Reparative Procedures

An important consideration for you to consider is that, as a 26 year old, you are only going to continue losing more and more hair in the crown region, which will therefore require more and more work to keep up with it.

I do recommend Propecia, as it has a 70% chance of slowing down or stopping altogether the progression of hair loss in the crown, but this must be taken every day or every other day until a better medication becomes available. I suggest you email some photos for me to evaluate.

Posted by Jeffrey S. Epstein, MD, FACS

Dear J- Given the likelihood of the scar widening after excision, I would recommend hair transplants into the scar, where likely 300 to 350 grafts into each scar would be indicated. At the same time, the smaller scars from the scalp condition could be filled in.

For the face, in general leg hair would not grow very well, so once again, I’d recommend scalp hair for these areas.

Finally, the FHRPS has offices in south Florida, NYC, and Scottsdale- so you could have your procedure wherever is most convenient.

Thank you for answering my question... at the same time I have some hair around my neck and facial cheek that I don't need...can we harvest those hair follicles to the mustache/goatee area without scarring on my face? 

So with about 700 grafts to my major scars, I can have a short hair without knowing I had a scar?

And lastly if it's in Arizona...do realize you Dr. Epstein perform these procedures at this location...I wasn't sure you travel to the other offices to perform the procedures.

You're welcome J. In general, scalp hair is the most reliable and an excellent match for beard restoration. If it is the incision that is of concern, then the grafts can be obtained by the FUE technique. However, if you strongly wish to use beard hairs, we can try them but often they are not of sufficient quality.

With your question about "without knowing I had a scar"-  to which scar are you referring?

Posted by Jeffrey S. Epstein, MD, FACS

The procedure you are inquiring about is the endoscopic removal of the scar tissue causing the ridging. Essentially this is done through 2 relatively small incisions, then under endoscopic guidance I am able to remove a moderate to significant amount of the scar tissue from below. On the patients I have performed this on, all but one have had a significant reduction in scar tissue, while the fourth has an improvement but it is not quite enough and we are contemplating doing it again for me to get more aggressive with the removal.

This procedure has relatively few risks, and has a reasonable chance of reducing the ridging by 40 to 50%. Once the ridging is removed, you may benefit from routine injections of Kenalog for the first 6 months or so to prevent the scarring from recurring.

It would be a pleasure to consider you for this procedure.

Posted by Jeffrey S. Epstein, MD, FACS

The reality is, most individuals can be successfully transplanted using their own existing hairs, in sufficient quantities, to create significant improvement in the treatment of hair loss.  The average male patient presents with over 8000 donor grafts total (over 16,000 hairs)- a significant number that can allow for two procedures of 2600-plus grafts, then subsequent smaller procedures.
  
However, given the amount of reparative work I perform, I do see individuals who, because of excessive scarring and/or inefficient transplanting techniques, have a serious deficiency of an adequate amount of hair for transplanting.  While these individuals can be helped even with conservative procedures, they strike me as those who would benefit most from cloning techniques of the future that could provide much larger- potentially unlimited- numbers of donor hairs or cells to initiate the growth of new hairs.

Posted by Jeffrey S. Epstein, MD, FACS

No, in most cases, Dr. Epstein can simply excise the existing scar and the site heals to as fine line scar, as before. So there will only be one scar even after multiple procedures.

Posted by Jeffrey S. Epstein, MD, FACS

I am sorry but I only perform procedures in Miami and New York City. I have a number of patients from the Middle East, including at least 2 from UAE who have traveled here to have me perform their procedure. You can send some photos for me to evaluate.

Posted by Jeffrey S. Epstein, MD, FACS

I am sure that your research has shown you that I have extensive experience in reparative procedures. It is usually possible, even in cases such as yours, to obtain at least enough donor hairs- say 800 to 1200 or so grafts- to create a moderate to significant improvement in appearance. This is because the grafts can be strategically placed so that they provide the cosmetic improvement that makes the biggest difference.

Posted by Jeffrey S. Epstein, MD, FACS

I see a lot of potential for significantly improving the appearance- a more natural hairline, increasing the density of the frontal and midscalp region.  There should be little if any shock hair  loss, due to the techniques we use-  which involve making incisions 0.6 to 0.9 mm in size that minimize trauma to existing hairs.

Posted by Jeffrey S. Epstein, MD, FACS