Expertise in hair replacement
There are essentially three aspects to addressing the hair loss concerns of women. The first aspect is hair restoration in areas of hair loss that can include diffuse thinning, a receding hairline, loss of sideburns or scarring from prior facial plastic surgery, or overly thin eyebrows. This is best achieved with hair grafting. The second aspect is addressing the overly high hairline due to genetics, which can be achieved with either the hairline lowering/forehead reduction surgery or hair grafting. The third aspect is diagnosing then treating progressive hair loss in women that is typically multifactorial, including due to genetics, stress, vitamin or hormonal abnormalities, certain types of scarring alopecias, and more. To achieve this, the Women’s Center for Hair Loss was created to provide complete diagnostic workups and the full scope of surgical and medical therapies, that include but are not limited to individualized compounded topical formulas, laser light therapy , cell-based therapies including platelet rich plasma and autologous fat therapy, and more
The Women’s Center for Hair Loss is a state-of-the-art hair transplant treatment facility dedicated to the hair restoration needs of women. Dr. Epstein regularly performs hair replacement procedures on women and has extensive experience addressing their unique concerns. Surgical hairline advancement and follicular unit hair transplants are the most popular procedures for women. They treat an overly high hairline, female pattern baldness, distorted hair growth, and scars from cosmetic surgery, and can even be used to restore eyebrows.
Immediately After a Hairline Lowering/Forehead Shortening Surgery
* All patients are unique and individual results may vary.
Woman’s hair loss expert
Since 1994, a significant component of Dr. Epstein’s practice has been focused on addressing the hair concerns of women. While there have been advancements in techniques and diagnostic skills, the approach has always been one based on a sensitivity for the impact hair loss can impose on women, and incorporating various modalities.
Patients from throughout the US and the world come to be treated by Dr. Epstein, many of whom first meet with the doctor by webcam or photo reviews. His expertise in the hairline lowering/forehead reduction surgery, in eyebrow restoration, in hair transplant techniques and female hairline design, and in the work-up and cutting-edge medical therapies for hair loss provide patients with a sense of confidence that they are being treated properly.
Hair grafting, also known as hair transplantation, involves the moving of “permanent” usually thicker hairs from one part of the scalp to areas of thinning. The hairs are moved as “grafts”, each containing one to three, occasionally four hairs, then distributed in an aesthetic fashion. These donor hairs are obtained by one of two techniques- either FUT (follicular unit transplantation), also called the “strip”, which is still used on some women as it allows for the obtaining of as many as 1800 or more grafts (equivalent to 3500 or more hairs) from a single incision in the back of the head which is sutured closed and typically heals as a fine line scar; or FUE (follicular unit extraction), where each hair graft is removed one at a time from the scalp using a tiny punch, thus avoiding any linear donor site incision. Each technique has appropriate indications, and while FUE is chosen in the majority of cases, FUT can be an appropriate technique. As an experienced expert in both techniques, each patient can be advised as to the best approach.
The number of grafts transplanted determines the total procedure time, which typically ranges from four to seven hours. Every recipient site is made by Dr. Epstein, as this is one of the key aesthetic steps. The doctor is assisted by his team of hair assistants who average over 13 years working with him in the practice. An ideal out-patient procedure, returning to home- even flying- is permitted the very next day. Hair grafting is used not only for scalp restoration, but also in Dr. Epstein’s experienced hands as a way to aesthetically restore eyebrows, or to fix scarring or restore sideburns that are the result of prior facial plastic surgery. To learn more about eyebrow restoration.
Hairline lowering/forehead reduction surgery
This procedure, also called the surgical hairline advancement (SHA), is unsurpassed in its ability to lower the overly high female (and occasional male) female hairline in a single step. The density achieved surpasses that achievable with one even two hair transplants, equivalent to 6,000 to 10,000 hairs. This surgery is best performed on women with a lifetime of a high hairline who have a reasonably flexible scalp without any hair loss. Some rounding out is achieved with Dr. Epstein’s modification to this technique. In a typical procedure, 20 to 24mm (or just under or at a full inch) of lowering is achieved, but this can when indicated be as much as two inches.
The surgery is performed under twilight or general anesthesia, taking less than two hours. Recovery is quite easy, with a pressure dressing removed the first day after the procedure allowing patients to be presentable and fly back home that day. Sutures are removed at one week, either returning to the office or by a local doctor or friend or walk-in clinic.
