Jeffrey S. Epstein, MD, FACS, makes hair restoration cool | Plastic Surgery Practice August 2014

By Denise Mann

Jeff Epstein optJeffrey S. Epstein, MD, FACS, is considered one of the fathers of modern-day hair transplantation, but calling him a father makes Epstein sound older than his years. It’s more that he almost single-handedly reimagined the process and helped make it cool. The field of hair transplantation took some hits in the 1980s due to the impossible-not-to-notice, AstroTurf-like plugs, but doctors like Epstein, director of the Foundation for Hair Restoration, with offices in Miami and New York City, have moved this field forward.

Epstein and his team of 18 full-time hair assistants refined the look and feel of hair transplantation and began catering to such niche populations as the transgender and hipster communities.

Here, Epstein, a member of Plastic Surgery Practice magazine’s editorial advisory board and a voluntary assistant professor at the University of Miami, talks to PSP about the evolution of the modern-day hair transplant and what it will look like in the next 20 years.

1. How much of your practice/s are devoted to hair restoration?

Hair restoration constitutes around two-thirds of my work; the great majority of it is surgical.

2. Why superspecialize in hair restoration?

Like any other plastic surgery procedure, hair restoration requires expertise and perfectionism that is best achieved by subspecializing. My decision to make it “hair” has to do with my exposure during fellowship when I had an opportunity to study in San Francisco, and my recognizing 20 years ago that the specialty of hair was poised for huge growth in popularity and evolution of techniques. I wanted to be a part of that growth.

3. Why should more facial plastic surgeons consider adding hair restoration to their menu of services?

It’s a natural for any surgeon who specializes in aesthetic facial surgery. We are already treating the face and neck, and the scalp is a natural extension of this area. Also, hair restoration is more than just hair transplants. I frequently lecture my colleagues on other techniques that address hair concerns, such as the surgical hairline advancement/forehead shortening procedure.

4. Hair transplants got a bad rap in the 1980s. Why are they better today?

The evolution in outcomes got a huge boost in the late 1990s with the acceptance of microscopic follicular unit grafting as the standard of care. With the dispensing of information online, prospective patients became educated to accept nothing less, driving less than contemporary surgeons to either change technique or become obsolete.

5. What has been the greatest advance in treating hair loss in recent years?

The major advance in the past 5 years has, without a doubt, been the development of the follicular unit extraction (FUE) technique.

6. Anything else that has helped move the field forward?

The use of laser light therapy is growing in popularity, due to patients and doctors realizing that it works.

7. What role should robotics have in hair transplants?

I’m not sure yet, but I imagine that the opportunity exists for a potentially important role. Technology cannot replace aesthetics, at least at this time, and hair transplantation is more than just the extracting of grafts. Only a hair transplant surgeon can understand the progressive nature of hair loss and make treatment decisions based on sound judgment.

8, From hipster beards to transgender hair restoration, what other trends are you seeing today that may surprise readers?

Eyebrows are always trending along with beards, which are huge right now. I’d also say that FUE without shaving of the  entire head would further jump-start the popularity of this technique.

9. Where do you see platelet-rich plasma (PRP) and stem cells coming into play?

The potential role of regenerative cells in treating hair loss is huge. For the past 18 years, I have been counseling patients and telling my colleagues that hair cloning (or technically, hair multiplication) will be here in 8 to 10 years. Well, today I feel confident saying that in 8 to 10 years, regenerative cells will have an important role. Despite claims, PRP is far from a consistently effective therapy, although it shows potential in helping the healing of the recipient and donor areas of both FUE and strip, and as a stand-alone treatment for hair loss.

10. Take out your crystal ball and tell us what hair restoration will look like in 20 years.

As goes the whole field of aesthetic medicine, the treatment of hair loss will be addressed at the cellular level.

Denise Mann is the editor of Plastic Surgery Practice. She can be reached at [email protected].

Original citation for this article: Mann D. Hair raiser. Plastic Surgery Practice. 2014;(8),34.