Hello, My name is Dana and I'm really desperate (as everybody there, I'm sure) with my hairloss. I'm living in Monterrey, Mexico and i would like to know if you could recommend me a place for hair transplant. My problem is that a doctor told me I'm not a potential donor because my hair is too thin, but i hope something appears on the market for my case also. I hope you understand my english :) and i wish you a Happy New Year! Thank you :)
Answer:
Dear Dana- I see a number of female patients who are told by other surgeons the same that you have been told- that your donor area is too thin- and that do in fact benefit from a well performed hair transplant by someone like myself who has extensive experience in treating women (on average 4 procedures on women a week).
The key thing is providing you with realistic expectations. It would be possible to restore some density in one procedure to one of the two main areas of thinning in your case- one being the crown, the other being the upper entradas/entrances and midscalp region. I would anticipate that with a procedure of 1600 or so grafts, I could somewhat fill in and definitely improve the thinning of the entradas and midscalp region, not to where you would no longer be able to see your scalp, but to where it would be moderately fuller and the scalp would be less visible. This would be the same situation if the crown area would be filled in, but in general the results with hair transplants of the crown are not as impressive as they are with the frontal part of the scalp.
To help get the very best results, at the time of your procedure, I would perform PRP (platelet rich plasma) which you can read about in the attachment, which helps the success of the transplant.
Another nonsurgical option Dana is to simply perform PRP as a stand-alone treatment, and recommend that you use Laser Light Therapy and see how you do over the next 6 to 8 months, then consider at that time performing a hair transplant if a good result is achieved from the PRP and LLT.
Female hair transplantation on a patient from the United Kingdom
Answer:
Dear Dr Epstein,
Thank you very much for taking time to review my case. I do appreciate your response and the emails you sent me, plus the illustration of the proposed treatment.
I am a 32 year old female from the UK. For years I have been experiencing male type hair-loss and I have lost most of my hair on my temples. The quality of my life has deteriorated significantly due to this condition and I would be grateful for hope of restoring my hairline. Looking at the photos I understand this is possible. I have close up pictures of my hairline and I will send them to your address Drepstein@foundhair.com in a few minutes. I would be very grateful for a consultation, diagnosis and recommendation of what can be done and when.
I am definitely interested in having this procedure done; I would love to speak to one of your UK patients; would you kindly forward this email to your Office Manager, Roxy, so that she can arrange such a meeting for me. If she needs me to call her to discuss this rather than write an email I am happy to call; please let me know.
I have a number of questions I would love to discuss with you if possible; do you take calls from prospective patients? (If this is difficult due to your other commitments I am happy for us to correspond until I come to New York for my procedure).
In terms of my concerns I am wondering about the following:
QUESTION: Can I have FUE rather than strip method please? ANSWER: This is not something typically performed on women, due to several reasons: Women tend to have already a low donor density and a high need for as many hairs as possible; and women have no trouble concealing whatever scars are present, typically scars that are 2 MM in witdth or narrower. You can read much more about FUE versus Strip/Fug procedures on the www.foundhair.com Website.
QUESTION: Can this procedure be done with my hair long? (shoulder length) ANSWER: As long as you would like it.
QUESTION: Will there be any shock loss in the adjacent areas? ANWER: I feel that with the experience I have in working with women that I have developed techniques for minimizing any shock hair loss, while maximizing the numbers of hairs that can be placed between existing hairs. That being said, there is always a risk of some shock hair loss, but this has happene in only a very very small number of patients of mine, and none in the past 4 years since I further refined my technique.
QUESTION: Will I have any small scars or marks in the recipient site (hairline)? ANSWER: None
QUESTION: How long will it take for the scabs and the redness in the recipient site to completely disappear? ANSWER: Typically 7 to 8 days for all crusts and most pinkness, but this can sometimes take 10 to 12 days - But you will have no trouble concealing the crusts in as soon as 3 days after the procedure.
QUESTION: Will I have small bald spots at the donor site (back of the head) or will you be taking individual strands from all over my head? ANSWER: Only a fine line donor site scar.
QUESTION: Can I get reasonable density with one procedure? ANSWER: Some of this depends upon the exact thickness or density of your donor area, but you should have a nice cosmetic improvement.
I have a large number of patients from throughout the UK, including at least two who have, in the past, been happy to speak with prospective patients. Please let me know if you are interested in being put in touch with one or more of them.
What are the issues with transplants causing damage to other follicles for women? Do growth hormones such as KGF help post surgery?
Answer:
With women there is a slightly higher risk of “shock” hair loss- however I have found that with the use of very small recipient sites measuring each less than 0.8 mm on average, along with the use of careful technique, I am able to keep this hair loss to a minimum. Finally- as far as GH and other similar agents- there is some anecdotal evidence of a subtle thickening of existing hairs, however, this has not in any way been proven efficacious.
