Posts Tagged: Eyebrow Hair Transplant

Can Follicular Unit Extraction Hair Transplant Repair Scar on Scalp?

April 17th, 2009

Q: I wanted to determine if I would be a candidate for FUE (to camouflage a scar). After reading through your vastly informative website, I had become aware that the Fox test is necessary to determine patient viability for FUE. When I mentioned the test, I believe I heard you say it was unnecessary. Please confirm if a Fox test is, in fact, necessary.

A: I generally perform FOX tests on patients when I am considering a FUE hair transplant. I do not routinely perform FOX tests before repairs (or on eyebrow transplants) where the number of grafts is relatively small.

The purpose of FUE is to identify those patients in whom FUE is particularly inefficient — i.e. where there is a greater than average risk of damage during the harvest. If this is the case, I would not perform the hair transplant, since even slight inefficiencies create a significant problem when thousands of grafts are transplanted.

Remember, compared to Follicular Unit Transplant (FUT), FUE is a relatively inefficient procedure to begin with. Even when a small FUE hair transplant is performed (i.e., in a Norwood Class 3) we have to anticipate that eventually the person will need a large amount of grafts, so a FOX test is still important.

However, when the total number of grafts is small, such as in scar revisions or eyebrow restoration, small inefficiencies are not as important.

In addition, with repairs, the donor area is altered so that extraction in different areas may be very be different, rendering a FOX test in scar revisions far less useful.

Finally, if a FUE hair transplant is started, but then aborted due to extraction difficulties, the patient must either be reverted to a strip (which was not the preferred means of harvesting or a FUT would have been planned to begin with) or the patient will be left with a partial procedure – both less than ideal situations. However, if a FUE repair has to be aborted due to the inability to efficiently harvest hair, no harm was done; we just won’t be able to achieve our goal.

Topic: Follicular Unit Extraction

Tags: / / / / / / / / / / / /

Posted by Robert M. Bernstein M.D. at 8:09 am

What Makes Eyebrow Hair Transplant Different from Other Hair Transplants?

May 9th, 2007

Q: I have had thinning eyebrows since my early twenties (I am now 32) and they have gotten to the point that I can’t make them look good with mascara anymore. I am considering an eyebrow hair transplant, how is it different from other hair transplants?

A: Eyebrow hair restoration procedures are similar to hair transplants to the scalp in that the hair, once transplanted, is permanent. They differ both in the techniques used to perform them and in the results.

In eyebrow transplants, only individual hairs should be used, whereas follicular units containing from 1 to 4 hairs are used in a hair transplant to the scalp. In eyebrow transplants, the hairs must be positioned to lie as flat as possible to the surface of the skin. In hair transplantation to the scalp, the angle between the hair and the scalp surface can be as much as 45 degrees or more.

As with hair transplants to the scalp, the hair transplanted to eyebrows will continue to grow and must therefore be cut. However, in contrast to hair transplants where the donor hair is generally a perfect match for scalp hair, in eyebrow transplants the hair is taken from a different part of the body and will have slightly different characteristics both in growth rate and in appearance.

Topic: Hair Transplant

Tags: / / / / / / /

Posted by Robert M. Bernstein M.D. at 7:09 am

What are Obstacles to Hair Cloning Techniques?

November 16th, 2006

Q: What are the major obstacles for scientists to cloning hair?

A: The main problem is that the cultured cells may lose their phenotype with multiple passages, i.e. lose their ability to differentiate into hair follicles after they have been multiplied.

Another problem of hair cloning is that the orientation of hair direction must be controlled. With mouse experiments, the hairs grow at all different directions. Scientists need to find a way to align the hair so that it grows in the right direction. Hair, of course, must also be of a quality that is cosmetically acceptable and matches the patient existing hair. And the hair should grow in follicular units. Individual hairs will not give the fullness or natural look of follicular units.

Another problem is the issue of safety. Are we sure that cultured cells may not turn into something else – such as malignancy cells with uncontrolled growth?

Finally, FDA approval would be required and this takes time. It is true that you do not need FDA approval for using your own hair, such as a hair transplant; however, when you take cells from the body and manipulate it in the lab, this requires FDA approval.

Topic: Hair Cloning

Tags: / / / / / / / /

Posted by Robert M. Bernstein M.D. at 11:20 am

After Follicular Unit Extraction Hair Transplant, Why Pimples and Redness?

July 21st, 2006

Q: I had a hair transplant of over 600 grafts using Follicular Unit Extraction (FUE) to my frontal hairline and the frontal part of my scalp. The procedure was done less than a year ago by another doctor. Since then I have had persistent pimples and redness in the area that the grafts were placed. Also, the surface of the skin in the area is irregular.

A: One of the causes of having pimples and redness following Follicular Unit Extraction may be buried hair fragments and there are significantly more hair fragments generated with the two-step FUE technique than with the three-step method.

In the three-step procedure, we use blunt dissection which minimizes transection (cutting of hair follicles) and thus reduces the incidence of hair fragments. See the Instrumentation for Three-Step FUE page at the Bernstein Medical – Center for Hair Restoration website.

In our practice, we also place every extracted graft under the microscope. This serves a number of purposes:

  1. It gives me immediate feedback on transection rates, so that I can adjust my technique in real-time (using a stereo-microscope is much better than visual inspection for this purpose)
  2. It enables us to trim away excess tissue and hair fragments (we use the same judgment as we do with strip harvesting, so that a “viable looking” fragment would be left attached
  3. It allows us to accurately count the number of hairs in each follicular unit graft, as it is particularly important to have pure 1-hair grafts for the frontal hairline. This also allows us to better anticipate the end cosmetic result.
  4. It allows us to dissect larger follicular units into smaller ones for specific cosmetic purposes, i.e. eyebrows, hairlines, temples etc.

One of the ironies of FUE is that it is more efficient to extract the larger FUEs, since this gives us a greater hairs/hole ratio, but this often leaves us with an inadequate number of 1-hair units, which must be obtained though traditional stereo-microscopic dissection of the larger extracted grafts.

Other causes of folliculitis (manifested by pimples and redness) can result from placing the grafts too deep in the recipient site (where they may get buried) and secondary infection. A mild, transient folliculitis is often seen after a hair transplant without any precipitation factors.

Topic: Follicular Unit Extraction

Tags: / / / / / / / / / / / / / / / / /

Posted by Robert M. Bernstein M.D. at 8:03 am





© 2009 Bernstein Medical, P.C. All Rights Reserved.