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Frequently Asked Questions
What causes hair loss?
There are many reasons for hair
loss but some 95% of all cases are due to a condition
called "androgenetic alopecia." In
men, this is commonly referred to as "male
pattern baldness." The onset of this condition
is due to several factors including: 1) a genetic
predisposition to lose hair; 2) the presence
of the male hormone, dihydrotestosterone; and
3) age.
It is normal for an individual to lose approximately 100 hairs every day, but
these hairs then regrow several months later. When the hair loss exceeds new
hair growth, baldness results. Once it starts, hair loss is progressive and
often continues for a lifetime.
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How effective is medication
against hair loss?
Several medications have FDA approval
for the treatment of androgenetic pattern hair
loss. Minoxidil (brand name Rogaine) is a topical
medicine for men and women that must be applied
twice daily. Finasteride (Propecia) is a pill
only for men to be taken once daily. These medications
have limited effectiveness, slowing down or stopping
altogether the progression of hair loss in the
back of the head in less than two-thirds of all
men. The only permanent remedy for hair loss
is surgical hair restoration, or hair transplantation.
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What is hair transplantation?
Hair transplantation involves transferring
hairs from the back and side of the head (the "donor
area") to those areas undergoing hair loss
or thinning. The hairs from the donor area are
genetically programmed to be permanent. Once
transplanted, these hairs will continue to grow
for a lifetime. Today the state of the art procedure
is follicular unit grafting, the only procedure
Dr. Epstein performs. A follicular unit is the
naturally occurring grouping of hairs containing
from one to three, occasionally four, hairs.
Each graft is cut individually under the microscope.
As many as 2500 grafts are able to be transplanted
in a single procedure lasting three to six hours.
Click
here for an in-depth look at follicular unit
micrografting, Dr. Epstein's procedure for
hair transplantation.
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Am I a good candidate for
hair restoration surgery?
Anyone who is concerned about hair
loss and is willing to undergo a minimally invasive
procedure is a potential candidate. Dr. Epstein's
patients have ranged in age from the late teens
to the late 70'5, with hair loss patterns ranging
from early thinning or minimal hairline recession
up to advanced baldness where there is only a
rim of hair along the sides and back of the scalp.
To view the
various categories of hairloss, click here.
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Does the procedure hurt?
Virtually all our patients report
that there is very little, if any, discomfort
in the hair restoration process. Anesthesia can
now be delivered painlessly with a computerized
device called The Wand@. In addition, patients
are offered a pill for relaxation.
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After the procedure can
I resume my normal activities?
Most people are able to return to
work and most social activities in one to three
days. In four to six days all activities, including
most exercise and regular hair care, can be resumed.
Tiny crusts will develop around
each graft, falling out after one week. During
this first week a powder, Toppik, provided by
the office can be applied to the scalp to conceal
the crusts. The transplanted hairs then usually
fall out two weeks later, only to regrow in two
to three months.
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What about detectability
and scarring?
If you can tell an individual has
had a hair transplant, then it wasn't performed
properly. Using artistic state-of-the-art techniques,
an individual should have a completely natural
looking head of hair, including a hairline so
natural that the hair can be brushed back or
cut very short. This naturalness is achieved
by designing a hairline in harmony with the individual's
facial proportions, as well as using the right
combination of different sized follicular unit
micro grafts transplanted at the proper angle.
While technically demanding, follicular unit
transplantation creates the most natural appearing
results for most individuals.
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What treatment works best
for women?
In general, women do not respond
well to minoxidil and are not to take Propecia@.
Therefore, hair restoration remains an important
option. The procedure is similar to that performed
on men, with some important variations in technique
that can be discussed with the patient at the
time of consultation. Hair restoration is also
a frequent choice of women who have scarring
from previous surgery, notably facelifting. Any
areas of absent hair can be replenished with
follicular unit grafts.
Click here
to learn more about Dr. Epstein's procedures
for women.
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What can be done if I have had a less
than satisfactory previous hair transplant?
Over 30 percent of the procedures
Dr. Epstein performs are on individuals who have
had transplants previously and are disappointed
with the results. A variety of techniques are
available to dramatically improve appearances.
Because of his experience, Dr. Epstein has lectured
and written on the subspecialty of revision surgical
hair restoration.
Click
here to learn more about Dr. Epstein's reparative
procedures.
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What about transplants to
other parts of the body?
Through follicular unit grafting,
hair can be transplanted to virtually any part
of the body. Dr. Epstein has successfully transplanted
hair to the eyebrows, beard, mustache and chest.
To view
before and after patient photos showing Dr.
Epstein's body and facial transplant procedures,
click here.
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I will be traveling to
Miami for my procedure. Are there special arrangements
or requirements?
Some 30 percent of the patients
on whom Dr. Epstein performs procedures live
outside of south Florida. The hair transplant
procedure is ideally suited to be performed on
a fly-in/fly-out basis. An overnight stay in
a local hotel is recommended after the procedure;
however the patient may fly the same day. The
patient's hair is washed in the office the first
day. Gentle hair care is resumed on the third
day, and sutures removed at ten days by a friend,
family member or local physician using a suture
removal kit supplied by the office.
Our staff can assist you with all
your travel arrangements.
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