Hair loss and hairs lost.

[Occam's Razor]

Greetings all. I have read this site and others for some time now and have decided to share my experience and deductions. In my early thirtys I began to notice that my hairline was beginning to become somewhat transparent. I was into the music scene (metal) and had long hair and to me it just didn't look as good even though the recession was minimal. After doing some research, including this site, I decided to go with one of the featured doctors, Dr. Edwin Epstein. After a consutation with the doctor it was determined that I had about 2.5 cm of recession with about 20-25 thinner native hairs per sq. cm within this area. The doctor recommended a small procedure of just 300 fut.s to thicken things up. Other doctors I had consulted recommend much more, but doctor Edwin Epstein seemed much more sincere, and his personal website looked much more impressive. That with the fact he was featured with the many esteemed doctors here cinched the deal for me. So in May of 2003 I had my first procedure and received 383 fu.s into my hairline. The whole process took less than 2 hours, I didn't even have time to finish watching the movie the doctor was kind enough to put on for my comfort. The whole operation was painless, even the numbing, and I was impressed at how quickly that I had healed after the procedure. Unfortunately, this is where the accolades end. After nearly one year this minor procedure had not just minor, but negative results. Not only were the existing hairs shocked away to never return, but less than 50 new fu.s apparent. In another consultation with the doctor he had expressed his disappointment and offered another larger procedure at a discount. After consideration and consulting with another clinic familiar with Dr. Edwin Epstein, I had agreed to what I was told would be a final procedure. On June of 2004 I had a second session in which I received 1105 fu.s into the same area and even a little above. Nearly a year after this second procedure the results were quite bleak. I have coarse nearly black hair and a lighter complexion, the dreaded combo for hairline transplantation. With that said I now have about 10 fu.s per. sq. cm. of thick black hairs going across my entire hairline by 3 cm. high. No matter how I style my hair I cannot entirely hide this bizarre new look. I have since cut my hair short and wear hats, something I have never done before, to hide this. Also the fact that nearly 1000 of my donor fu.s were MIA, more that likely KIA, has added to the trauma. I had initially done about two months of research with multiple resources before my first procedure. In the three years since my last procedure I have learned you cannot do enough research. I will be posting photos soon and will be happy to field any futher questions.

[Occam's Razor]

Greetings all. I have read this site and others for some time now and have decided to share my experience and deductions. In my early thirtys I began to notice that my hairline was beginning to become somewhat transparent. I was into the music scene (metal) and had long hair and to me it just didn't look as good even though the recession was minimal. After doing some research, including this site, I decided to go with one of the featured doctors, Dr. Edwin Epstein. After a consutation with the doctor it was determined that I had about 2.5 cm of recession with about 20-25 thinner native hairs per sq. cm within this area. The doctor recommended a small procedure of just 300 fut.s to thicken things up. Other doctors I had consulted recommend much more, but doctor Edwin Epstein seemed much more sincere, and his personal website looked much more impressive. That with the fact he was featured with the many esteemed doctors here cinched the deal for me. So in May of 2003 I had my first procedure and received 383 fu.s into my hairline. The whole process took less than 2 hours, I didn't even have time to finish watching the movie the doctor was kind enough to put on for my comfort. The whole operation was painless, even the numbing, and I was impressed at how quickly that I had healed after the procedure. Unfortunately, this is where the accolades end. After nearly one year this minor procedure had not just minor, but negative results. Not only were the existing hairs shocked away to never return, but less than 50 new fu.s apparent. In another consultation with the doctor he had expressed his disappointment and offered another larger procedure at a discount. After consideration and consulting with another clinic familiar with Dr. Edwin Epstein, I had agreed to what I was told would be a final procedure. On June of 2004 I had a second session in which I received 1105 fu.s into the same area and even a little above. Nearly a year after this second procedure the results were quite bleak. I have coarse nearly black hair and a lighter complexion, the dreaded combo for hairline transplantation. With that said I now have about 10 fu.s per. sq. cm. of thick black hairs going across my entire hairline by 3 cm. high. No matter how I style my hair I cannot entirely hide this bizarre new look. I have since cut my hair short and wear hats, something I have never done before, to hide this. Also the fact that nearly 1000 of my donor fu.s were MIA, more that likely KIA, has added to the trauma. I had initially done about two months of research with multiple resources before my first procedure. In the three years since my last procedure I have learned you cannot do enough research. I will be posting photos soon and will be happy to field any futher questions.

