Hair Loss & Replacement for Dummies is filled with important information for men and women of virtually all ages anxious to preserve their full head of hair, put the brakes on balding, or explore the safest and most reliable hair replacement techniques currently available. The book offers readers not only the full gamut of modern-day hair-care options, but crucial tips on how to avoid unscrupulous hair transplant doctors and potentially harmful products as well.

Topics include:

• Getting To Know Your Hair – What Causes Hair Loss; The Devastation Of Hair Loss In Women; Undergoing Hair Restoration Surgery
• Splitting Hairs – How Hair Grows; Aging Hair; Hair & Ethnicity, Maintaining Self-Esteem in the Face of Hair Loss;
• Taking Better Care Of Your Hair – Washing & Drying Your Hair Correctly; Avoiding Hair Damage; Caring For Childrens’ Hair
• Understanding The How & Why Of Hair Loss – Stress & Hair Loss; Environmental Issues; Male Pattern Thinning In Men and Women; Diseases & Disorders That Cause Hair Loss
• Creative Techniques For Concealing Hair Loss – A Brief History of “Rugs”; Today’s Toupees
• Taking Prescription Medications For Hair Loss – Being Aware of Side Effects
• Supplementing Your Diet To Help Slow Hair Loss – Pumping Up Proteins; Minding Your Mineral Intake
• Hair Transplant Surgery – Do You Really Need A Hair Transplant; Psychological Considerations; Choosing A Doctor; Possible Complications; Heading Home With A New Head Of Hair!

For further reading see the transcript of an interview with Dr. Bernstein about the book, the original press release, or purchase the book at Amazon.com.

So you have become reacquainted with your scalp (a place on your body that you hoped to remain strangers with), and it looks like you’re about to see a lot more of it if you don’t find a solution soon. You’ve tried a few “cures” already; Rogaine, Propecia, Saw Palmetto oil, and vigorous scalp massage, you are now considering having a hair transplant.

Surprisingly, people generally spend more time researching a new car purchase than they do choosing a surgeon, but researching the right hair transplant doctor is not something you want to rush through. There are a couple of things you will want to be mindful of when seeking a surgeon for a hair replacement operation. Here are a few tips to help you when interviewing a doctor for your hair loss.

Starting Your Research
Hair transplantation has become a fairly large field with many doctors performing these procedures. There are some great surgeons out there and some lousy ones (evidenced by some of the unnatural looking hair transplants that we have all seen). How do you start your quest to find the best physician for you?

In general, the best way to find a physician is through a referral either from your dermatologist, GP, or from another patient. The worst way to choose a doctor, who may be performing surgery on your head, is via infomercials or aggressive marketing campaigns. You should be wary of any medical practice that is spending lots of money on marketing, rather on patient care.

The internet can also be helpful in your research because, unlike infomercials and TV ads, where the doctor can make any kind of claim they want to, online message boards and user forums make it difficult for a doctor to control what is being said about them. But remember that on the internet you have to take any medical advice you might read with a grain of salt.

The Doctor’s Background
The first thing you will want to know is what the doctor’s specialty is. Ideally, he or she is a board certified dermatologist or plastic surgeon. If they do not specialize in these two fields ask them why they have chosen to work in hair restoration. If they are trained as a gynecologist or an internist, why are they doing hair? You are within your rights to know the answer and you should be concerned that they are only in it for the money.

Doctors to consider should be members of the International Society of Hair Restoration Surgery (ISHRS) and be Diplomats of the American Board of Hair Restoration Surgery (ABHRS). The ABHRS is the only board in the United States that certifies hair transplant surgeons.

There are a number of non-physician consumer advocacy groups that help consumers find the best doctors in the field. The most popular are the Coalition of Independent Hair Restoration Physicians and the International Alliance of Hair Restoration Surgeons (IAHRS).

