Jeffrey Epstein MD, FACS

Dear Posters, Pat and Bill, and everyone reading this- I wanted to make a few comments, to hopefully help clear the air.. 1. I perform on a typical day 2 procedures, and work 5 days a week, 51 to 52 weeks a year. Of the 500 procedures I perform yearly on average, 75 are eyebrow procedures (which take 2 to 3 hours at most to perform), 100 are on women (which take 4 hours on average to perform as they tend to be 1600 to 1800 grafts in size), 100 are reparative procedures which, and 225 are for male pattern hair loss. I start my day with a large case- 2400 to 2800 grafts- at 7 am, and am usually finished with with this procedure by 1 or 2 pm, sometimes 3 pm. I have a team of 15 full-time assistants, so this provides us with not only the ability to have all the grafts cut in 3 hours or so, but constant rotation of 4 to 5 specially trained and skilled planters to get the grafts efficiently placed. Please also note that I often will remove the donor strip in two parts- so that the hairs are out of the body for the shortest period of time, thus preserving the blood supply for the longest period of time to help with hair regrowth. The second procedure, which is usually smaller (i.e. eyebrow transplant, or a 1600 to 1800 graft procedure) I usually check in around 1 pm, and the donor strip is then ready to be removed at 2 pm which coincides when the first procedure is usually finished. Then, this case will be over by 6 or 6:30. 2. The very comments that my assistants are talking is what most of my patients love- for they are engaged in this conversation. I do not have TV sets in my procedure room- rather I prefer that the patient, who is often taking some sedation, can engage in conversation with the 15 or so people working on him/her. I cannot tell you how many of my patients tell me what a wonderful team of assistants I have, and how the "casual" atmosphere helps put them at ease. But don't be fooled- I have a AAAHC certified operating room (I believe one of the only hair transplant facilities in the country to achieve anywhere close to this level of certification, assuring patients of the highest standards of care and sterility). In addition, the average assistant in my team has 5 to 6 years of experience- with some of them working with me for as long as 14 years. So these girls are true professionals, who follow my lead in interacting with patients. I just completed an eyebrow transplant procedure, and received a big hug from her to thank me not only for wonderful results but also for a wonderful experience. Does anyone notice how the top guns are able to work with what some of us would regard as a distration: i.e. Rap music playing as the Detroit Pistons warm up; Country and Western music blaring in the NY Giants locker room, per the request of Eli; Mozart in the Open Heart Operating room. When people are relaxed and things are going well, with people confident in their abilities, they are able to converse with patients, talk amongst each other, listen to whatever music the patient requests, and are able to go about doing their work to the highest degree possible. Personally, I am more relaxed and sharper when listening to some great rock and roll. 3. I am an active participant in ALL phases of the procedure. In addition to removing then suturing closed the donor site in a plastic surgery fashion, I make EVERY SINGLE RECIPIENT SITE, constantly returning to the operating room to make additional sites so that the hairline has exactly the natural look that patients desire and that I demand, as well as the maximal density. In addition, I will often do some planting, especially along the hairline and central forelock. 4. In over 14 years of practice, with over 5,000 procedures performed, I have had literally thousands of very happy patients. In those occasional cases when there is less than full (90 plus %) growth, I replace these grafts AT NO CHARGE. I also encourage patients to contact me at any time, providing all of them with my personal cell phone number 305-310-6361. 5. Every single one of my 15 assistants has their own Mantis microscope, their own 3 dishes of iced Petri dishes, and is paid not upon the number of grafts they cut (which can encourage slopiness) but on a salary. For anyone who cares to take a look- on my website www.foundhair.com, you can view a video of an actual procedure being performed. To all the readers and posters out there: I apologize for any defensive stance I took. I have worked for so many years to establish what has been a stellar reputation, and put my heart and soul into each and every case I perform. I love what I do- next to my 3 kids, there is nothing more important to me than my practice. After 6 years of plastic surgery fellowhip and training, and 14 1/2 years of practice, I understand the importance of listening to every patient, and realize that my reputation is only as good as the work I perform. I will always adhere to the highest standards, and wish to convey to everyone reading this that I will always stand by my work, always will operate in an accredited facility, always will be accessible to my patients, always will have the top trained assistants, and never stop trying to get better and better, and will do my very best for every patient. Sincerely, Jeffrey Epstein, MD, FACS www.foundhair.com www.womenscenterforhairloss.com