[kamin]

I can relate to this post as I am a musician and also suffered from the dreaded receding hairline. It definitely looked like crap on stage under the lights!

 

I received two HT's, one with approx. 1500 grafts and another with 1000 grafts. Unfortunately, these HT's were not with a Coalition doctor recommended from this forum. I am still happy with the results compared to what I had before but I still want to have yet another, smaller, session with a Coalition doctor to fill everything in. My hairline is still too conservative for my taste.

 

The moral of the story is: Make sure the doctor knows exactly what you want so he/she can make an informed decision on whether or not he/she can, or will, do what you want. If you don't want a conservative hairline (like me), then tell the doctor. Otherwise, you may not be satisfied with the results.

 

I think you need to have some consultations with some of the other Coalition doctors, like Feller, Ron Shapiro, H and W, to name a few. They'll do consultations online and should be able to tell you what can be done to help you.

 

Just my opinion.

[hairbank]

Sorry to hear about your bad experience...........I'll be anxious to see your pics.

 

Of more concern to me is what Dr. Epsteins reponse to your situation has been? Was it poor growth? Did you have mega shock loss after the HT's? Have you spoken to him about the poor results of the 2nd procedure?

 

This site takes very seriously any negative performance by its Coalition Docs. Please do post your pics so we can see them and advise of any additional comments from Dr. Epsteinn for HT #2.

 

Thanks,

[Bill - Seemiller]

Occam,

 

Firstly, welcome to the forums. Secondly, I'm sorry to hear that you have had a bad experience so far.

 

I am definitely concerned and for a couple reasons:

 

1. 300FUs is a very small number of grafts and would hardly thicken things up unless transplanted in a very small area. BUT, if you had that minimal loss to begin with, getting an HT may not have been the best thing for you, and Dr. Esptein should know this.

 

2. Did Dr. Epstein recommend that you try any medication first like finasteride or minoxodil? The rule of thumb, ESPECIALLY those with minimal loss should get on finasteride ASAP to minimize the risk for future loss AND minimize the risk for shockloss

 

3. If you indeed had 50% growth, I'm also concerned about this. However, are we certain that you only had 50% growth or is it that all the native hair was permanently shocked and you are left witih all the grafts. I ask this because even with both your surgeries combined, this is not a large number of grafts.

 

Before, immediately post op, and after photos will help us determine this.

 

I am definately interested to see what Dr. Epstein has to say about this. He does have a proven track record of yielding positive results from what I've seen on the forums. Have you talked to him? What is he going to do for you?

 

Keep us posted bro.

 

Bill

 

interested to see how this is going to be resolved

[Occam's Razor]

Thank you all for your concern. I expected nothing less after reading your thoughtful, well informed posts for years now. To start let me clarify, the doctor that I had seen was Edwin Epstein. He was a recommend doctor on this site for years but is now no longer featured. To get an idea about the charcter of this doctor, please refer to the post Faceless man made in Open Hairloss Topics on June 21 of last year. Of course that and other posts about this doctor were made years after my encounter with him. When I was considering doctor Epstein, I had contacted the two top clinics, one in Minnesota and the other in British Coloumbia. I had spoken with their two spokes people. They both new and met Dr. E. Epstein, and although they were careful not to give an official endorsement, they both spoke glowingly of him and mentioned his tutelage under their respective employers. I had searched Dr. E online and found nothing negative about him at the time. I had met a former patient of his, and saw what I thought to be good photo results at the time. I did all this and read the forums for almost two months before committing to this clinic. All to no avail. Which is why I am here now. Allow me to reiterate, I am here to share my experience and deductions with those who are concerned and considering a procedure. You see, I started this years ago, as many of you have, and I have not been idle about this at all. I have been reminded of this for years when I see my image in the mirror, or when I am humiliated by strange looks when I have my hair cut. This has motivated me to do a great deal of research and reflection. I am ready to speak, and I have a lot to say.

Bill, astute as ever and I shall respond to you first. Yes, I now realize half a decade later that 300 was inadequate amount, but I mentioned in my initial post why I had agreed to that at the time and what ensued. The doctor did mention medication but also stated that there were poor results when it came to the front hairline for finasteride and/or minoxodil. The same is repeated on those respective drug websites. Lastly, it is quite evident that what remains is transplanted fu.s. Not just from the pitting, but as I mentioned in my initial post that the hairs that I had were quite thin, and what I have now is thick, far apart and quite obvious. To add, I am sure that my native hairline was going anyway based on family genealogy, which is why I elected to do this in the first place. I went with, what was at the time, a reputable doctors advice when it came to approach.