The most coveted awards in the field of hair restoration are the Golden and Platinum Follicle Awards given by The International Society of Hair Restoration Surgery (ISHRS) for outstanding achievements in science or clinical research relating to hair restoration. If the prospective doctor is the recipient of either of these awards, this would certainly show the confidence that their peers have in their skills and abilities as hair restoration surgeons. Each of these is given to only one outstanding physician a year.

Lastly, feel free to inquire if the doctor has helped contribute to the science of hair restoration by performing some research in the field and publishing his or her findings. Publishing medical papers shows that the physician is sharing ideas and experience with other doctors in order to promote patient care. If the publications are in peer reviewed medical journals, the medical community holds them to be of significant value.

Techniques and Approach
You are going to want to ask the Doctor what techniques they use and how long they’ve been performing them. Follicular Unit Transplantation, or FUT for short, is the procedure that has made modern hair transplantation completely natural – if performed correctly that is. If they do perform FUT, ask the doctor where they learned it. It is preferably that they learned the procedure from one of the technique pioneers, like Dr. Robert Bernstein, Dr. William Rassman or Dr. Bobby Limmer. This will give you a sense of whether they really know the nuances of this procedure.

When conducting your interview, ask whether the surgical staff uses microscopes for dissection, loop magnification, or simply the naked eye. Using the naked eye does not allow the optimal harvesting of the follicular units and loop magnification is only a tad better. Stereo-microscopes allow the surgeon and his team to perform the most accurate graft dissection and best preserve donor hair. Take a look at the operating room to make sure it has clean up-to-date equipment, and that there are plenty of microscopes on hand, as each clinical staff member will need one.

Questions to Ask

• What percentage of patients do you recommend surgery for? (People may not be candidates for a hair transplant for a variety of reasons. If the doctor recommends surgery for most patients that he sees, then something is wrong). Many men with early hair loss should be first treated with medication and the majority of women is actually not good candidates for surgery (because of their generalized thinning) and will never be.
• What about shedding? (If the doctor says “my techniques are very good so my patient’s never shed existing hair after surgery” then run out the door because that is simply not a realistic prediction of the surgical outcome of a hair transplant).
• What did my examination show? (The doctor should be able to tell you exactly what he ascertained about your hair loss condition after examining you).
• What age do you start treating patients? (Anyone under 25 has yet to display the traits used to predict their hair loss in say 10 years, for that reason a good surgeon will not perform a hair transplant on anyone too young).

Red Flags
Here are a few red flags to tip you off that a medical practitioner may not have the patient’s best interest at heart:

• Are you being evaluated by a salesman or a doctor? (Though it is fine for a medical assistant to answer general questions, and a salesman to answer financial ones, any examination should be conducted by a doctor and he should be the one making the recommendations. The doctor should not come in as the finisher; he should be the starter and the only one practicing medicine.
• Is your consultation focused on your long-term plan for your hair loss problem or is it just about quickly getting a “hair fix”? (A good doctor will be thinking about where your hair loss is headed many years from now.)
• Is the doctor examining you thoroughly? (He or she should not take a cursory glance at the back of your head and exclaim “oh you’re a great candidate for a hair transplant!” Make sure that you are examined very carefully, having your density checked, with a diagnostic tool called a densitometer, and your scalp assessed for laxity.)
• Is your doctor at the office all the time or does he travel from office to office with some other person doing the follow-up care?
• Are you getting the feeling that you are being rushed? (Hair restoration surgery, or any cosmetic procedure, is not right for everyone. It is important that the doctor not rush you into surgery, but rather discuss all options, emphasizing the importance of medical therapy with, or without, surgery.)

When choosing any kind of health care practitioner a patient should always go with their gut. If you feel uncomfortable with a doctor, it is usually a sign that you are in the wrong place.

What to Focus On
Surgical hair restoration has made some remarkable advances in the past 5-10 years and a hair transplant might be a solution for your hair loss, but only an experienced doctor can determine the likelihood of your benefiting from this option. You should find a health professional specializing in the diagnosis and management of hair loss. Make sure his or her focus is on finding the optimal course of action for treating your future hair loss for the long-term – be it medical or surgical. And resist the dangerous temptation toward self diagnosis and, of course, don’t rush any decisions. Good Luck!