Dear Posters, Pat and Bill, and everyone reading this- I do feel I need to make some additional comments, to respond to some of the comments posted, as well as to explain how I work. 1. I perform on a typical day 2 procedures, and work 5 days a week, 51 to 52 weeks a year. Of the 500 procedures I perform yearly on average, 75 are eyebrow procedures (which take 2 to 3 hours at most to perform), 100 are on women (which take 4 hours on average to perform as they tend to be 1600 to 1800 grafts in size), 100 are reparative procedures which, and 225 are for male pattern hair loss. I start my day with a large case- 2400 to 2800 grafts- at 7 am, and am usually finished with with this procedure by 1 or 2 pm, sometimes 3 pm. I have a team of 15 full-time assistants, so this provides us with not only the ability to have all the grafts cut in 3 hours or so, but constant rotation of 4 to 5 specially trained and skilled planters to get the grafts efficiently placed. Please also note that I often will remove the donor strip in two parts- so that the hairs are out of the body for the shortest period of time, thus preserving the blood supply for the longest period of time to help with hair regrowth. The second procedure, which is usually smaller (i.e. eyebrow transplant, or a 1600 to 1800 graft procedure) I usually check in around 1 pm, and the donor strip is then ready to be removed at 2 pm which coincides when the first procedure is usually finished. Then, this case will be over by 6 or 6:30. 2. The very comments that my assistants are talking is what most of my patients love- for they are engaged in this conversation. I do not have TV sets in my procedure room- rather I prefer that the patient, who is often taking some sedation, can engage in conversation with the 15 or so people working on him/her. I cannot tell you how many of my patients tell me what a wonderful team of assistants I have, and how the "casual" atmosphere helps put them at ease. But don't be fooled- I have a AAAHC certified operating room (I believe one of the only hair transplant facilities in the country to achieve anywhere close to this level of certification, assuring patients of the highest standards of care and sterility). In addition, the average assistant in my team has 5 to 6 years of experience- with some of them working with me for as long as 14 years. So these girls are true professionals, who follow my lead in interacting with patients. I just completed an eyebrow transplant procedure, and received a big hug from her to thank me not only for wonderful results but also for a wonderful experience. 3. I am an active participant in ALL phases of the procedure. In addition to removing then suturing closed the donor site in a plastic surgery fashion, I make EVERY SINGLE RECIPIENT SITE, constantly returning to the operating room to make additional sites so that the hairline has exactly the natural look that patients desire and that I demand, as well as the maximal density. In addition, I will often do some planting, especially along the hairline and central forelock. 4. In over 14 years of practice, with over 5,000 procedures performed, I have had literally thousands of very happy patients. In those occasional cases when there is less than full (90 plus %) growth, I replace these grafts AT NO CHARGE. I also encourage patients to contact me at any time, providing all of them with my personal cell phone number 305-310-6361. 5. Every single one of my 15 assistants has their own Mantis microscope, their own 3 dishes of iced Petri dishes, and is paid not upon the number of grafts they cut (which can encourage slopiness) but on a salary. For anyone who cares to take a look- on my website www.foundhair.com, you can view a video of an actual procedure being performed. To all the readers and posters out there: I apologize for any defensive stance I took. I have worked for so many years to establish what has been a stellar reputation, and put my heart and soul into each and every case I perform. I love what I do- next to my 3 kids, there is nothing more important to me than my practice. After 6 years of plastic surgery fellowhip and training, and 14 1/2 years of practice, I understand the importance of listening to every patient, and realize that my reputation is only as good as the work I perform. I will always adhere to the highest standards, and wish to convey to everyone reading this that I will always stand by my work, always will operate in an accredited facility, always will be accessible to my patients, always will have the top trained assistants, and never stop trying to get better and better, and will do my very best for every patient. Sincerely, Jeffrey Epstein, MD, FACS www.foundhair.com www.womenscenterforhairloss.com

I wanted to add one more thing. As I typically perform 500 procedure a year (513 for the year 2007), having one, two, or three patients represents a less than 0.5% rate of less than perfect results. And furthermore, at just 6 months, this is far too early to assess final results, as some patients, especially those who do not use minoxidil post-procedure, can have regrowth typically not beginning until 3 1/2 to 4 months. Finally, let me point out that, in the case of the one patient at 9 months, the wearing of a hair piece can be a major contributing cause of delayed hair growth. That being said- I wish for transparency. I want my patients to have the very best results, and to feel comfortable speaking with me. I provide every patient with my email address and cell phone number, so that they can contact me day or nite. I stand by my work and assure every patient that when there is the rare case of less than 90% plus growth, that I replace those grafts at no charge, simply because I want to do everything to keep every one happy. Jeff Epstein, MD, FACS

I do wish that kevkristy and female hair loss contact me directly so that I can properly work with them within the professional doctor-patient relationship, the foundation for any successful physician. However, I do feel that I need to reply publicly to some of the comments made about me on this thread, for the sake of sticking with facts and not speculation. Unfortunately, because I do not know who female hair loss and kevkristy are, as they have not contacted me directly, I need to ask some questions. Firstly, female hair loss- you stated you have had two procedures. Was the first performed by me- and if so, were the results from that first procedure good? And if not, why did you have a second procedure? As you all may be aware, or perhaps not, I tend to do a lot of reparative/secondary procedures, in which patients have been disappointed by prior work, and they come to me as a last resort. In these cases, I assure patients that I will do my very best, and often need to remind them of the limited possibilities that can be achieved with these procedures, despite the very best technique. I do wish I could help you in the best way, and certainly replying to accusations provided anonymously is frustrating, to say the least. The same goes for kevkristy- being that you are only 6 months, it is far far too early to evaluate your hair growth. How much shock loss did you have- and were you one of those cases in which you had fine hair, and I explained to you that there were limitations? Once again, replying to patients' posts that were made anonymously is challenging, plus not the way I wish to address concerns. I assure Please Grow Please that my techs are in fact worth a damn- in fact, they are the same techs I have had for the past 4 plus years- some I have had for more than 10 years- and they are the very same techs that did the 500 procedures I perform every year- the same ones whose work can be seen on my photo gallery on my website. There have been no changes to them, and in the way we perform these procedures. Every graft is dissected individually, then placed in chilled saline, then planted one at at time. Secondly, and most importantly, these procedures are in fact performed by me. I make every single recipient site, and as they have always done, my assistants do a large amount of the planting, but I am continually coming back into the procedure room, making more recipient sites, and doing some placing of grafts as well. As I am not performing multiple procedures a day, and only seeing some consults and follow up visits, I can assure you that I am actively involved in each patient's procedure, committed to giving them the very best results. Finally, I always stand by my work. Perform 500 procedures a year, there are always going to be a few patients whose growth is not what they expect- despite my efforts to educate patients so that they have appropriate expectations, and my efforts to always take the road of highest quality (I have 15 full time assistants working for me, each one of whom I allow to work to their best capacity so that my patients always get the very best results). What I can control is how the procedure is performed, and the artistry of the technique. What I cannot control 100% is how patients grow after a procedure- assuming grafts have been protected and kept moist and dissected properly, something that has not changed in over 5 years in my practice being that I still have the same team together. There are always going to be a few patients whose growth is simply less than the 90 to 95% plus rate of growth that I typically achieve. Just look at some of the hundreds of before and after photos on my website to be assured of this. Examine closely the hairlines that I create. And finally, come meet with me and see how seriously and professionally I approach this entire procedure process. Respectfully, Jeffrey Epstein, MD, FACS www.foundhair.com www.womenscenterforhairloss.com Miami and NYC