Hairbank, thanks for the empathy and I shall post a picture soon. Also again, Dr. E. Epstein is no longer here. For your shock and amusement search out the above mentioned post by Faceless Man to see where Dr. E.E. matriculates presently.

kamin, sorry about the split with Valarie and also you gave a great piece of advice, make sure the doctor knows exactly what you want...I did, but in this case it simply didn't matter.

Again, thank you all and I shall post again soon.

[gus hansen]

hey bro,

 

sorry to hear about your story. Just wanted to make sure that theres no confusion. Dr. E. E could very well be confused with another dr. J. E (Jeffrey Epstien). Just wanted to clear this up as dr. Jeffrey Epstien is a Very skilled doctor. Must admit that your first post scared the shit out of me as I'm 2 month out of surgery with dr. J. Epstien. But now I get it

[Bill - Seemiller]

Occam,

 

Thanks for your response...I want to clarify this right off the bat so nobody is confused:

 

You are NOT talking about the below doctor correct?

 

Jeffrey Epstein MD, FACS

6280 Sunset Drive, Suite 504

Miami

Florida

Tel:305-666-1774

To learn more, click here

 

The only Dr. Epstein I am familiar with is this doctor...I have no idea who Edwin Epstein is.

 

Please confirm this, but it appears that this is the case...which of course, still makes me feel bad for your situation, but glad that we don't affiliate this doctor with this community.

 

So allow me to try to help you...

 

What are you currently doing about your hairloss situation? Pictures would definiately be helpful, so I hope you'll post them.

 

I strongly encourage you (if you have any native hair left) to stay/get on finasteride in order to keep what you have.

 

I recommend starting your research here: http://www.hairlosslearningcenter.org/hair-loss-content...s/our_physicians.asp selecting one of the coaltion doctors who have met the "gold" standard of HTs. Do extensive research first and look for consistent positive results with that doctor. Depending on your situation, (if you received mini/micro grafts), you might want to look up "repair work" by using the "find" feature of this forum.

 

When selecting a physician, do NOT let location impact your decision on which doctor you ultimately go to. You want to get it right this time.

 

Again, I'm sorry that this doctor made your situation worse. I am sure with proper research and the right clinic, that you can definiately be in a much better position moving forward.

 

Bill

[hair2stay]

Hey Occam,

 

Welcome to the board. Man, I feel your pain and can totally relate to where you're coming from. I came out and posted my story and photos a couple weeks back, if you care to check it out just do a search with my name. Although I started in on this journey much earlier, '91-'92, I was in a similar situation with my hairline and where I was at in life. I too was playing in bands and very much part of the rock scene in my community and wanted to keep a hairline.

 

Here's the deal... What I think based on my experience and this corresponds with yours as well, is that transplanting into an existing hairline when more recession is emminent is not a wise decision, it's risky, and the outcome is very unpredictable. I am going to go out on a limb and say that doctors should recommend NOT doing these surgeries, instead prescribe the drugs, and let time takes it course a whole lot more before considering surgery. If you look at all the greatest photos that doc's have on their website, they are mostly complete restorations of men or they're of men who have a state of recession that is further progressed or stabilized.

 

I have lived this out over the last 15 years and you are now in the middle of it too. I've listed some observations below, perhaps others would care to comment on them.

 

-hair density in a receding hairline is lower than the back of your head, and is progressively getting less dense. Yes that is why it is called "thinning hair". Trying to match this surgically is most difficult.

 

-hair quality in a receding hairline is often lighter in texture and sometimes in color as well. In my case, the hair in the back of my head is darker and more coarse than the my native frontal hair. Mom thought I colored my hair because of appearence of the transplanted hair!

 

-Transplanting hair into regions where there is a good amount of existing hair (receding hairline)is problematic. The trauma causes shock loss and based on my observations accelerated hair loss in the surrounding area.

