Endoscopic Ridge Reduction

[rivalNYC]

Hi. My name is William and I had some hair transplants when I was in my early 20s, and I'm now 45. I was never happy with the transplants and I've been trying to reverse the process recently with laser hair removal (to reduce the pluggy hairs) and have also tried Fraxel laser to smooth out the cobblestoning/bumpy skin on the top of my head. Unfortunately, the Fraxel laser did little to smooth out the bumpiness.

To make a long story short, I was in contact with someone from Dr. Jeffrey Epstein's office and they said they could reduce the cobblestoning or ridging by 90% with the Dr's "Endoscopic Ridge Reduction" surgery. I have a consultation with Dr. Epstein at the end of the month and was told on the phone that the surgery could cost anywhere from $5k to $12k, which is very expensive!

My question is, is there anything cheaper and just as effective to eliminate this problem? Any information would be greatly appreciated!

-William

[topcat]

My first thought would be that I have never seen ridging reduced using endoscopic surgery in all my time investigating this industry. With that said does this clinic have any proof with at least a dozen cases showing that this has actually produced the desired results and if so please post those pictures right here in this thread. If pictures are not available I would not believe it nor would I suggest being the person to test it out. Desperation makes for bad choice so as long as you are not desperate and take your time asking many questions you should be okay.

Outside of that I have found the best advice can be found from those that are at least 40 years of age, have actually had the procedure one has a question about and does not work in the industry or derive their source of income from the industry.

BTW this is a very interesting topic so please keep us updated on how your research goes.

[rivalNYC]

My first thought would be that I have never seen ridging reduced using endoscopic surgery in all my time investigating this industry. With that said does this clinic have any proof with at least a dozen cases showing that this has actually produced the desired results and if so please post those pictures right here in this thread. If pictures are not available I would not believe it nor would I suggest being the person to test it out. Desperation makes for bad choice so as long as you are not desperate and take your time asking many questions you should be okay.

Outside of that I have found the best advice can be found from those that are at least 40 years of age, have actually had the procedure one has a question about and does not work in the industry or derive their source of income from the industry.

BTW this is a very interesting topic so please keep us updated on how your research goes.

Thanks for your response, topcat! I haven't had my consultation yet, so I can't provide any photos as of yet. If you go to the following link and scroll to the bottom of the page, you'll see the procedure explained.

http://www.foundhair.com/pages/reparative.shtml

[greatjob!]

I also have never heard of that procedure. I would cation you about Dr. Epstein, he was very highly regarded on most forums some years ago, however I have seen many unhappy patients of his over the years. I would do a lot of research before you zero in on a doctor and not base your decision solely on the information provided to you from the clinic. If you are located in southern Florida I would also recommend consulting with Dr. Glenn Charles he his a very reputable surgeon that could give you a very honest assessment of your possible options going forward, good luck!

[topcat]

Thanks for the link, I read the explanation and understand the concept. Didn’t see any cases posted so I would ask. My first thought would be seeing these people that go in for liposuction which I honestly don’t quite get as just how lazy can a person possibly be. But anyway they end up very often with texture underneath the skin that looks all lumpy and uneven and not something aesthetically pleasing so that is something to think about and ask if this is a possible consequence.

I would definitely ask for pictures and speak to a few patients ideally seeing them in person. That is where often the industry has an edge on patients as they are too embarrassed to meet people as they feel foolish for their past choices so they are more inclined to just take the clinic's word for it and move forward with a procedure. I have slowly over time gotten over all of that and none of this matters so much for me anymore except what I continue to see going on. I will eventually have to post full face pictures of myself and start speaking publically about what goes on. Something my conscience tells me I need to do as I can’t continue to watch all this without doing something.

Good luck and additional updates are appreciated as I too have ridging although I can live with it. But it’s always good to know as much as possible.

[topcat]

I would also have to agree with some of what greatjob posted. It is very important for those researching to focus on history and not so much on the latest threads. Past actions and results often predict future actions and results.

What doctors and reps have done in the past is crucial in research. Read and speak to patients as those thoughts are often not posted. Develop a network of patients and speak among yourselves. You will slowly connect the dots.

[rivalNYC]

Thanks for all your replies, folks! I wrote quite a few HT doctors about my issue and Dr. Epstein's "Endoscopic Ridge Reduction" surgery, but yet to hear back. I'm wondering what my alternative to this would be, if I decide not to shell out thousands for this procedure. Should I get the transplanted plugs surgically removed? If so, will my head be smooth? Will there be very noticeable scars?

I've struggled with this for so long and I hope I find the answer soon. I don't expect perfection...just quality results that will be worth the money.

[topcat]

Well there are those in the past that have had the plugs removed using fue and the results have been mixed at best with no guarantee that it will not be noticeable. Others have tried cortisone shots and lasers when it comes to trying to eliminate their raised strip scar once again with mixed results and I’m not sure if that would be effective for ridging as it’s almost like dealing with a bump on the head as opposed to a raised scar. I suggest searching the history of some of the forums to see results from the past.

Sometimes a matte type cream can reduce the reflection of light off the skin which helps as that shiny reflection seems to accentuate the raised area making it more noticeable.

[greatjob!]