DEAR FORUM MEMBERS- I AM IN TOTAL SHOCK- HOW MY REPUTATION OVER THE COURSE OF 5 PAGES HAS GONE FROM ONE OF THE 2 OR 3 TOP SURGEONS IN THIS SPECIALTY TO ONE WHO NEARLY EVERY POSTER IS QUESTIONING MY INTEGRITY, MY DEVOTION TO MY WORK, AND MY WORK. THIS IS TRULY A TRAVESTY. I HELD OFF ON ENTERING PUBLICLY THIS FORUM AFTER REPLYING TO MY PATIENT IN THE PROPER WAY A PHYSICIAN SHOULD- PRIVATELY AND WITH DEEP SINCERITY. I REASSURED THIS PATIENT THAT I DID NOT KNOW THE CAUSE OF HIS LESS THAN EXPECTED HAIR GROWTH AT THIS TIME- BUT WAS CONSIDERING SEVERAL REASONS, THAT HE REPEATED- THE MAIN ONE BEING HIS CONTINUED WEARING OF THE HAIR PIECE. HOWEVER, THERE IS AN "X" FACTOR - THAT EVERY SINGLE COLLEAGUE OF MINE, EVERY ONE WHO IS PART OF THIS COALITION- HAS EXPERIENCED. THAT X FACTOR IS THE OCCASIONAL LOWER THAN EXPECTED RATE OF GROWTH THAT, DESPITE OUR BEST EFFORTS, OCCURS FOR AN UNKNOWN REASON- YES, PAT AND BILL ARE CORRECT IN THEORY- IT CAN BE DUE TO POOR GRAFT HANDLING OR DESSICATION (DRYING OUT). HOWEVER, HERE IS MY POSITION. I PERFORM 500 PROCEDURES EVERY YEAR- PERSONALLY, WITH THE SAME TEAM OF 15 ASSISTANTS I HAVE HAD WORKING WITH ME FOR YEARS- SEVERAL HAVE BEEN WITH ME FOR 10 TO 14 YEARS! THESE ARE THE SAME ASSISTANTS WHO WORKED ON JULY 4TH, 2007- ASSISTANTS WHO DO THEIR VERY BEST, UP TO THE VERY HIGHEST STANDARDS, EVERY SINGLE DAY. THERE WAS NO "I WISH I WAS SOMEWHERE ELSE?" THERE WAS NO "DRYING OUT OR MISHANDLING OF GRAFTS BY INEXPERIENCED ASSISTANTS" THERE WAS NO "DR. EPSTEIN IS COMPROMISING QUALITY". AFTER ALMOST 15 YEARS OF PUTTING MY HEART AND SOUL INTO MY PRACTICE- TO WHERE PATIENTS KNOW THAT THEY WILL TREATED BY ONE OF THE BEST TRAINED, MOST DEMANDING SURGEONS IN THE FIELD- I HAVE EARNED MY PLACE AS ONE OF THE BUSIEST IN THE FIELD OF SURGICAL HAIR RESTORATION. I INVITE YOU TO GO AHEAD AND ASK DRS. CHARLES, NUSBAUM, FELLER, SHAPIRO, BERNSTEIN, MEJIA, STOUGH, RASSMAN, HASSON, MCANDREWS, HABER, COOLEY, PARSLEY, KNUDSEN- EVERY ONE OF THEM, TO A TEE, KNOWS OF MY INTEGRITY AND THE QUALITY OF MY WORK. I TRULY FEEL LIKE THIS THREAD HAS BECOME A WITCH HUNT- I THOUGHT THIS IS SOMETHING THAT ONLY HAPPENS IN POLITICS- AND I AM NOT A POLITICIAN, NOT "W' BUSH, NOT BILL CLINTON, NOT CHENEY, NOT OBAMA- RATHER A BOARD CERTIFIED FELLOWSHIP TRAINED FACIAL PLASTIC SURGEON, WHO SPECIALIZES IN THIS SPECIALTY PERFORMING 2 PROCEDURES EVERY DAY BECAUSE I AM PASSIONATE ABOUT MY WORK, LOVE MY PATIENTS, AND AM REALLY TALENTED AT IT. I INVITE EVERY ONE OF THE POSTERS ON THIS THREAD TO COME VISIT MY OFFICE. PAT HAS. TO SEE HOW I AND MY TEAM OF ASSISTANTS ALL WORK ON ONE PROCEDURE AT A TIME, EVERY ASSISTANT WITH 3 ICED PETRI DISHES INTO WHICH THEY PLACE EACH INDIVIDUAL 1, 2, AND 3 HAIR GRAFTS. HOW MY 6 "PLANTER" ASSISTANTS- EVERY ONE WHO HAS BEEN WORKING WITH ME FOR A MINIMUM OF 4 YEARS, 5 