Dr. Jeffrey Epstein

[Ralph J.]

Greetings,

This is actually my first post. however I've been browsing the site for around a year and my first and hopefully last HT is scheduled for this April 16, with Dr. Jeffrey Epstein. I know that he has a good reputation in this community, but if there is any former patient that can tell me about their experience with Dr Epstein would be great. My consultation with him was very good; he was honest and told me his recomendations based on my hair loss. I also hear that he is a little conservative in regards of hairline, (Restore my hairline is one of my goals) but since he is well known in this community; I will trust my HT to him. I also will keep you posted after my surgery on April 16, ( I will have before and after pictures). Your thoughts will be greatly appreciated. Thanks

Best Regards

Raphael

[its-only-hair]

If you do a search you might find some patients of Dr Epstein.

 

How extensive is your hair loss? How many grafts are you going in for? Any photos?

 

Good luck with your surgery.

[hairworthy]

 

if there is any former patient that can tell me about their experience with Dr Epstein would be great.

Had my 2nd HT with him last year. My story is here. I highly recommend him.

[Neptune]

Ralph: A search is indeed a good starting place as some of us have posted here about our exerience with Dr. E. As for me, I had my procedure done three weeks ago tomorrow and I have been very pleased with everything so far. My results won't be known for a year, but thus far, everything I was told to expect has been what's happened.

 

I had 2100 grafts (you can catch my post under the photos section) and was able to go back to work undetected in a very short time though I took a full two weeks off. Dr. E. filled in my hairline and helped restore my temples. Again, time will tell but thus far very happy with my results. Dr. E. and his crew are a good bunch and his techs are outstanding.

 

Let me know if you have specific questions and I'll try to help out.

[Ralph J.]

Dr. Epstein suggested 2,700 grafts, he told me that I have a good donor area with good flexibility (I've been doing my scalp exercises for more than a month now) Check these top and frontal pictures attached. Your thoughts...

[Ralph J.]

Here is the picture from the top.

[the B spot]

How many consults have you done Ralph?

 

For a patient with good laxity, and your level of loss, I would think a larger session would be in order.

 

Did Dr. E state why he was approaching your treatment in such a manner?

 

Thanks,

J

[Ralph J.]

That was my first question to Dr. Epstein B spot, He stated that I'm only 31 and that since I seen an acceleration in hair loss in the past year plus my family history with hair loss, (I have an uncle that looks exactly like me, however he is 52 years old) he fear that I will loose more hair by 35 and that's why he wants to use a conservative approach in this procedure, (Only 2700 grafts). B, this is my second consultation (I don't know if boesly counts like a year ago). I appreciate your thoughts on this. Thanks

Ralph

[Neptune]

Ralph: Are you on Finesteride or Proscar? How about Rogaine? If not, I hope you get started on one or both right away to help try to stop the loss so that whatever you have implanted gets the most impact.

[Ralph J.]

I started both Finesteride and Rogaine like a month ago. I know that Finesteride is for life and I will be on it for the long run. I would like to know what you guys think about Dr. E approach to my hair loss. The day of my surgery I will try to push for 3000 grafts. Thanks in advance guys.

Ralph

[rjvw]

Ralph, I had my HT with Dr. Epstein in January. My story and photos are on this site. So far I could not be happier. I'm starting to show signs of growth and my scar is really disappearing.

 

His staff was great. After my HT I had a question about swelling. I called his office around 7:00 on a Saturday night and within an hour HE called me back. That says a lot. I highly recommend him.

[Here I Grow Again]

Hi Ralph,

 

I too have had a very good experience with Dr. Epstein (and have posted a very detailed experience with pics) back in November.

 

My consultation was similar to yours in that I was/am a N5-6 and relatively young. Dr. E did take the conservative approach which I thought was right for me. My hair line restoration approach was in line with my age however.

 

I would make sure that you get a good assessment on your hairline expectations so that you are clear on what Dr. E feels he can and cannot do for you. Don't leave that area unclear since it is of particular interest to you, if I understood your post correctly.

 

In my opinion, Dr. E is a great choice if you decide to go with him. I was very happy with his work.

[hairbank]

The quality of work Dr. Epstein will give you is great. I would question only 2700 grafts at your level of loss. Even if you "conservatively" fill in your areas of loss you could use more like 4000-5000 rather than 2700. IMO you don't really have too much native hair left in frontal 1/3 or midscalp to me concerned with and the crown's pretty much gone.

