Hairline Advancement

If the surrounding hairs are weak and almost ready to fall out, you may experience some shock loss. Shock loss is HWNE the weak, miniaturized existing hairs start to fight for the blood supply with the newly transplanted, healthier hairs and fall out a bit prematurely. There is no way to tell if you will or will not experience shock loss but we take every precaution to prevent it. About 1/3 of patients experience no shock loss. Another 1/3 experience some only they personally notice. Whiloe NTHE remaining 1/3 may experience some which is slightly noticeable.

Posted by Jeffrey S. Epstein, MD, FACS

Hair loss is progressive.  The fact that you have just started noticing your hair loss in your early 50s is a good sign that you are likely not going to lose all your hair, therefore a more "aggressive" approach can be taken, whereby we focus on giving you the restoration and hairline that you desire.  Younger patients are more likely to continue to lose a lot more hair, therefore a more conservative approach needs to be taken.  The success of the procedure is just as good on a 70 year old as on a 25 year old -  and because of the older age implying less future hair loss, the results can even be more impressive over the long run.
After a procedure, any existing hairs can help conceal the tiny crusts that are present for the first 7 to 8 days after a procedure.  A baseball cap or other hat can allow you to go out in public undetected as soon as the very first day after the procedure.

Posted by Jeffrey S. Epstein, MD, FACS

Yes, it can, to some degree, but most effectively if your donor area (back of the scalp) is somewhat thicker in density, and the transplanted hairs are concentrated into certain areas- most commonly the frontal region and partline- to provide the most cosmetic benefit. I see many female patients who have been told by other hair transplant surgeons that nothing can be done for them, yet in many of these cases the reality is that a procedure can improve their hair loss situation- perhaps not as dramatically as they would want, but it is a definite improvement.

Posted by Jeffrey S. Epstein, MD, FACS

Andrew Because your frontal hairline is all grafts that will not fall out in the future due to male pattern hair loss, you are an appropriate male candidate for this procedure. The key thing as to how much advancement you could expect is: how much laxity you have in the scalp/forehead region, and how much if any lifting of your brows you desire. To assess laxity, place your index finger right along the central aspect of your hairline (widow’s peak area), then see how much excursion you can get out of it sliding the hairline up and down- excursion being the amount of movement in each direction. Let me know what is the result. The fee for the procedure, which is usually performed under local anesthesia and some oral sedation, can be provided to you by Jon from my office.

Posted by Jeffrey S. Epstein, MD, FACS

From your photos, you appear to be an excellent candidate for a hair transplant procedure- well defined hair loss pattern, nice colored and good density donor hair, and you are older than 30 years old. My recommendation would a procedure of 2200 to 2600 or so grafts to work primarily in the frontal half of the scalp, reinforcing the receded and thinning hairline, filling in the frontotemporal recessions and anterior central scalp to significantly increase density, and if desired, placing an additional 600 or so grafts (assuming they are available in the donor area) to provide some coverage in the crown. For the back half of the scalp, including the crown, I would suggest you consider going on Propecia to slow down or stop the progression of hair loss.

Posted by Jeffrey S. Epstein, MD, FACS

Absolutely-your hair can be dyed as soon as 3 weeks after your procedure. Remember, once performed, your hairs will continue to grow just like your own original hairs, and can be treated in whatever way you wish.

Posted by Jeffrey S. Epstein, MD, FACS

I have many patients from Mexico- in fact, just this past week I performed a transplant on a patient from Mexico City. Most patients first send some photos for me to evaluate, which will allow me to make recommendations. I look forward to helping you in whatever way I can- and can assure you that the work we perform is of the very highest level of aesthetics.

Posted by Jeffrey S. Epstein, MD, FACS

I would go a bit more conservatively, given your young age and risk for further hair loss in the future-  plus we want the hairline to look good not just when you are 25 but also in 20 and more years from now.  My suggestion-  1800 to 2100 grafts, the exact number depending upon exactly how low your hairline is placed and the degree of thinning you have higher up that needs to be addressed with this procedure.  I have extensive experience working with Asian hair-  and efforts must be taken to assure that the results are truly aesthetic and natural appearing- such as the use of many single hair follicular unit grafts along the hairline angled at just the right direction.
I also would recommend, if you are not already on it, taking Propecia.
 
Your procedure can be set up for Miami or New York, or one of the other Foundation for Hair Restoration locations - with you needing to stay there just one night.  We use absorbable sutures so there is no need for you to return to the office for suture removal.  Typically if a procedure is performed Friday, you would still have some crusts on the scalp for 6 to 7 days.

Posted by Jeffrey S. Epstein, MD, FACS

A variety of specialists perform hair transplantation-  for most doctors, it represents only a portion of their practice, not the majority.  With the demands of today’s most modern techniques-  assuming you are seeking the most natural appearing results-  it requires a full or near full-devotion to performing hair transplants.  This means typically that the doctor performs at least 3 to 5 of these procedures every week, and has a full time staff to assist him.

As far as the type of specialty the doctor has-  usually dermatologists are well versed in the basic techniques, while plastic surgeons who do specialize in this procedure can be expected to bring a more aesthetic approach, given their years of experience with cosmetic surgery.

The most important criteria, however, is to find a doctor whose work looks natural.  You should be able to view tens, if not hundreds, of the doctor’s own before and after photos, with results that you would be proud to have as your own.  For most of my patients, the internet is the best referral source-  not only can the doctor’s own website be viewed, but many patients share their experiences and photos on one of several community websites that contain forums.

Posted by Jeffrey S. Epstein, MD, FACS