OF WHOM HAVE BEEN WORKING IN THIS SPECIALTY FOR 7 TO 14 YEARS- PLACE EACH SINGLE GRAFT INTO THE SMALLEST POSSIBLE RECIPIENT SITES, SIZED 0.6 TO 0.8, OCCASIONALLY 0.9 MM IN SIZE, EVERY ONE THAT I PERSONALLY MAKE. I AM TRULY CONCERNED ABOUT THE RESULTS THIS PATIENT HAS RECEIEVED, AND I TOLD HIM THAT. I ALSO TOLD HIM THAT, IN THOSE FEW CASES IN WHICH THIS HAPPENS, I WILL REPLACE THOSE GRAFTS THAT DO NOT GROW, AT NO CHARGE. DO YOU REALIZE THE ILLOGICAL NATURE OF THE COMMENTS MADE HERE- SOME POSTERS ARE SAYING THAT 2500 GRAFTS IS TOO SMALL- INSINUATING THAT ONLY A FEW DOCTORS ARE CAPABLE OF PERFORMING THESE STATE OF THE ART PROCEDURES. I HAVE IN FACT PERFORMED PROCEDURES OF AS LARGE AS 4300 GRAFTS- BUT FOR THE OVERWHELMING MAJORITY OF PATIENTS, 2400 TO 2800 GRAFTS SEEMS TO BE THE IDEAL NUMBER. NOT PLACING ENOUGH GRAFTS WAS NOT THE CAUSE OF THIS PATIENT'S RELATIVELY DISAPPOINTING COVERAGE AT THIS 9 MONTH MARK- RATHER, HE HAS EXPERIENCED A LOWER PERCENTAGE OF GROWTH THAN EXPECTED. JUST YESTERDAY I PERFORMED A SECOND PROCEDURE ON A MAN FROM SARASOTA- FIRST PROCEDURE I PERFORMED IN MID-SEPTEMBER, 2400 GRAFTS- AND AT 3 1/2 MONTHS HE HAD OUTSTANDING COVERAGE, AND YESTERDAY AT THE 7 MONTH MARK I DID A LITTLE FILLING IN UP FRONT WITH THE MAJORITY OF THE WORK PLACED INTO THE MID SCALP AND CROWN REGION. DID I DO ANYTHING DIFFERENT ON THIS PATIENT? NO. I INVITE EVERY ONE OF YOU TO GO THROUGH MY WEBSITE- SEE THE LITERALLY HUNDREDS OF PATIENTS' BEFORE AND AFTER PHOTOS. LOOK CLOSELY AT THE HAIRLINES, THE DENSITY, AND READ THE COMMENTS THAT MANY OF THESE PATIENTS HAVE MAILED INTO ME UNSOLICITED. JUST 2 WEEKS AGO, IN SOUTH FLORIDA, AN 18 YEAR OLD TEEN HAVING A BREAST AUGMENTATION DIED ON THE OPERATING ROOM TABLE. ANESTHESIA COMPLICATION. HAPPENS ONE IN EVERY 10,000 CASES. RESPECTED PLASTIC SURGEON- DID ABSOLUTELY NOTHING WRONG FROM EVERYTHING I CAN TELL, YET HERE THIS YOUNG GIRL DIED. THIS IS MEDICINE. YOU, AS A PROSPECTIVE PATIENT, CAN ONLY DO YOUR HOMEWORK, AND FIND THE MOST RESPECTED, DILIGENT, HARD WORKING, HONEST, ARTISTIC, DEVOTED SURGEON - AND THEN AFTER THAT, THERE IS SOMETHING CALLED INDIVIDUAL VARIATION. I HAVE ABSOLUTELY NO CONTROL, UNFORTUNATELY, AS TO THE RATE AND SPEED OF GROWTH OF TRANSPLANTED HAIRS, PROVIDED THAT I PERFORM THESE PROCEDURES UP TO THE VERY HIGHEST STANDARDS. THAT IS WHY THERE CAN NEVER BE A "GUARANTEE" AS TO THE OUTCOME. I CAN TELL PROSPECTIVE PATIENTS THAT IN OVER 90% OF MY PATIENTS, THERE WILL BE SOME NICE EARLY GROWTH AT THE 3 TO 4 MONTH MARK, AND THAT AT 9 MONTHS THERE SHOULD BE 70 TO 80% OF THE FINAL RESULT- BUT THERE IS INDIVIDUAL VARIATION. I CAN ALSO TELL PATIENTS THAT I CAN ASSURE THEM THAT THEIR WORK WILL BE PERFORMED TO THE VERY HIGHEST STANDARDS, AND THAT THEIR RESULTS WILL BE NATURAL IN APPEARANCE. LOOK AT WHAT I CAN CONTROL: 1. ARTISTRY OF THE HAIRLINE- I INVITE EVERY ONE OF YOU TO GO THROUGH MY WEBSITE PHOTOS AND SEE THE AESTHETICS OF MY HAIRLINES. THERE MUST BE AT LEAST 400 HAIRLINES THAT I SHOW CLOSE UP. 2. FINENESS OF THE DONOR SITE SCAR- ALTHOUGH THERE ARE PATIENT VARIABLES IN THIS AS WELL, BUT GO AHEAD AND LOOK AT THE 50 TO 70 OR SO DONOR SITE SCARS THAT I SHOW ON MY WEBSITE. 