 

Are you just planning to restore the frontal 1/3 with that number and not concerned with the crown? What's you're overall plan of attack? If you have the donor hair available, it will be more cost effective for you in the long run to have more grafts now rather than 2700 now and another 2700 or so later plus you only go through the healing and growth process one time.

 

Something for you to consider............best of luck to you.

[Ralph J.]

When I came to this site I was getting ready to go to Boesley for a procedure, you guys save me the aggravation and that's how I came across Dr. E, he has a great reputation and is on the neck of the wood, however after the consultation, I'm a little undecided because when I see those large procedures coming from doctors like Hanson & Wong, Shapiro and others, I wonder if that's the way to go for me. You guys are more knowledgeable than me on HT and feedback from you guys will be greatly appreciated, (By the way I already schedule a date for my procedure with Dr. E. on April 16)

[Neptune]

Ralph: I would call Dr. E and tell him what you are thinking. With only two weeks to go, you certainly want to get this straight. The number of grafts you ultimately need will be whatever it is. If you need more than 2700, you can always go for number two later. But, if you think you'll need more and you want it all at once, I'd discuss with Dr. E and you two can decide which way to go. One thing that is great about him is he'll talk to you about it willingly. Good luck!

[the B spot]

Ralph--- yes you will need more grafts to ultimately reach your goals.

 

However, while I champion larger session sizes, there is some very solid logic in Dr. Epstein's approach with respect to native hair and future loss.

 

What I tell many patients who are in situations like this is do a consult or two with a couple of other Docs--- compare and contrast--

 

IMHO, bumping you to 3500 will not present a substantial risk and with a virgin scalp you should be plenty loose.

 

I would not go past that for reasons Dr. E stated.

 

In any case, we are seeing that regardless of session size, MOST patients are still going back for #2--- So even if you get 3000, going back for 2500 more 1-2 years later is not a big deal and is a very controlled approach that encompasses many factors.

 

If you were slick bald my advice would be very different.

 

Take Care,

J

[Gorpy]

As usual Hairbank makes some great points. How many of those would go into the crown? I think you could easily put 2700 in the front only. I had 2700 on my first HT. Then recently went back for another 1000. If I had it to do over again, would I opt for 3700 in one session? Surprisingly, probably not. I liked my more conservative approach. I was more comfortable with it and it allowed for a strategic follow up that worked out well for me.

 

I have fine hair characteristics. So 3700 naturally occurring FU's most likely would not have made me happy either. My second HT we strategically placed many multi-haired Fu's to add more density.

 

The point is, it's a little more complicated that just numbers alone. Dr. Epstein's strategy is a valid strategy. But I would ask him how many are going into the crown and how conservative he is going to be with the hairline, any temple closure, etc.

[hairbank]

Ultimately, I believe Dr. Epstein does great work and you should trust his judgment. One caveat........I would THOROUGHLY discuss your goals with him and try to get a better understanding to his overall approach including his recommendation for 2700 grafts.

 

In my honest opinion.....given your loss..........I'm still not sure why you would not try to cover ALL balding areas in the first pass if possible. Even if you have further loss, and you likely will, what difference is there if you have 2700 grafts the first time then have further loss, OR, you have 5000 grafts the first time then have further loss? The only risk I see is available donor hair which I believe Dr. E could provide you with some sort of estimate as to how much you possibly have.

 

Ralph, in the end, you have to do what your comfortable with. Your loss is very similar to mine before my 1st HT at age 38. I only received 1200 grafts the first HT and would gladly have taken 5000+ to have gone through it only once and saved money in the process. I just want you to be aware of all information before going through with the HT. As I've said, the quality of work from Dr. E is great so no concern. My concern is with your expectations and your plan for the future.

 

Hope this helps.

[Ralph J.]

Thanks for all your help guys. Today I will contact Dr. Epstein office and try to schedule another appointment before my procedure (less than 2 weeks now)or at least get him on the phone to address a few things, (you guys got me plenty ammunition). However ultimately I will trust his judgment as long as I feel good with it. Hairbank has a valid point, if I have a good donor area why can't we go for a larger session, I understands Dr. E conservative approach, but if I can avoid another HT,(I will probably need another anyways) that would be nice for me. Thanks again guys, you truly help me to have a better understanding on HT.

