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Dr. Ende’s arsenal of hair restoration techniques allows him to offer several options in repairing donor site scars. A quick google search will reveal many pictures of bad donor area scars from poorly performed hair transplant procedures. There are many reasons for visible donor scars or widening of donor scars. Simple mistakes like cauterizing during hair restoration surgery are unfortunately very common. Poor suturing techniques, poor donor site selection, performing strip surgery when there is too much tension, hair transplant infections, unrecognized breakage of the donor strip sutures, surgeon only in Manhattan a few days per month and not available to resuture areas of broken sutures, and many other mishaps can occur leading to a widened or obvious donor scar. Widened donor scars from hair transplant can be repaired using scalp expansion techniques, serial excision with undermining of the scalp, or hair transplant to the scar itself using grafts obtained from follicular unit extraction (FUE).
Dr. Ende is often called upon to repair hair restoration procedures performed using older techniques, poorly performed hair transplants using current techniques, or poorly designed hair transplants that didn’t keep the progressive nature of hair loss in mind. Certain types of scalp flaps did not have progressive hair loss in mind. We have all seen patients who have hair sticking straight up when the surgeon thought it was just as simple as plucking hairs out and plugging them back in. Unlike most hair transplant surgeons, Dr. Ende incorporates his facial plastic surgery background and artistry in repairing a vast array of different hair transplant tragedies. Patients with plugs can choose from a variety of different techniques and Dr .Ende will explain the benefits of each. Some patients qualify for removal of the plugs with a punch tool that Dr. Ende has performed for many years despite others claiming to have “invented it”. These plugs are dissected into follicular units and then replanted. Follicular unit extraction of individual follicular units from a plug is also a great tool that Dr. Ende uses on a regular basis. Any hair that the patient deems funny looking, misplaced, or just doesn’t want any more can be removed with minimally invasive surgery, and is much more reliable than hair reduction laser.
Follicular unit extractions is a growing part of Dr. Ende’s hair restoration practice. Although incorrectly described as incisionless surgery by some of Dr. Ende’s competitors, Dr. Ende provides a more accurate description as sutureless surgery without a straight line scar. Although the scar in standard donor strip follicular unit hair transplant is rarely of concern, follicular unit extraction is an excellent option for some patients. Dr. Ende usually performs follicular unit extraction with tiny circular punch devices which allow for removal of single hair follicles in patients of all hair types. Even patient with curly hair can have a follicular unit extraction procedure. Although Dr. Ende’s team is capable of 4000 hair grafts with the strip technique, most follicular unit extraction procedures produce less than 1500 hair grafts. The advantage of follicular unit extraction, is that patients can keep their hair shorter since there is no need to hide the linear scar from the other type of transplant. Follicular unit extraction is great for patients whose scalp is too tight from too many previous hair transplants were taking an additional strip of hair would lead to a wide scar. If another surgeon has told you that your donor site was exhausted of any remaining hairs for a strip hair transplant, make an appointment with Dr. Ende to discuss follicular unit extraction. Since follicular unit extraction takes longer, the cost of a procedure is much higher. Call Dr. Ende’s office to make an appointment to discuss all of the available options and their associated costs.
Some patients compare Dr. Ende to Dr. Epstein when choosing where to get their hair restoration procedure in Manhattan, New York. Dr. Ende and Dr. Epstein learned hair transplant from the same surgeon. Both Dr. Ende and Dr. Epstein are double board certified facial plastic surgeons. While Dr. Epstein is based over 1000 miles away in Florida and performs surgery all over the country and world, most patients are quite comfortable knowing that Dr. Ende works in New York nearly every day. When choosing which surgeon to have your hair transplant procedure with, most patients are comfortable with Dr. Ende’s training and experience, as well as his permanent status in New York during the post-operative period. Granted, hair transplant surgery complications are very rare, but only Dr. Ende is available in New York every day.
Bald spots on the crown and other regions of the scalp are common reasons for hair restoration. Bald spots can be progressive due to hair loss, or can occur all at once from trauma. Some patients who were born with bald spots have a misconception that hair cannot grow in that spot. Hair restoration with either scalp surgery or hair transplant can improve almost and kind of bald spot. Dr. Ende frequently discusses donor dominance as the reason why hair transplants work so well. This term means that if you take hair from a part of the body where you would probably never lose it (donor area on back of head) and move it to another area where there is hair or no hair, the transplants will grow the same in the new area as they did in the old area. A simplified explanation is that hair transplants work no matter where you put them, even if you never had hair in that area. Bald spot reduction is an open scalp surgery that is not frequently performed any more, but is appropriate in certain circumstances. Dr. Ende will always discuss all of the available options with you since he is one of the few surgeons capable of performing every option to help you achieve your hair restoration goals.
Childhood hair transplants are routine procedures in Dr. Ende’s practice under local anesthesia. Dr. Ende typically waits until the patient is about to enter High School for small patches of hair loss due to trauma, burns or congenital (born that way). Babies who were delivered by forceps or who had scalp infections at birth can have small patches of hair loss which are easily amenable to hair transplant. Due to the relatively painless advanced hair transplant techniques that Dr. Ende uses, most children have no issue with a hair transplant during the procedure or after. Dr. Ende is also skilled in scalp surgery and will give you all of the options for restoration of the balding area including both hair transplants and scalp reductions of many different types. This range of hair restoration is unparalleled by most hair transplant surgeons due to their lack of any surgical background what-so-ever. Many families ask if they should wait to have their childs hair restored until later in life. Children tend to heal very well. Hair transplants work very well in every age group, especially children. Dr. Ende performs hair restoration and hair transplant on children of all ages, but usually suggests a time frame about 1 year prior to entering high school.
A receding hairline is one of the most common reasons for patients to contact Dr. Ende. Many patients have seen Dr. Ende’s results for hairline lowering procedures and they wonder if the hairline lowering is the right procedure for their actively receding hairline. The answer is unfortunately no. However, Dr. Ende is able to use the most advanced medical and surgical techniques to restore a natural hairline in both men and women. Male pattern baldness has been well described, and there are some reliable descriptions of hair loss progression. Many patterns of hair loss do occur along the hairline. Not only does hair transplant help restore a hairline by replacing what was lost, but if the remaining hairs are miniaturized, adding new hair can significantly improve the density and scalp coverage. Only an experienced hair transplant surgeon can restore your hairline while keeping in mind future patterns of your progressive hair loss. The question always comes up about waiting until the patient loses more hair before getting a hair transplant. Because the procedure is performed under local anesthesia and is relatively painless, most patients choose to fill in the area of hair loss now with hair transplants, while understanding that future hair transplant sessions can be performed for future hair loss when it occurs. Hair loss can occur at any age, and hair transplant can be performed on patients in their childhood (due to trauma or if they were born with a patch of hair loss) with no limit on how old a patient can be.
Hair transplant consultations with Dr. Ende are offered free of charge in our Manhattan office. However, an in person consultation is not a requirement to have a hair restoration procedure. Dr. Ende offers hair transplant consultations via a web camera on Skype®, Facetime®, or by emailing photos and speaking on the phone. There are advantages to coming for an in person consultation which include feeling more comfortable with having a procedure with Dr. Ende after meeting him, and the opportunity to meet with Dr. Ende’s competent, experienced and confident hair team. However, many patients do come from other states and countries, and in person consultations are not always possible.