3. EDUCATING AND CHOOSING OF PATIENTS- JUST LAST WEEK, I CANCELLED A PROCEDURE ON AN IRAQI WAR VET, A 28 YEAR OLD, WHO HAD UNREALISTIC EXPECTATIONS OF THE SURGERY, AND WHOM I THOUGHT LOOKED QUITE GOOD WITH HIS HEAD SHAVED. HE HAD PAID 100% OF HIS SURGICAL FEE- WHICH I RETURNED, AND LEFT ME WITH A HALF DAY OF 15 PAID ASSISTANTS WITH NO WORK TO DO. NOT EVEN AN ISSUE AS TO WHAT WAS THE PROPER THING TO DO. I FELT HE WAS BEST OFF NOT HAVING A PROCEDURE, AT LEAST FOR THE NEXT YEAR OR SO, UNTIL HE FIGURES SOME THINGS OUT AND UNDERSTANDS THE LIMITATIONS OF THE PROCEDURE. 4. MY REPUTATION- I CAN ONLY LOOK EVERY PATIENT IN THE EYE AND TELL THEM THAT I STAND BY MY WORK, WILL ALWAYS DO THE VERY BEST I CAN, AND WILL NEVER RIP OFF A PATIENT. I DO NOT HAVE INFORMERCIALS. I DO NOT HAVE A YELLOW PAGE AD. I DO NOT DO PRINT, RADIO, OR TV ADVERTISING. NOTHING OTHER THAN WORD OF MOUTH- BY OVER 5000 HAPPY AND HAIRIER PATIENTS, AND BY A NUMBER OF MY PHYSICIAN COLLEAGUES. I HOPE THAT EVERY ONE OF YOU, BEFORE YOU BECOME JURY, JUDGE, AND EXECUTIONER TO MY REPUTATION ALL AT ONCE, CHOOSE TO TAKE A MOMENT TO EDUCATE YOURSELVES, AND PROCEED INTELLIGENTLY AND APPROPRIATELY. THESE POSTINGS HAVE DONE LITTLE OTHER THAN TO UNDERMINE THE PHYSICAN-PATIENT RELATIONSHIP. I AM ONE OF THE DOCTORS WHO HAS ALWAYS WANTED THIS SITE TO TAKE THE HIGH ROAD. HAVE ARGUED AGAINST PAID CONSULTANTS POSTING COMMENTS ON THIS SITE OTHER THAN PROVIDING NON-BIASED EDUCATIONAL INFORMATION. HAVE PUBLICLY COME OUT IN THE JOURNALS AGAINST SURGEONS PAYING HAIRDRESSERS AND OTHER HAIR PROFESSIONALS FOR PATIENT REFERRALS BECAUSE THEY ARE UNETHICAL. GO AHEAD AND READ THE TENS, IF NOT HUNDREDS, OF POSTS ABOUT ME ON THIS SITE. GO AHEAD AND READ JUST A FEW OF THE HUNDREDS OF PATIENT LETTERS I POST ON MY WEBSITE. COME TO MY OFFICE AND ASK TO SEE THE 4 VOLUMES OF COLLECTED EMAILS AND LETTERS FROM HAPPY PATIENTS. I WISH TO CONTINUE PARTICIPATING IN THIS SITE AS A POSTER AND EXPERT- BUT WILL NOT STAND BY WHILE MY REPUTATION GETS HACKED AWAY AT. I AM SORRY THAT THIS PATIENT HAS NOT HAD THE GROWTH I WOULD HAVE EXPECTED AT 9 MONTHS. HE IS NOT THE FIRST. HE AND PERHAPS 3 OR 4 OF THE 500 PATIENTS ON WHOM I PERFORMED A PROCEDURE ON IN 2007 I WILL NEED TO BRING BACK TO THE PROCEDURE ROOM AND PERFORM A TOUCH UP OR WHATEVER IS NEEDED, DUE TO A LOWER THAN EXPECTED RATE OF GROWTH. BUT AT 9 MONTHS, IT IS FAR TO EARLY TO DETERMINE THIS. RESPECTFULLY, JEFFREY EPSTEIN, MD, FACS WWW.FOUNDHAIR.COM MIAMI AND NYC

