Dr. Bernstein was interviewed by Dana Tyler, host of the television program “Eye on New York” on CBS, for the show that aired on April 17th. The wide-ranging interview was the feature in a 9-minute segment on hair transplantation and hair loss. Read further for a partial transcript of the interview.

Q: What is the problem with transplanting the crown too early?

A: If a person’s hair loss continues –- which is almost always the case -– the crown will expand and leave the transplanted area isolated, i.e. looking like a pony-tail. The surgeon can perform additional hair transplant procedures to re-connect the transplanted area to the fringe, but this is a large area that can require a lot of hair, and it is often impossible to determine when a person is young if the donor supply will be adequate. View the full post to see a photo of a patient who had an early hair transplant to his crown.

Q: What happens to hair diameter when you age?

A: From infancy to puberty, hair gets progressively thicker. From adulthood to old age the hair becomes thinner again and this is exacerbated by the effects of DTH in susceptible persons. The later process is called androgenetic alopecia (common baldness) and is characterized by miniaturization – the progressive decrease in hair diameter and lengths as a result of DHT.

However, even without the effects of DHT, hair gradually thins over time in many people.

Asylum.com reporter Brett Smiley interviewed Dr. Bernstein to get his take on hair loss and the balding pattern known as a “power alley”:

“Power alley is an accurate term for that type of balding,” says Dr. Robert M. Bernstein, a clinical professor of dermatology at Columbia University and world-renowned hair-transplant surgeon. “It’s Norwood Class III balding, which is the most common type.”

Q: At what level of thinning should the hair transplant be done?

A: A hair transplant should be considered in an area of thinning when:

• The area has not responded to medical therapy (finasteride 1mg a day orally and minoxidil 5% topically for one year).
• The thinning is significant enough that it can’t be disguised with simple grooming (i.e. is a cosmetic problem even when the hair is combed well).

Other factors that are important include:

• the age of the patient
• the donor supply
• whether the thinning is in the front of the scalp or in the crown