If you feel comfortable with posting some pics (you can crop out your face) it may be useful for us to give our opinions on your situation. Sadly often the only way to remedy a poor hair transplant is by going forward not back. There are many cases published on this forum and others of repair cases, were some of the old plugs were removed and redistributed and then further transplanting used to fill the area. Although if price is an issue this may not be the best option for you, or if you are not willing to move forward with more work. Again pics would be helpful in giving you my honest opinion.

[35YrsAfter]

Hi. My name is William and I had some hair transplants when I was in my early 20s, and I'm now 45. I was never happy with the transplants and I've been trying to reverse the process recently with laser hair removal (to reduce the pluggy hairs) and have also tried Fraxel laser to smooth out the cobblestoning/bumpy skin on the top of my head. Unfortunately, the Fraxel laser did little to smooth out the bumpiness.

To make a long story short, I was in contact with someone from Dr. Jeffrey Epstein's office and they said they could reduce the cobblestoning or ridging by 90% with the Dr's "Endoscopic Ridge Reduction" surgery. I have a consultation with Dr. Epstein at the end of the month and was told on the phone that the surgery could cost anywhere from $5k to $12k, which is very expensive!

My question is, is there anything cheaper and just as effective to eliminate this problem? Any information would be greatly appreciated!

-William

If I'm understanding your situation, the grafts you had placed are raised above the surrounding skin. Steroid injections may be your safest initial treatment option. Excessive adipose transplanted with the grafts is the common culprit causing the bumpy appearance on your scalp. Steroid injections can eliminate some of that fat that cause your grafts to bulge outward.

[rivalNYC]

If I'm understanding your situation, the grafts you had placed are raised above the surrounding skin. Steroid injections may be your safest initial treatment option. Excessive adipose transplanted with the grafts is the common culprit causing the bumpy appearance on your scalp. Steroid injections can eliminate some of that fat that cause your grafts to bulge outward.

Thanks very much for the reply! Here's a link of someone who has something similar to what I'm referring to. While this isn't my head and mine is not nearly as severe as this, the raised/shiny skin is what I have and mainly on my right side. This man's scalp is much redder than mine, as well.

http://i424.photobucket.com/albums/pp325/c1tom/3months006.jpg

It would be great if steroid injections could eliminate that bulkiness and achieve a much smoother scalp.

[FHRPS]

Ridge Reduction

Thank you very much for this interesting topic and discussion. This is a post written directly by a team member at Dr. Epstein's practice and these opinions are my own:

- Dr. Epstein has performed endoscopic ridge reduction consistently for the last 5 years or so. He performs an average of around one of these procedures each month, which is "a lot" compared to most doctors, though there are few people worldwide who specialize in this procedure.

- We do not provide many examples of ridge reduction by photograph. Unfortunately, we have found that the ridging does not show itself well in photos "pre-op" so it is hard to see the results in a "post-op" photo. With that said, we do have many happy patients who have had this procedure and we would be happy to have a prospective patient speak with a patient or two who underwent the procedure.

- Additionally, to understand more completely how this procedure works, here are some thoughts:

Essentially, in most patients, ridging is formed by scar tissue. This scar tissue is removed using a tiny, endoscopic tool through very small incisions along the hairline which heal up to essentially undetectable dots. In most cases Dr. Epstein can remove around 70% of the ridging along a hairline. In some cases, inexplicably, the first removal results in a portion of the scar tissue returning and a 2nd and even a 3rd treatment is indicated, though this is exceedingly rare.

- The procedure, when it works well, is truly impressive. When it doesn't work well, there are limited downsides other than the need to perhaps have a 2nd round of ridge reduction with Dr. Epstein.

- Most have not heard of this as most hair doctors have a variety of specialties (dermatology, emergency medicine, radiology, cardiology etc.) and then decide to do hair. Dr. Epstein is a rare triple board certified facial plastic surgeon and this endoscopic ridge reduction is less of a "hair transplant related procedure" and more of a cosmetic surgery of the face that affects one's look for a lifetime. For this reason, Dr. Epstein performs and specializes in this procedure.

- We do offer photos that can be shared candidly in-office from patients not willing to post their face online, have references to speak with, and can provide wonderful results in the majority, but not all, of cases as is the nature of the procedure.

While some on this chain have chosen to suggest some doctors are good, while others are less respected, Dr. Epstein remains among the most selected doctors in the country for hair transplantation, endoscopic ridge reduction, reparative hair transplantation and much more, with over 60% of his patients traveling from all 50 states and now 79 countries for his services. Our entire team is at your service to answer specific questions and help you to plan your procedure or to help you to determine if this procedure may or may not be for you. The cost can vary, though an average for this procedure is around 5-7k give or take, not 12k as noted in this discussion. Again, we thank you for considering Dr. Epstein and his team and please contact us directly with any comments, needs, or questions.

[topcat]

Since I do have ridging from procedures performed in the past specifically Thomas/Elliott group using robust grafts in hairline and it can be somewhat seen in a pre op photo I am posting one here. It is also my opinion that when you hear about robust grafts from robotic fue devices as being a good thing I would disagree completely, just my opinion.

[aim4hair]

Anyone has tried this procedure or got any luck reducing the ridging issue whether using this method or any other method?

[Sam23]

I have same problem, this hair transplant totally ruin my scalp

Someone can save us here ?