Club Head- I appreciate your offer to delete portions that refer to me- however, you still have "the exact opposite of Dr. Epstein" in your original post. I still do not understand why you chose to attack me, more than once, in your original post- for things which I most certainly did not tell you. Furthermore, I am still waiting for you to contact me directly. I appreciate your explanation, and will let sleeping dogs lie. Jeffrey Epstein, MD, FACS

I respect Dr. Lindsey's opinion, however I have a different perspective. We do not require any of our patients to shave the hair in the recipient area, for a few important reasons: first, it makes it difficult to resume regular activities for the first few weeks after the procedure, and second, during the course of the procedure I find the presence of the existing hairs allows me to more accurately determine the relative thinness of different areas of the scalp. Yes, it may take as much as an additional 90 to 120 minutes longer to perform a procedure of 2500-plus grafts when the hair is present, but this extra time put in is a small price for the advantages of leaving the hair alone. Sincerely, Jeffrey Epstein, MD, FACS www.foundhair.com

Dear Club Head- I too, like Bill, am surprised at your interpretation of what was discussed at your consultation. Having been specializing in the field of hair transplantation for over 14 years, in which I personally meet with every patient, personally reply to every email inquiry, and still provide every patient with my cellphone number so that they have full access to contact me at anytime, I find your comments difficult to believe. I am not sure who you are- it would be helpful for you to contact me privately so that I can go over your chart and properly "defend" myself against what I feel are rather incendiary and mean-spirited accusations. Perhaps my advice was based upon you having unrealistic expectations of achieving full scalp coverage of your Class 5 plus hair loss pattern- and if that was your goal, perhaps I told you that you are better off continuing to wear a hat. I can assure you Club Head that I have no reason to be anything other than fully supportive, as well as accurate, in the advice I give to young men like yourself struggling to deal with your hair loss. I hope you will be fair and contact me, and furthermore, explain why, as a brand new poster to this site, you decided right from the start to criticize me while lauding the work of your surgeon, a respected colleague of mine, who I know would not encourage such negative commentary on this site. Sincerely, Jeffrey Epstein, MD, FACS www.foundhair.com

Gator Mario- Your thread was brought to my attention this evening, and I feel it worthwhile to add to the conversation- not with the intention of "selling" myself, but better, to help educate you and the other posters. I respect Dr. Griffin as well as many of the other doctors on this site, but want to explain why I feel my approach is indicated and what goes into my grafts. Follicular unit grafts is what I use- my team of 15 full time assistants dissect down every one of the grafts into pure follicular units- which on average contain 2.2 hairs, but this can vary from 1.4 to as high as 2.6 hairs per graft. I DO NOT divide follicular units to artificially elevate graft counts- this is, unfortunately, done by some less reputable clinics, and unfortunately does nothing but disappoint patients ("You mean that I had 4,000 grafts and I look this thin?). In the crown region, in any individual with hair that is not blonde or salt and pepper and/or quite curly, it is essential that only pure follicular units are used to achieve a natural appearance- occasionally I will combine two 1-hair grafts into a single recipient site. From your photos, it is clear GM that you have a moderate amount of thinning- and to transplant just 1300 grafts simply will not provide you with enough coverage, in my opinion. I hope that helps. Please feel free, any of you, to ask further questions, either on this post or directly to my email jsemd@foundhair.com. Sincerely, Jeff Epstein, MD, FACS Miami and NYC www.foundhair.com

I appreciate all the dispensing of valuable information from members of the HTN community, some of whom are my patients. The patient did contact me, to first apologize, and second, to let me know who he was. While I will not disclose any personal information, there are some facts which I can share. I have over 10 email correspondences between him and I from before his procedure, in which I made very clear that, because of his relatively young age (in his early 20s) and the high risk of further hair loss, that I was recommending, if he was going to have a procedure at all (which I did spend a lot of time talking about all the negatives to having a procedure at such a young age) a very conservative course in which I would be filling in the density of the frontal region without any lowering of his hairline. This could not have been more clear, and he fully understood this all through the time of his procedure. He is also not even 7 months out from his procedure. Having said that, I am most happy that I have established the same rapport that I had with him pre-procedure. There is no more important element than the doctor-patient relationship. Jeff Epstein, MD, FACS www.foundhair.com

I must say- here I have not been on this site for almost 2 months, and I happen to click on this link. First of all, to my knowledge, I have not been contacted by any patient telling me of their dissatisfaction, so I am not even sure who dbk20032002t is. Second, it is apparent that this patient's donor density was quite low and/or his goals were relatively limited- not only did I only recommend or agree to a rather conservative graft count of 2200, but I was only able to transplant 2100 or so grafts. This patient received a reimbursement for the lower graft count (anyone who knows me as a doctor knows that I typically give 100 or more grafts at no charge). Third, with a planned procedure of 2200 grafts, there is a definite limit on how much lowering of the hairline can be achieved (and considering that I got less than this graft number, it is a good thing the hairline was designed as such), yet this patient claims that I "didn't listen to him"- which once again, anyone who is familiar with me knows that I establish an honest communication line with every patient of mine, and have more than once cancelled an out-of-town patient's procedure after meeting him if I felt that I could not do a good job which includes meeting his expectations. Fourth, for some patients, at just 7 months growth can be at just 40 to 50% of expected. All those points being made, I hope that this patient contacts me directly, so that I can have the opportunity to : know who he is, reassure him, provide him with some feedback, and lastly, assure him that if he does not have the full growth that he should realistically expect that I will replace those grafts that do not grow at no charge. This forum is an invaluable asset to the online community suffering from hair loss, but should NOT be a substitute for the doctor-patient confidential relationship. This confidentialty also limits me from adequately responding to his comments, once I find out who is the patient. Anyone who visits my website can read the literally hundreds and hundreds of letters I have received from happy patients, as anyone who spends time on this site can communicate with just a small sampling of my many patients, who complement me and my staff for our professionalism, caring, and top work. I have spent 14 plus years building this reputation, that has come with placing my patients' interests first, and never compromising in the work I perform. I love what I do, and want to do the best for every one of my patients. Therefore, I hope that dbk20032002 will contact me directly. Thank you. Jeffrey Epstein, MD, FACS www.foundhair.com Miami and NYC