Regards

Ralph

[MrJobi]

Hi Ralph

 

Hbank, I think the conservative approach is to maximize the donor area. If Ralph loses additonal hair such as he has been ( regardless of the meds). The doc will have to use future hair more conservatively i.e. less dense packing, or focusing on the KEY area's important to the patient.. Once it's used up, you can't really change the strategy.. In a perfect world he could cover everything but if he loses more hair, he might have to choose a fuller frontal area and less crown..

 

In my opinion, this might be a bit safe although a longer approach..

[hairbank]

Originally posted by Mrjb:

Hbank, I think the conservative approach is to maximize the donor area. If Ralph loses additonal hair such as he has been ( regardless of the meds). The doc will have to use future hair more conservatively i.e. less dense packing, or focusing on the KEY area's important to the patient..

 

Just so I'm not misunderstood ...

 

My point is this...........if Dr. E feels there is sufficient donor hair to provide more than 8000 grafts in Ralph's lifetime, why not harvest 5000 now and use them strategically? In other words, plant them over the frontal 1/3, midscalp and crown, just not at 45 cm2 everywhere.........maybe 40cm2 frontal 1/3, then blending back to 25cm2 in the crown. IF, he has the donor hair, it will be much more cost effective for him (and provide other benefits) to do more in one session. Then, if and when his loss further progresses, a decision can be made as to whether he has enough for more density in certain places or he must use the grafts to help the areas now experiencing loss that were not evident at the time of the first HT.

 

I agree that ANY plan should be conservative so the HT patient doesn't run out of grafts in the quest for hair. However, HT's are expensive, and, with the availability of mega sessions in the 4000-5000 graft range I believe it's appropriate for certain situations (like this, with mucho slick real estate to cover - no offense - I mirrored that remark before HT #2 ). A surgeon should always "mind the donor availability" in the overall plan. In this case, 2700 grafts is likely well under half of what this person has in donor hair................if he is blessed with more than 8000 then using 5000 at this point should leave enough for work due to further loss in the future.

 

At any rate, it sounds as if Ralph is going to get clarity before moving forward. The bottom line for him is to go into this with eyes wide open knowning his plan and understanding what it will take to achieve his goals.

[Ralph J.]

Today I scheduled another person to peson consultation with Dr. E, I will see him this Thursday April 5th. I will go over all the points made by you guys and my personal goals. Hopefully we can reach a level where he can feel comfortable with the approach as well as myself. I will let you know the outcome of the appointment. Thanks for all your help.

Ralph.

[MrJobi]

Always good to ask questions and make the best call prior to surgery. We know the wait is long and we all would like more NOW!

 

Let's see what Dr. E says

[Jeffrey Epstein MD, FACS]

Dear Community- I have read with great interest all of your comments and input on this topic. As a surgeon with almost 14 years of specializing in surgical hair restoration, with plenty (too much, unfortunately) of experience repairing bad hair transplants, and seeing many many patients seeking to improve their results from prior procedures, I have in turn developed an approach that I feel maximizes results, while minimizing the risk of complications. As such, there is a balancing act- as to obtaining the maximum number of grafts, while avoiding any significant donor site scarring as well as making sure that patients achieve the kind of density they have come to expect from seeing my work.

I have not embraced the 4000-plus graft procedure except in those cases of significant scalp laxity, high donor density, and maximum demand for hair. Not to say that this is the norm, but I have seen TOO MANY patients who were told by their surgeon that they were getting 4500 grafts- but in reality, these grafts contained no more hairs than what I transplant in a 2800 graft procedure where I do not divide up follicular units, and/or these patients were left with too wide of a donor site scar to be acceptable to my standards.

 

I am looking forward to seeing my patient again, for I do anticipate speaking with him about going to perhaps 3000 or 3200 grafts, if it seems appropriate and without increased risk.

 

I so encourage all of you to visit my website photo gallery and see the kind of results I typically achieve with procedures of 2500 to 2700 grafts. Furthermore, I welcome any of you to write me directly with your thoughts/feedback.

 

Sincerely,

Dr. Jeffrey Epstein

www.foundhair.com

Miami and NYC

[rjvw]

Doc, thanks for your explanation. I've stated in other post that when I had my HT with you in January I had left it totally up to you on the number of grafts.. You said 2100, I said ok. Hell, you could have said 3500 and I would have agreed. I selected you for your expertise. For the record, I've never second guessed you. And from the early results I'm getting... I choose wisely.