUE. With over 24 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, hair transplants can be performed to create 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 transplantation is most commonly performed for individuals with male pattern baldness or female pattern baldness. It can be used to restore density or lower a thinning hairline, fill out areas of thinning, and can when performed properly to improve diffuse hair loss, using hairs from the back and or sides of the scalp- or even when indicated from the beard or chest or back in what is called BHT (body hair transplantations) where these donor hairs are considered permanent. 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. Reasonably good health, and realistic expectations are important, which will be provided by Dr. Epstein so you will understand what to expect. Hair transplants can be performed on individuals from the early 20s to the 70’s and beyond. In general, most men are best treated with the follicular unit extraction technique since it avoids the making of a linear donor site incision scar. A particular technique Dr. Epstein has developed for men who have already had a prior strip procedure in the past is the Hybrid approach, whereby a relatively small donor site incision is performed in the back of the head removing the prior donor site scar to obtain 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. Dr. Epstein also offers a no-shave FUE, whereby all the hair grafts are obtained from the back and sides of the head without the cutting of any of the hairs in this donor area, thus leaving the remaining hairs in place so that patients are presentable the very next day. Few doctors offer the no-shave, because of the challenges in performing it, but for the patient who needs to return to work and be presentable right after the procedure, it is the procedure of choice.
With the No-Shave FUE technique, a patient can be presentable right after a transplant, with this patient one day after 1600 grafts.
Techniques in Hair Transplantation: FUG and FUE
The most popular hair transplant technique is 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 his custom-designed E-Fue System, as well as the WAW system developed by his colleague in Belgium that utilizes a “hybrid” punch and thus minimizes hair transection to a very low less than 4% rate. This is not using any type of “robot” or other proprietary “automated” drill system, as these heavily marketed devices utilize just sharp punches that generally have higher rates of graft transection and therefore lower rates of regrowth, and oftentimes are used by doctors who have little experience with FUE or even little experience with hair transplants. When performed properly, theseFUE grafts have excellent regrowth, and when performed by an experienced hair transplant surgeon, can yield truly natural appearing results. Note that in the top of the head where the grafts are placed, we do not shave the hair at all, allowing these existing hairs to conceal the transplants during the first week of healing.
With follicular unit grafting (FUG), sometimes referred to as the strip technique, 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, just like with FUE procedures, into tiny slit incisions in the bald or thinning area where they can then grow like normal hair.
Hair transplant procedures are performed in our Miami and NYC certified procedure rooms. Most patients have the procedure done under oral sedation and local anesthesia, however we offer intravenous sedation for the occasional patient who chooses to have the procedure under twilight anesthesia. A procedure typically takes three to eight hours to perform, with Dr. Epstein and Dr Bared working with their team of 10 full time hair technicians (two are fully licensed Nurse Practitioners, two are Registered Nurses) who average over 11 years working with the practice. Please realize that these are NOT hired per diem technicians, but full-time members of the team and are committed to taking the very best care of the practice’s patients.
Planting of these grafts into the recipient sites is a technically demanding part of the procedure. The video below shows how our use of implanters allows for the least traumatic placement of the grafts, thus assuring their optimal regrowth.
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, and exercise can be resumed on the sixth day. The occasional patient develops 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 and fuller look, and will continue to get thicker typically for a full 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 Epstein. 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.