One other thing. The ability to minimize or avoid altogether shock hair loss (whether of the scalp or the eyebrows) is due to several steps, including not placing an excessive amount of grafts, making all recipient sites parallel to existing hairs, and using the very smallest recipient sites. It is only with an experienced hand guided by sound judgement can these steps be accomplished. Jeffrey Epstein, MD, FACS

I want to thank Bill for bringing to my attention this post. I greatly appreciate the effort to clarify things. I hope that EYEBROW understands that, in the over 200 eyebrow transplant procedures I have performed over the past 3 years, I have had literally just one patient who has had the experience of Felicity. And while I do feel quite bad about this, I have yet to see her in person post-procedure, and have offered several times to have her schedule a touch up procedure to see what I can do to give her the very best results so that she will hopefully be happier. While around 40% of the eyebrow procedures I have performed have been on patients with little to no hair, the majority have had some hair and in them the goal was to thicken the brows up. In these cases, there has been very little if any shock loss- in fact, I do not recall a single patient complaining of/reporting this phenomenon to me-and if I have not had any other patient but Felicity reporting it, then I can assume it occurs very infrequently. However, the last think I would ever want to do would be to mislead my prospective patients- one of the reasons I have been so successful, especially in all my work with women, is my always providing realistic worse case scenarios in my pre-op consultation- this way, I can exceed these expectations and have particuarly happy patients. So, I would want you to know, EYEBROW, that while shock hair loss is a very atypical occurrence, it can infrequently occur, although not to my typical experience. Thank you. Jeffrey Epstein, MD, FACS Miami and NYC www.eyebrowtransplantation.com

Thanks Bill for notifying me as to what is going on with my patient's posted results. In all fairness, there are several points that need to be made so that a more balanced perspective can be obtained. I prefer not to be compared to some of the large chains, for I have spent almost 15 years refining my techniques and providing my patients with the very best work possible. When I first consulted with this patient by email, I informed him that the goal would be to transplant a minimum of 2200 to 2400 grafts, but that the goal would be to try to obtain as many as 3200 grafts if possible, given: his relatively light scalp that would contrast significantly with his very dark and wiry hairs; his relatively young age and the high likelihood that his remaining vellus scalp hairs in the area of the transplant are at high risk of soon falling out; and that my experience was that individuals with his presenting characteristics simply do not achieve significant results with procedures of 2200 to 2400 grafts- that the resultls would be quite natural appearing despite the challenges of working with such coarse hair, but that I would do everything I could to give him the very best results, and that he likely would benefit from a second procedure. Obviously my patient heard quite well what I advised him about, and therefore he is NOT DISAPPOINTED for I was honest. In fact, I am happy with his results, which obviously are not my "poster" results, but not every patient can have incredible results. In fact, I have had the patient speak with at least one other prospective patient from his area, so I am not trying to "hide" anything. In the procedure, I was able to obtain 2411 grafts, for a total of 3743 hairs. This was because of the relatively low donor density and the tightness of his donor area- and of course I wanted to minimize donor site scarring so did not try to obtain too wide of a donor strip- he obviously wears his hair somewhat short. The procedure went quite well, but he had over 8 weeks of prolonged erythema/redness and irritation in the recipient area which was successfully treated with two courses of antibiotics. So, what is going on? Hopefully there will be at least a bit moroe growth to come. In any case, I anticipate, and have relayed these thoughts to my patient, that he will be able to have a second procedure that will make a nice improvement in his density. I really like this patient, have a wonderful rapport with him, and look forward to giving him the very best possible results. Jeffrey Epstein, MD, FACS Miami and NYC www.foundhair.com

Sometimes even small numbers of grafts, given limited donor supply, can make a big difference when these hairs are placed strategically, and/or combined with graft removal and retransplanting techniques. Sincerely, Jeff Epstein, MD Miami and NYC www.foundhair.com

Just wanted to clarify things KulMD. I do in fact perform procedures in my NYC office, only that my fees are less when performed in my Miami office. Sincerely, Jeff Epstein, MD, FACS Miami and NYC

You know that sometimes the patients with the most scalp laxity are at greatest risk for a scar- due to the nature of the collagen. Scar repairs can be tricky, and humility is the key for the consulting doctor. I typically advise patients that with a scar repair, there is a 50% chance I can get the scar 50% thinner, while a 40% chance 20 to 40% thinner, and 10% chance minimal change or worse. Sincerely, Jeff Epstein, MD, FACS Miami and NYC www.foundhair.com