 

With this info, I believe that unless the doctor is going to do a complete hair line restoration the process is flawed. How does one approach this knowing that the density is changing as time progresses and that the transplanted hair is characteristically different? The scam I got sold, was "we'll stay one step ahead of time with your hair transplants" Well, yes I have hair and haven't gone bald but the net result is a checkerboard disaster of transplanted hair and native hair and I am married to the process for life. As you lose more hair in the receding area, the transplants become more obvious and back we go for more. I am looking at another 1500+ on top of the 5 surgeries I have already had just to keep up with the process. And at best, all I can do is put faith in the surgeon once again unsure of the net result. What happens in another 10 years??? In hindsight, I'd rather be bald!

 

My guess is that Occam will require some course along these lines. A lot of hair up front to do a complete hairline restoration. His observation of grafts failing to grow is of great concern. I have always felt that doctors have been slow to admit that the percentage of growth in some patients is low, in my case I would venture to guess 30% failure. Now with digital photography it's easier to track.

 

Occam, I wish all the best for you and hope that you can find peace in this in the future. You are going to have to visit with some of the best doc's and see what they have to say. It sounds like from your last post that you did talk with Shapiro and Hasson & Wong at some point, now it's time to revisit with them. As for me, I am off to Dr Feller in another week and will share with all the next step in my follicular fiasco, stay tuned!

 

H2

[Bill - Seemiller]

hair2stay,

 

Your post has merit, but I don't entirely agree. If we were to make a blanket statement that transplanted hair should never be transplanted in the hairline where native hair exists, we'd have to apply that same principle to all areas of the scalp. We'd then have to agree that Diffuse thinners are NOT viable candidates for an HT, which is simply untrue. Additionally, MOST people would not be good candidates since many patients don't have completely bald areas to fill. And even if that was the case...what if the bald areas were filled and then the native hair in other parts of the scalp die to to MPB? Then you are still left with a hairy spot in the filled in area, leaving an unnatural look. So unfortunately...it's not as simple as creating general rules to follow.

 

Not everyone experiences permanent shockloss...though it surely is true that it's POSSIBLE that more native hair will be lost.

 

This is why it's imperative not to just fill in bald patches, but try to accomplish a "stand alone" HT, at least, as much as possible. Now I don't want to contradict myself...I did say in another post that a stand alone HT is NOT always possible depending on the hairloss situation.

 

The bottom line is, each cliinic should come up with a strategic long term plan for each individual patient. Unfortunately, blanket statements cannot work in this business, because there are always patients that are exceptions to any rules that can be set. Make sense?

 

But you are correct...a HT physician must proceed with caution and not just dense pack an area with a lot of native hair already present...this could potentially, at the very least increase the risk of temporary shock, let alone permanent shock of those hairs are already susceptable to MPB.

 

To review...knowing both your cases somewhat...both of you will need to find an HT doctor that will strategically plan with you what is best for your long term needs.

 

Anyway...these are my thoughts on the matter.

 

Hope this helps.

 

Bill

[hair2stay]

I agree... my blanket statement certainly is a bit dramatic, a reflection of the emotion from myself as well as Occam and all others that have been through this. I would like to believe that there are Doc's that can dance the dance with a progressively receding hairline over time. I just feel that a Doc and patient should try to get to a place where they have observed the recession over time (a year or more perhaps), after drug treatment, and then make a decision about surgery. Many doc's are ready to have a go at it as soon as you walk in, and this often is a time where the patient really needs to step back and not make an emotional decision. Patients need to be reminded that this could be a life long process, not a one or two time stop particularly if they are progressively receding.

 

I think we can all agree that going into a receding hairline that is progressing with HT surgery is very tricky. Plotting a long term plan for something that is by nature somewhat unpredictable presents all sorts of challenges. The key, like you said, is each HT surgery needs to stand on its own. Thus, if a quantity of hair is lost in the surrounding area that HT surgery better look natural with or without that surrounding hair. This is the bottom line and a great challenge.

 

Occam and others like myself are told that their respective surgeries are going to be undetectable or not recognizable, afterall if a surgeon does not promise what patient would sign up, right? Every patient asks the doc, how's it going to look? The thing about Occam's case is it is very recent, within the last 5 years. And, he did good research going into it. I'm willing to bet he was told, it would look natural and stand on it's own.

 

h2

[Bill - Seemiller]

hair2stay,

 

Glad we are in agreement here

 

Do some "find" requests on this forum when you have a chance regarding "stand alone HTS". Though this is ideal, it's not always possible...that's where long term planning comes in BEFORE any surgery should EVER take place. It is up to the physician/clinic to sit down with perspective patients and go over what is in their best interest. There should never be a rush to get into the chair, even if a patient is pushing for an immediate fix...immediate fixes rarely fit in with what is best for the patient.

