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Dr. David Josephitis

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About Dr. David Josephitis

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Hair Transplant Clinic Information

  • Hair Transplant Surgeon
    Dr. David Josephitis
  • Hair Transplant Network Recommendation Profile
  • Hair Transplant Clinic Name
    Shapiro Medical Group
  • Primary Clinic Address
    5270 West 84th Street, Suite 500
  • Country
    United States
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  • Provides
    Follicular Unit Hair Transplantation (FUT)
    Follicular Unit Extraction (FUE)
    Eyebrow Transplantation
    Body Hair Transplantation (BHT)
    Prescriptions for Propecia
    Free In-depth Consults

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  1. naveenram15, It is a big challenge for smokers after hair transplant surgery. While there have not been any studies done on hair surgery, we know from other general medical studies that smoking can and does hinder the healing process. One of the big issues right after transplantation is that the grafts have not yet established an adequate connection to the circulation. We try to do everything possible to improve the likelihood that grafts survive. (Grafts stay moist after surgery, they are placed as quickly as possible back into the scalp, ATP spray after surgery to increase oxygenation to the hair, etc). The issue with smoking and surgery is that there is a chance that it will affect the overall results. The fact is that occasionally after surgery the results are not as we expect. Usually, there is poorer overall result or there are thinner areas here and there. Smoking increases the chance that there can be a poor outcome. The chances are still good that a smoker with have a great outcome. Still, the chances are also slightly higher that if the patient has a bad outcome, it might be connected to smoking. At Shapiro Medical Group, we try to do everything to reduce the chance of a poor outcome. As mentioned before, we add many things to surgery to improve on this rate of success. The patient also plays an important part in increasing the chance of a great result. Stopping smoking or greatly reducing it is one of the things they can do. In reality, it is very difficult for a smoker to quit. For those patients, I recommend cutting down and/ or nicotine replacement. It looks like you did a great job of holding off for the first week. The longer you can hold off, the better. After that, within reason do your best to cut it down. Because of all you invested in your hair at this point, it may also be a great reason to quit! Good Luck.
  2. A scar revision is just the act of removing scar tissue safely. If one takes our scar in addition to hair, then there may be to much tension on the healing incision and it will scar again possibly worse. In the end, it is all about tension. You can only take out so wide of a piece of tissue. If you are only taking out scar, the chances of there being little tension on the incision and healing well is higher than if you took out the scar AND the additional width of tissue with hair. I recommend visiting with an experienced local physician who has experience with FUT. The recommended physicians on the site are an excellent place to start looking.
  3. During a scar revision, the focus is on removing the scar only. When we perform a hair transplant surgery using the strip method, we can not get the same improvement in the scar as if we took only the scar out. Occasionally we can improve on the scar an the same time as the hair transplant surgery. We call this transplant with scar revision. If you have a poor scar that you would like to improve and transplanting hair right now is not an issue, then the physician can focus soley on improving the scar with a revision (no hair transplanting) Physicans who routinely perform FUT (strip) surgery and have experience are usually good a these types of scar revisions. There can also be somewhat of an art to improving scars as well. Occasionally it may take 1-2 scar revisions with a poor scar to make improvement in it. Also, some patients may benefit from using FUE grafts (from the scalp or beard) to be placed in the scar. Finally, SMP (micro tattooing) can be done into the scar to help camouflage it with the surrounding scalp.
  4. hairsafelife, Welcome to the forum. It sounds from your post that you have normal male pattern alpecia. This is diagnosed, as you know, from the typical pattern that one sees on the top of the scalp. The donor area usually is not affected by this type of alopecia. DUPA (diffuse unpatterned alopecia) is a condition that results in diffuse thinning throughout the entire scalp including the donor region on the sides and back of the head. These patients are not good candidates for surgery. It is hard to determine how much hair you are losing from this area from your post. Remember that most people (even people without hair loss) lose 100-150 hairs on average per day. This is normal. These hair are going through the normal hair cycle. This hair is shed from all areas of the scalp, including the donor area. If you are concerned about your donor region, I recommend you visiting with a hair restoration surgeon to get an accurate assessment of your donor area and a potential plan for hair transplantation if you are interested in that as well.
  5. I think in order to know accurately how many grafts you need, it would be a good idea to visit with a hair transplant surgeon. The area of loss is not the only thing we look at when deciding how many grafts to use. We also look at age, future loss, family history, your own goals. Having said that, FUE is an excellent choice for this type of restoration. Your graft range ca be anywhere from 1200-1800 grafts. Also, occasionally people do additional surgeries on the same area to increase density. This is also something you might want to do. I hope this helps.
  6. Thanks for the ongoing interest in the study. We currently have 4 people in the study at various post op points. The first two are currently around the one year post op. I unfortunately can't reveal any of the actual data or photos at this time, as all of the data from all of the patients is not in yet. We want to make sure we are careful in our assessments before coming to any conclusions. Having said that, preliminary results have been very promising! At this point, there is very little to no differences in the results of the recipient in the FUT vs FUE side. The growth, yield, and density visually appears to be the same. This is from photography alone. As I mentioned, hair counts have not yet been fully counted. This is good news though for patients debating whether to go with the FUT or FUE. We are still looking for a couple more patients to enroll in the study to further bolster our results. Thanks.
  7. It appears you have the option of doing another FUT of an FUE this time around. As other have suggested you could do another FUT because you already have a linear scar. You noted that you would prefer a shorter post operative healing period and that is why you are leaning towards FUE. That is not a problem. The only issue you may run into is that it may be challenging to hide the linear scar in the short term while your has has been shaved short for the FUE extractions. You might want to consider doing the "non-shaven" FUE. This way you could maintain your current hairstyle and still get the FUE. Dr. Harris in Colorado has been doing this for a while. We are also doing it here at Shapiro Medical Group. There might also be physician near you as well. The density of 70 should not be a problem unless the donor area becomes very depleted. A physician can evaluate that for you. Also, if you ever want to do an FUT later, the FUE now should not hinder that procedure. Again, an exam by a hair physician would be your best bet.