Nice to hear such nice comments about me, as well as my colleagues. I do not require patients to shave their heads- yes, it does mean the procedure takes a bit longer and requires a bit more concentration on my part, but the upsides (don't have a buzzed head for 6 weeks) far outweigh the downsides. Just last week we performed an almost 4300 graft procedure, and it took just under 8 hours with a non-shaved head. Patient was happy. Jeff Epstein, MD, FACS Miami and NYC

One other thing KulMD. Regarding my fees- understand that because we do not shave the recipient area for the procedure, it takes approximately 30% more time to perform it- due to the need to work carefully around the existing hairs. For many men, they are willing to pay a bit more to have it performed this way so that they can much more easily conceal their work in a day or two after the procedure and not have to deal with a shaved head. Sincerely, Jeff Epstein, MD

I am writing to apologize to KulMD re: his perceived lack of good follow up by my office. It is our policy to always get back to patients within 2 to 3 days after being seen, to provide them with any additional information they may need- which often includes putting them in touch with another patient to meet and speak with them. In this case, one of our patients was contacted, and when he replied 2 days later that he could speak with KulMD, we then contacted KulMD with his contact info. I understand our fees may be a bit higher than others. My fees have been set to reflect the intensive nature of the work we perform - having a staff of 14 full-time hair transplant assistants who work only for me and whom each work on every case we perform, one at at time, thus allowing cases to proceed smoothly and efficiently for the highest possible percentage of growth. Furthermore, my background is as a facial plastic surgeon, having specialized exclusively in surgical hair restoration for the past 14-plus years. Finally, I spend a lot of time personally emailing to every patient who contacts me, and meet with every patient in consultation. I wish KulMD the best of luck with his procedure. Respectfully, Jeffrey Epstein, MD, FACS Miami and NYC

Dear Nick- I take offense at the aggressive selling techniques utilized on this site by Spex, who is a paid consultant of Dr. Feller's, and therefore I assume may be done with his approval. It is my belief that the purpose of this website is not to "sell" specific doctors when there is a financial incentive for the poster. I will be notifying Bill re: this problem, and I do hope that it does not become more endemic than it seems to have. Jeffrey Epstein, MD, FACS Miami and NYC www.foundhair.com

I do welcome any discussion of my work on this forum- to date, comments from those on whom I have worked have been nothing but stellar. Anyone who comes in contact with me knows that I am a perfectionist to the nth degree. This includes the way I discuss procedures with patients, going over their goals and providing them with realistic expectations as well as reviewing the risks and benefits. In fact, in the letter I send to all my patients about eyebrows, there is a specific area where I discuss that eyebrow transplants, unlike scalp transplants, do not produce perfect results - rather they improve the fullness and appearance of the eyebrows. I would guess that no fewer than 10 emails were sent back and forth from my office to Felicity prior to her having her procedure. Furthermore, I have at all times been actively encouraging of follow up questions and trying to help the patient- including offering a touch up procedure at no charge. I have performed many eyebrow transplants, likely more than anyone in the field over the past 3 years, and included in these cases have been some patients for reparative/revision procedures. Jeffrey Epstein, MD, FACS www.eyebrowtransplantation.com www.foundhair.com www.womenscenterforhairloss.com

I feel it is essential that I reply to "Felicity's" post, to clarify the situation. It was actually the moderator Bill who brought this post to my attention, out of concern that I have the opportunity to protect the reputation that has taken me almost 15 years to achieve. First, I and my office manager Roxy have been in consistent communication with this patient. She has my cell phone number 305-310-6361, my email address jsemd@foundhair.com, and we have discussed her situation with her, the content I prefer not to share with the public. Let me say that I have offered to do whatever it takes to help her to feel happier with her results, but the fact is, unrealistic expectations are difficult to overcome- despite the fact that I do my best to explain to all my eyebrow transplant patients that the transplanted eyebrows are not perfect, but for just about all of the 130-plus patients on whom I have performed this procedure over the past 4 years, the procedure has made them very happy. In fact, around 10% of the eyebrow procedures I perform are reparative, so I have extensive experience in what can go wrong. But as I said, keeping in mind realistic expectations are essential to having a happy patient. Also, it is simply not true that I was not actively involved in this procedure. I made every one of the recipient sites, did some of the planting myself of the grafts (assisted by my designated eyebrow subspecialty "team" of assistants), made sure all of the grafts at the end of the procedure were in the proper orientation, and, as with all of the cases we perform, made all the final adjustments/refinements at the end of the procedure with the patient able to see the results. I am so sorry that "Felicity" is disappointed. I do not settle for having less than very happy patients, and have been taking all of the exhaustive steps to taking care of this. Jeffrey Epstein, MD, FACS www.eyebrowtransplantation.com

please note- the SAFE technique is a method for obtaining the donor hairs without the use of an incision. the key to obtaining an aesthetic result with the delicate procedure of eyebrow transplants is the use of very small recipient sites placed at just the right angle and position. jeffrey epstein, md, facs www.eyebrowtransplantation.com

Donna- Hair transplantation in women is the fastest growing area of my practice, for a number of reasons. Perhaps the most important is that the results that are able to be achieved as so much better than that from 8 or more years ago, primarily due to the technique of follicular unit grafting and the combining of multiple follicular units into single tiny recipient sites. another key element is in providing women with realistic expectations- letting them see actual results, of patients with donor hair similar to their own. jeffrey epstein, md, facs www.womenscenterforhairloss.com www.foundhair.com miami and nyc