A: All of the patients that appear on the Bernstein Medical website were operated on by me personally. My own staff assisted me in these procedures.

I worked with Dr. Rassman at NHI from 1995 to 2004. Photos of patients that I operated on during this period may therefore also appear on the NHI website.

The technique gives important information on hair density, the composition of the patient’s follicular units and the diameter of their hair shafts. The new instruments give doctors vital information for making decisions about whether patients are candidates for hair transplant surgery, the amount of donor tissue needed for the hair restoration, and to help them better predict how the results of hair transplants will ultimately look.

For more information, please see Dr. Bernstein’s publication on densitometry, a podcast on hair transplantation that discusses densitometry, and the Bernstein Medical – Center for Hair Restoration press release on the news below:

Baldness Detection Devices Featured in Medical Journal

Hair Transplant Forum International publishes new article on hand-held instruments used in hair loss detection and planning for hair transplants.

The lead article in the March/April issue of the journal published by The International Society of Hair Restoration Surgery (ISHRS) focuses on the latest tools available for assessing whether or not a person experiencing hair loss is a good candidate for hair transplant surgery.

The cover story: “Densitometry and Video-microscopy” written by Robert M. Bernstein, M.D. and William R. Rassman, M.D. explores the often overlooked diagnostic practice of analyzing the scalp under high-power magnification. Getting an extreme close-up of hair patterns at the base of the scalp allows hair transplant surgeons and dermatologists a chance to not only screen candidates for appropriateness for surgery, but can also predict future hair loss patterns.

Dr. Bernstein, founder of the New York based Bernstein Medical – Center for Hair Restoration, is known for his pioneering work in new hair transplantation techniques. When asked why he thought the article was given so much prominence in the Hair Transplant Forum, he suggested that “these simple hand held instruments should be essential tools of the hair transplant doctor.” He cautioned that without precise measurements doctors run the risk of performing surgery on persons who may is not suited for this procedure.

Dr. Bernstein has authored over 50 papers on hair transplantation including some of the most influential research on techniques used to repair badly performed hair transplants. In his seminal publications describing Follicular Unit Transplantation (FUT), Dr. Bernstein introduced a brand new method of hair restoration surgery which recognized follicular units (groups of naturally growing hair follicles) as the ideal element of donor tissue to be used in hair transplants. FUT is now considered to be the state-of-the-art in surgical hair restoration.

Dr. Bernstein and his colleague Dr. Rassman began utilizing the Densitometer to determine specific hair characteristics such as hair density, and changes in hair diameter that are important in both determining who are potential surgical candidates for the new hair transplant procedures and who may respond to medications.

The International Society of Hair Restoration Surgery (ISHRS), a non-profit organization of over 700 hair restoration doctors, publishes Hair Transplant Forum to keep the Society abreast of the most recent developments in the field of hair transplantation.

Dr. Bernstein is known to the general public from his appearances on NBC’s Today Show with Matt Lauer, CBS’s The Early Show, ABC’s Good Morning America, The Discovery Channel and other nationally syndicated programs.

A: The hair densitometer was introduced to hair restoration surgeons by Dr. Rassman in 1993. It is a small, portable, instrument that has a magnifying lens and an opening of 10mm2.

To use it, the doctor clips the hair short (~ 1-mm) and the instrument is then placed on the scalp. The doctor counts the total number of hairs in the field, looks at the number of hairs per follicular unit and assesses the diameter of the hair, looking in particular for abnormal levels of miniaturization (decreased hair shaft diameter caused by the effects of DHT).

The densitometer can increase the accuracy of the diagnosis of genetic hair loss by picking up early miniaturization.

It can also better assess a person’s donor hair supply, thus helping to determine which patients are candidates for a hair transplant.

Densitometry has helped us define the conditions of diffuse patterned and unpatterned hair loss (DPA and DUPA) and help to refine the diagnosis of hair loss in women.