  8. hairman22, It appears you have very early thinning in the vertex at this point. You may be correct that you also have a little shock loss, although it is less likely because the last transplant was in the frontal region. Some surgeons, like myself, do not like to do any work in the vertex in young patients.(<35 yoa) The reason is that we are not sure how your hairloss will progress. Typically starting to lose hair in your early 20s signals that you will have severe thinning for the rest of your life. It is great that you are on finasteride and minoxidil. These will go far for helping to prevent more loss. Even if you decided that you still wanted transplants in the vertex, I don't believe it would make a tremendous difference for you. It is a strange reality, but placing some grafts in an area with only a little thinning doesn't make as much as a difference as placing grafts in a very bald area. I believe you would be disappointed. Also, placing grafts in an area with already a fair amount of existing native hair could injure the native hair there. The best bet would be to consider growing you hair slightly longer to better cover the crown. Also, you could use topical coverup such as Toppik or the more permanent SMP to create an illusion of more density.
  9. This can be answered in a number of ways. One can talk about how long it takes for the graft to be physically adhered to the scalp. Also, one can talk about how long it takes before the graft can no longer be damaged by normal routine activities even if it is not dislodged. The graft itself after 4-5 days is very secure. Typically only the first day or two do we see the graft actually getting bumped out. When this happens, there is also associated bleeding from the hole that remains. As an example of how quickly the graft takes, we had a patient from another clinic come in for a visit. The patient was not happy with how low the hair line was placed and asked us to remove a number of grafts at 5 days since his surgery. It was very difficult to remove the grafts and only with considerable force using forceps were we able to take them out. After the grafts are placed and are secure, they still can be injured. We have the patient avoid sun for many months, because the skin is more prone to burning. A burnt scalp can diminish good growth of the grafts. Dyes or harsh chemicals should also be avoided the first couple months as these also can injure the scalp and potentially underlying follicles. The way you washed your hair at that time should also not have affected the growth. If you are concerned about the outcome of the surgery and growth you should see you hair tranplant surgeon for a complete evaluation.
  10. Yes, we matched up the number of FUT and FUE so we could have an fair side to side comparison. We also recorded transection rate. We did 2000 graft total for each case. For our clinic, that is an average sized case. If we had dozens of patients we would have a better time with the results. Unfortunately it is tough to get patient enrolled in transplant studies. I think, although this study will not be authoritative, it will give a good idea if there are large differences between the outcomes in both techniques. If there is little difference between the donor and recipient in both FUE and FUT it will also be important for the hair community to know. Thanks for the interest!
  11. Rashid36, Taking finasteride is not a problem. The study is taking place at Shapiro Medical Group in Minneapolis, MN, USA. Although the surgery is greatly reduced in price, we will require patients to return for follow up in the clinic at least 2 additional times.
  12. 1978matt, I am glad you asked. Currently we have 4 patients enrolled in the study. We are ultimately looking to do 5 or 6 total. The patients are at various stages of their post operative period. The results are very interesting though with the 2 patients we have at or near the one year post op mark. As many of us expected, the FUE and FUT sides look very similar. This is according to the before and after photography. We have yet to fully study the magnified views and hair counts to really see if there is a difference between techniques. Still, no difference would be seen as a valid conculsion for this study. If after looking at all 5 or 6 patients we determine that both FUE and FUT are equally valid, that will be a very useful piece of info for physicians and patients considering using on techniques over the other. There are additional aspects of the study, that over time, may become even more interesting than just the results in the recipient area. We are also looking at the effect of the donor region from each technique. We are trying to see which technique allows the most number of total grafts and how the visibilty of the scar fairs over time. It appears the more we learn, the more questions we come up with. We will update you as we can. BTW. We still have 2 spots available for the study. If there are any interested candidates please contact our office at Shapiro Medical Group. The procedure is at a very reduced rate. Thanks.
  13. I think Beard FUE would be an excellent way to help cover the scar. Typically we can get anywhere from 300-500 beard FUE grafts in a session. Because you have scaring also in the underside of the beard where we typically take the hair from, we would probably only get 200 -300 grafts. We could also take scalp FUE to supplement that. It is most likely going to take more than one session to really blend in the area. After one session of FUE into the scar, oftentimes the skin become more normal and softer. May goal for you would be to evenly place graft on the side and underside of your chin. That way, after shaving you would have a more even shadow.
  14. Rashid36 The good news is that body hair is for the most part DHT resistant. Over time and as you age, the hair does thin somewhat and also loses its color. It does not fall out though, like the scalp hair does because of androgenetic alopecia. The results that you may have had initially with body hair can be slightly lessened over time because of this. The bad new for people with considerably thinner body hair is that they are not good candidates for this procedure. In order for body hair to be effective, the donor hair must be somewhat coarse in order to make a considerable difference. It would still be technically possible to tranplant body hairs in someone with finer body hair, it would just not be very helpful in the overall results.
  15. I am not sure we know if beard and chest hair lasts a lifetime or not. My suspician is that body hair acts alot like the "safe" donor area on the scalp. It may very well last a lifetime, but it does undergo natural aging. The hair may lose its color and it may also get thinner over time. These changes would follow the tranplanted hair wherever they were moved. We transplanted about 500 chest hairs in this patient. These hairs we intermixed with scalp hair. The majority were placed towards the posterior part of the scalp in the recipient.