This is a procedure with a very high rate of patient satisfaction, due to the rapid results and the ability to design the incision such that hairs actually grow through the hairline incision scar. A small percentage of women will have, as soon as three months later, hair grafting to further round out and or to soften the hairline if indicated.
The women’s center for hair loss
The WCHL provides individualized diagnosis and treatment solutions for women experiencing all types of hair loss. Thorough history taking, physical examination, and additional diagnostic tools including dermoscopy, and as indicated scalp biopsy, lab tests, and more, a diagnosis can be made that then will guide appropriate therapy. Working with Nurse Practitioner Andrea Miranda and in consultation with Dr. Gorana Kuka Epstein a European plastic surgeon specializing in hair loss in women, Dr. Epstein is able to significantly improve the condition of most women, using one or more of the following therapies:
- Customized compounded topical formulas
- Topical Rogaine
- Viviscal and other vitamins
- Laser light therapy
- PRP – platelet rich plasma
- Steroid injections
- And other therapies including those as they become developed
A Hair consultation with Dr. Epstein
Your initial consultation with Dr. Epstein will be about you and your individual needs. This consult can be done either in the office or by webcam, or by review of photos and in the case of hairline lowering surgery with a video demonstrating scalp laxity. If indicated, a complete medical history will be obtained followed by examination of your scalp and hair. Any test as needed will be ordered. Based on these findings and results, Dr. Epstein will give his recommended treatment options. If you are a candidate for a surgical hairline advancement/hairline lowering surgery or a hair transplant, your procedure will be scheduled for a convenient time and date. All pre-procedure and post-procedure instructions will be given to you so you will be ready for your procedure and excited about seeing your results.
Frequently Asked Questions
Local anesthesia is administered via tiny injections. Oral or if desired twilight intravenous sedation is typically used for patient comfort. Patients feel no pain or discomfort during surgery and rarely feel pain or discomfort during recovery. If pain occurs, it is easily controlled by taking a pain medicine. Additionally, Dr. Epstein gives patients detailed post-procedure recovery instructions to ensure a smooth, easy, and pain-free recovery from start to finish.
Your medical review and physical exam will provide Dr. Epstein with all the information he needs to make a treatment recommendation. A hairline advancement procedure is usually recommended for patients who have an overly high hairline and a flexible scalp. Hair transplants are usually recommended for patients who have female pattern baldness and/or other hair loss issues. Sometimes medical therapy for the hair loss is also recommended or may be the first line therapy.
You will look presentable with a hat or headband the day after surgery.
When you are ready for your hair replacement for women initial consultation, you may contact Dr. Epstein’s office in Miami, FL at 305-306-8367.
OPTIONS FOR YOUR EVALUATION
CONSULT IN PERSON – You can meet with Dr. Epstein in the Miami office if you live in or will be visiting south Florida. Here you can not only have a chance to discuss your goals and undergo a full evaluation, but also see the modern facility that is designed with patient comfort and safety in mind. Our office is located in South Miami close to Coconut Grove, Coral Gables, downtown Miami and Miami Beach, and is just 20 minutes from Miami International Airport. The office is on the campus of South Miami Hospital (affiliated with Baptist Health), and provides covered underground parking and sufficient privacy. Please be sure to bring your parking ticket for validation. You can schedule a consultation or learn more by clicking HERE.
CONSULT BY WEBCAM – Dr. Epstein is no stranger to webcams, having provided hundreds of patients consultations over the past five years. Today, this has become the most popular method for patients to “meet” Dr. Epstein, especially considering that most patients are traveling from out of town. Your consult can be performed just like a regular in-office consultation, with the doctor discussing with you your goals and explaining his recommendations in a formal manner from the comfort of your home, your office, or even your car. The most common formats for the webcam are FaceTime or Zoom, but other modalities are available. You can schedule a consultation or learn more by clicking HERE.
EVALUATION BY PHOTO REVIEW – This is an easy way to have your case evaluated, without any charge. By sending your photos, along with information on your age, hair loss history, any prior therapies or procedures, family history of hair loss, and your goals, Dr. Epstein can provide his recommendations and advice. If desired, once you receive his recommendations, you can have a webcam or in-office consultation to learn more, however by photo review you will have the opportunity to ask questions and speak with his assistant Roxy or Dannette who will be able to guide you through this process.