Hair transplant in an African - American female - What are the concerns with respect to poor growth.
Answer:
The big challenge in your situation is the quality of your donor hairs- if you have a good density in the back of your scalp, I could anticipate a more impressive result. The other consideration is that, in women of color, there can be a lower percentage of hair growth, resulting in less coverage. The only way to assess the exact amount of hair growth you are likely to experience is to perform a test procedure of say 40 grafts, then waiting 6 months to see how things grow. The alternative is to proceed with a procedure of 1300 to 1400 or so grafts, filling in both temple areas (500 grafts per side) and placing the remaining 400 or so grafts along the hairline to provide increased density and perhaps bring it down/forward a bit. In addition, a second procedure may be desired in the future to provide more density.
Follow the Foundation Doctors’ Experiences at the annual meeting of the International Society of Hair Restoration Surgery in Amsterdam
Answer:
Greetings from Amsterdam, where it is currently midnite and rainy. Just got back from a delicious dinner with colleagues- Glenn (Charles), Arthur (Tzychinski- who knows how that Brazilian guy spells his name anyway?), Matt from Dr. Shapiro’s office, Dr. Eric from NY, and lastly Aaron. I am quite tired after a long red-eye flight that got me into Amsterdam around 10 am this morning. Putting the final touches on one of my lectures tomorrow for the ISHRS meeting- this one is on predictors of success in hair transplants for women- a topic quite relevant, given my particular interest in this area. The Power Point slides I presented are quite nice- pink backgrounds with white and maroon characters- very appropriate for a lecture on women, and definitely intended to get people’s attention. The other topic on which I am speaking tomorrow is as part of a panel discussing different treatments for scalp scarring. In particular, I am going to discuss the role of tissue expansion with the presentation of a particular favorite case of mine- 9 year old Addison of Missouri.
Quite a cozy city, and I am quite excited for the first (of 4) days of meetings.
I wanted to inquire about a hairline advancement on a female. I have a high and wide forehead and would like it 'reduced'. I have viewed the impressive results of the women’s gallery but I assume these are the best case scenario results. What would be the worst case scaenario? Also, what is the incidence of healthy hair dropping out due to trauma of the procedure? Thanks
Answer:
Those are good questions. The hairline advancement procedure is one in which many of the doctors at the Foundation for Hair Restoration specialize- in fact, I am performing one on a woman from Wyoming today. Depending upon the amount of lowering desired, anywhere from 700 to as many as 2500 grafts get placed in a single procedure, with the goal being to restore a natural appearing hairline and fill in the areas of thinning. The cost depends upon the number of grafts. When performed properly, no one should be able to detect you had the procedure, and there should be minimal to no damage to the already existing hairs in the areas of thinning. Typically I have 90% plus of my transplanted hairs grow. In the unlikely and very unusual case where there is more limited growth, I would perform a small touch up procedure to take care of this.
Thank you for your reply. I have been in California and only returned yesterday to find your e-mail. I am very interested and would like to proceed, but have a few questions/items that I wonder if you could clarify for me:
Answer:
Examples from my website include GW01- 02, -05, and -08. In photos, the results always appear more impressive than in real life, due to the 2-dimensional aspect of photos without the light shining from above. It may be possible to obtain the same density with a somewhat smaller number of grafts, especially given that with gray hair, it is possible to use more 3 and 4 hair grafts for maximal density.
Most patients are presentable 1-2 days after the procedure, considering that your existing hair can cover up any crusts. Normal hair washing and activity can be resumed at 5 days, while flying home is possible as soon as the first day after the procedure.
I wanted to inquire about a hairline advancement on a female. I have a high and wide forehead and would like it 'reduced'. I have viewed the impressive results of the women’s gallery but I assume these are the best case scenario results. What would be the worst case scenario? Also, what is the incidence of healthy hair dropping out due to trauma of the procedure?
Answer:
Those are good questions. The hairline advancement procedure is one in which many of the doctors at the Foundation for Hair Restoration specialize- in fact, I am performing one on a woman from Wyoming today. Depending upon the amount of lowering desired, anywhere from 700 to as many as 2500 grafts get placed in a single procedure, with the goal being to restore a natural appearing hairline and fill in the areas of thinning. The cost depends upon the number of grafts. When performed properly, no one should be able to detect you had the procedure, and there should be minimal to no damage to the already existing hairs in the areas of thinning. Typically I have 90% plus of my transplanted hairs grow. In the unlikely and very unusual case where there is more limited growth, I would perform a small touch up procedure to take care of this.
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