Bernstein Medical Blog
This page contains blog-style (reverse chronological) posts from our Bernstein Medical News, Hair Transplant Video & Audio, Hair Restoration Answers, and Research sections.
A recently published study is the first to measure the perceived benefit of hair transplantation on a patient’s age, attractiveness, successfulness, and approachability – key factors that play an important role in workplace and social success. The pilot study, published in the Journal of the American Medical Association Facial Plastic Surgery, found that hair transplant recipients were perceived by others to be 3.6 years younger following their hair restoration surgery. The data indicate that the person’s attractiveness, successfulness, and approachability also showed statistically significant positive changes as a result of hair restoration surgery.
Q: Does minoxidil play any role in the survival of the grafts after a Neograft/FUE procedure?
A: When a doctor performs a hair transplant, the hair should be taken from the permanent zone so, by definition, that hair is not affected by medication (i.e. does not need to be maintained by either minoxidil or finasteride). If the doctors using Neograft are suggesting that minoxidil increases survival, then they are probably harvesting hair outside the permanent zone. To clarify, I use the ARTAS robotic system for our FUE procedures, not Neograft, as the former is a far more accurate device for harvesting.
Robert M. Bernstein, MD, MBA, FAAD, FISHRS, a Clinical Professor of Dermatology at Columbia University in New York and distinguished pioneer of modern hair transplant surgery, was included for the seventeenth consecutive time in the ‘Best Doctors’ edition of New York Magazine. Dr. Bernstein was selected by his peers as one of New York’s top doctors on account of his prominent work in developing Follicular Unit Transplantation (FUT), Follicular Unit Extraction (FUE), and Robotic Hair Transplantation (Robotic FUE).
Dr. Bernstein has a long affiliation with New York-Presbyterian Hospital, the teaching arm of Columbia University’s College of Physicians and Surgeons. In U.S. News & World Report’s 2016-17 survey of America’s best hospitals, New York-Presbyterian was rated #1 in New York and #6 overall in the country.
Q: Does a man’s height and weight affect the dose of finasteride or Propecia he should take? i.e. will a 6’4″ man need a higher dose than a 5’7″ man. ~ T.B. — Rye Brook, NY
A: The dose of finasteride is the same (i.e. 1mg) regardless of a person’s height or weight. The reason is that one needs only 0.5mg a day for it to be effective, so there is much leeway built into the dose (but the rate of non-responders is slightly higher at the 0.5mg/day dose). That said, after 5 years or so, finasteride seems to be less effective and doctors often increase the dose a bit. The next step-up is generally to take 1/3 of a 5mg pill each day. Keep in mind that the dosing we are speaking about is for hair loss (androgenetic alopecia). When finasteride is used for prostate enlargement, the dose is 5mg a day.
There are many different treatments for hair loss. They include prescription and over-the-counter medications, foams, sprays, shampoos, oral supplements, and laser devices. They may contain any number of natural or pharmaceutical ingredients, and often have some claim of hair growth, regrowth, revitalization, health, glow, strength, or other promise. Reviews.com has turned to Dr. Michael B. Wolfeld of Bernstein Medical to narrow down the field from over 200 contenders to the top picks for the best hair loss treatment.
Synopsis: The current robotic system harvests follicular unit grafts in a random manner. A new capability of the ARTAS robot is to select follicular units based on the number of hairs they contain, in order to increase the hair/wound yield. This bilateral controlled study of 24 patients was designed to evaluate this functionality. Results showed that, compared to random follicular unit harvesting, robotic follicular unit graft selection produced more hairs per harvest attempt (2.60 vs. 2.22) and more hairs per graft (2.72 vs. 2.44). The clinical benefit was statistically significant at p<.01.
Can I Have a Hair Transplant if I Have a Scar in My Donor Area? If So, Which Do You Recommend, FUT or FUE?
Q: I have a diagonal scar in the middle of my donor area that I got during a childhood accident and I am concerned that it will limit my options for hair restoration. Will this type of scar prevent me from having either FUT or FUE? Do you recommend one or the other?
A: Traumatic scars in the donor area do not preclude us from performing a hair transplant. With an FUT/strip procedure, we can remove all or part of the scar when we excise the donor strip. In Robotic FUE, the ARTAS Robot can be programmed to avoid a scar during harvesting. In either procedure, we can improve the appearance of the scar by implanting follicular unit grafts directly into the scar tissue. The hairs will grow permanently in the scar, just like ones we implant in the recipient area, and the scar will become harder to detect.
It is important to note that transplanted hair will not grow in a thickened scar. If your scar is thickened, the doctor can thin it out (soften it) with injections of cortisone. They are usually repeated at 4-6 week intervals in advance of the procedure. The number of injection sessions required depends upon the thickness of the scar and your individual response to the medication.
The presence of a traumatic scar should generally not determine which type of transplant you have. That should be decided in consultation with your physician based on factors such as how much volume you need, how you intend to style your hair, how short you would like to keep it, how soon you need to return to strenuous physical activity, and other general considerations for a hair transplant.
We recently posted photos from a patient who had a robotic hair transplant with a scar in his donor area. The photos include images of his donor area (with scar) before his procedure, immediately after robotic graft harvesting and 11 days post-op. View this patient’s before after photos.
Q: I am an MMA fighter and I want to get a hair transplant. How long do I have to be out of commission and which type of procedure should I have, FUE or FUT? — J.A., Columbus, OH
A: With any type of hair transplant it takes 10 days for the transplanted grafts to be permanently fixed in place. The difference between FUE and FUT is in the limitations of activity due to the donor area. With FUE one would need to abstain from MMA for the same 10 days it takes the recipient area to heal (the grappling component of Mixed Marshal Arts is the most stressful on the scalp). With FUT, however, one would need at least three months for the linear donor scar to heal before one could resume contact sports like MMA.
Dr. Bernstein Patents Hair Transplant Procedure with Delay Between Recipient Site Creation and Graft Insertion
Hair transplant pioneer Dr. Robert M. Bernstein and his colleague Dr. William R. Rassman have received a patent on a new method that improves the outcome of Follicular Unit Extraction (FUE) – the type of procedure used in half of all hair transplants performed world-wide. The key invention is the addition of a delay between the creation of recipient sites and the insertion of follicular units into those sites. The delay allows the healing process to commence before grafts are inserted, resulting in increased success of the transplant and an improved outcome.
Q: How are PRP treatments for hair loss different at Bernstein Medical? — Huntington, N.Y.
A: There are three reasons Platelet Rich Plasma (PRP) treatments are different at Bernstein Medical from other facilities. First, we use the Emcyte Pure PRP System, the most sophisticated system for the preparation of Platelet Rich Plasma. Second, by using a double centrifuge technique, we generate the optimal concentration of growth factors in PRP. Third, and most important, we have the knowledge to know when PRP is appropriate and the skill to inject the proper quantity of PRP at just the right depth to achieve the desired result — a skill that cannot be overstated.
Stylecaster.com called upon NYC SuperDoctor Dr. Michael Wolfeld to increase awareness of common health issues that impact hair and its character. Among the issues that Dr. Wolfeld discussed in the article are dandruff, hair loss, oily scalp, itchy scalp, changes in hair texture, hair that won’t grow, and premature graying.