 

I do hope that both you and Occam are able to find resolutions to your situations...I trust with the right research and planning on both your part and whichever physician you choose, both of your appearances will improve

 

Bill

[hairbank]

I have heard of Dr. Edwin Epstein before, actually steered my brother-in-law away from him last when when he got his HT. When the thread started, I thought you were referring to Dr. Jeff Epstein, who we hold in high regard here as a member of our Coalition Surgeons AND who delievers top-notch results.

 

I highly advise you to do some consulting with some of the Coalition Surgeons recommended here. Even by sending pics via email and doing some phone consultations, you may be able to get a fairly acurate assessment of your position and what you may or may not be able to achieve going forward.

 

If there is any good news, it's that your poor results are likely due to poor quality work, nothing on your part, which means if you go to the right place you should be able to get the problem corrected.

 

Look forward to seeing your pics.

[Middleson]

Like others, I also thought Occam was referring to Dr. Jeff Epstein.

 

Since Dr. Jeff Epstein is so highly regarded here and since the confusion is almost unavoidable, might I suggest Occam edit the first post in this thread to clear this up.

 

I know I would appreciate the clarification if I were Jeff Epstein.

[bayscholar]

I agree w/Middleson, as someone considering Dr.E(short list of 4 docs)for my 2HT...I too thought lets make the list 3 instead; great to know that it was a different Dr.E.

[Occam's Razor]

Thank you all again for your replies. I thought I made it clear in several references in my second post that the doctor I had seen was Edwin Epstein, and not to be confused with someone else, but for parity I have gone back and added his first name to my first post as well. I also had mentioned he was a featured doctor on here for years and that anyone interested in seeing who he works for now to read the post Faceless Man made in the Open Hairloss Topics section on this site back in June 21 06.

That said, I do appreciate the advice but please read my posts carefully. As I have mentioned repeatedly that I had this procedure years ago and in the years since I have done enormous research including visiting several clinics, meeting many successful satisfied patients, and reading this very forum for years. I am not being flip, but I am no noob at this and I am here to share some insights to help those interested. In these initial posts I am giving you all some background so when I join in discussions I will not be some faceless entity interjecting.

In closing I wish to say that I would not use my limited time here if I felt it were a waste. I have read this forum for years and learned that people like Bill, Hairbank, and many others are truly not here just for themselves. Not just the lenght and frequency of their posts, but the rhetoric and substance of what they have shared reflect real altruistic concern. This is why I thank Pat and the rest of you for what you provide here. I shall be contributing actual substance myself here soon in the hope of giving a little back.

 

P.S. -still trying to download pic.s, will get them on here one way or the other.

[Bill - Seemiller]

Occam's Razor,

 

Thank you for your post and sharing your background with us. I'm glad you finally decided to come into the front line of our forum and post with us. I look forward to having you as a part of our community.

 

I am also glad that I, along with others, have been able to help you over the years.

 

So what are your plans now for repair work? I'm glad to see you have been consulting with qualified physicians. Have you narrowed it down to any choices?

 

Bill

[Occam's Razor]

Bill-

That's a tough question. It's kind of like being an art connoiseur and trying to find a masterpiece to fit your home. In your case it looks like you chose both a da Vinci and a Renoir, where as I chose a Picasso that needs replacing. There are about eight top tier doctors IMO, but in my research I have discovered just as many disappointing results as I have stellar successes from them all. What I have also learned is how some of these doctors have treated those who were not satisfied with their results, and to me that is an important factor. For the most part, the patients I had met, or corresponded with were eventually satisfied. Hence I consider these doctors to be among the best. I am sure there are others out there, like Dr. Rahal who has apparently done great work for years but only recently became a bigger blip on the radar, so I am still keeping my eyes open. Eventually I will once again have the time to commit to another procedure, but it will be tough to choose. Also, I have finally been able to post some pictures in the Album section. I shall respond to questions there as well.

 

Occam's R.

[Bill - Seemiller]

Occam,

 

Nice comparison. I know what you mean...there are many excellent physicians...trying to narrow it down to one that fits you best is sometimes difficult. There is a lot to consider for sure. Good luck and if you need any help, you know where to find me

 

Bill