A: Hair will grow in the scar but, as you allude to, the problem is often the abnormal hair direction rather than the scar itself.

Besides adding hair to the scar, if one transplants hair adjacent to the scar in a direction that causes it to lie over the scarred area, the visual affect of the “Red Sea” effect can be lessened.

How much improvement you achieve with the hair restoration will, in part, depend upon the amount of hair available to be transplanted (and the skill of the surgeon).

A: The scalp regains most of its laxity in the first eight months following the hair transplant, but it will continue to loosen slightly after that.

It is interesting that if the scalp is tight prior to surgery, the scalp is less likely to have its full laxity return than in patients who had loose scalps to begin with. With average or loose scalps, there is usually no difference. However, over time, the patient rarely, if ever, notices any permanent tightness unless aggressive procedures have been performed or procedures such as scalp reductions and lifts.

Hair Transplant Forum International 1997; 7(1): 16.

Surgeon of the Month: Robert M. Bernstein, M.D.

It has been my policy, since taking over as Editor of the FORUM, to nominate a Surgeon of the Month in each edition. Rather than give further honors to those illustrious member of our profession who have had frequent mention over past years, I have tried to seek out those who have much to contribute in the future. Recent editions have honored a Mexican, an Australian and two South American surgeons. On this occasion, we return to the USA, to pay homage to a young dermatologist who has contributed a great deal in a few short years since entering the hair transplant field. – RS

Robert M. Bernstein, MD, is Medical Director of the New Hair Institute Medical Group in New York. He is Assistant Clinical Professor of Dermatology at the college of Physician and Surgeons of Columbia University, and an Associate in the Dermatology Service at the Columbia Presbyterian Medical Center, where he teaches dermatologic and laser surgery, and hair transplantation. He is also an attending physician in dermatology at Englewood Hospital and at the Manhattan Eye, Ear and Throat Hospital.

Dr. Bernstein received his MS degree at the University of Medicine and Dentistry of New Jersey in 1978, and was the recipient of the Dr. Jacob Bleiberg Award for Excellence in Dermatology. He received his dermatologic training at the Albert Einstein College of Medicine, where he served as chief resident.

Dr. Bernstein is board certified in dermatology, and in his private practice, has a special interest in cosmetic dermatologic surgery and laser surgery. Dr. Bernstein has served as Chairman of the Quality Assurance and Compliance Committee of the Department of Dermatology at Englewood Hospital, and was Co Director of their annual dermatology seminar for 10 years. Although he trained in hair restoration surgery during his residency, and performed hair transplantation and scalp reductions when he started private practice, he soon abandoned both procedures when he was not satisfied with the results. He observed the evolution of the procedure for many years until, after seeing the work of Dr. William Rassman and others performing large sessions of small grafts, he decided to re enter the field. Dr. Bernstein soon joined Dr. Rassman at the New Hair Institute to devote his time solely to hair transplantation.

Dr. Bernstein introduced the concept of “follicular transplantation” in an article published in 1995 in the International Journal of Aesthetic and Restorative Surgery, which recommended that in all hair transplantation, the implants should consist of only the naturally occurring follicular units. The anatomic follicular units, seen clinically as the patient’s natural hair groupings, are different for each individual, and these differences should be reflected in the transplant plan. He has been a strong advocate of using follicular transplantation for the best possible cosmetic result, and has encouraged his colleagues to use this approach in both his writings and lectures.

Dr. Bernstein was born in New York City in 1952. He is married to Shizuka, who is a medical aesthetician, and they have two sons, Michael (age 12), and Taijiro (age 11), and a daughter, Nikita (age 2 1/2). Dr. Bernstein’s hobbies include skiing, basketball, piano, ballroom dancing, and chess all of which he enjoys with his family.