Bernstein Medical Blog

This page contains all posts in our News, Answers, Video, and Research sections.

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In Hair Transplant Repair, Can You Remove Plugs By Follicular Unit Extraction?

December 15th, 2016

Q: I was wondering if it was possible to use Follicular Unit Extraction (FUE) on the old plugs instead of graft excision. — N.B. ~ Westport, C.T.

A: Graft excision generally works better than FUE in removing old plugs and mini-grafts. The reason is that, in these grafts, the hair is not aligned due to the scar tissue that tugs on, and bends the hair. Because the hair direction is altered from the scar tissue, there is much more damage when the grafts are removed with the tiny FUE punches. In addition, FUE only removes a very small part of the plug. If the hair in the plug is pointing in the wrong direction or the plug is in the wrong location, the entire graft needs to be removed.

Another benefit of graft excision is that we can remove the underlying scar tissue and improve the appearance of the underlying skin. In FUE, only a tiny bit of the scar tissue is removed and, since FUE holes are left open, FUE actually causes its own scarring. With graft excision, the sites are sutured closed so some scar tissue is removed and the quality of the underlying skin looks more natural.

Read about Hair Plug Removal
Before/After Photos of a Plug Repair Patient

In Hair Transplant Repair, What is Hair Follicle Survival Rate for Re-implanted Grafts?

December 13th, 2016

Q: When you remove hair plugs and re-use the hair from the grafts, what is the survival rate for those follicular units? — W.B. ~ Upper West Side, N.Y.

A: The survival rate is close to that when grafts harvested via FUT or FUE. However, if the grafts are placed into a significantly scarred scalp, this can have a negative impact on growth.

After a Hair Transplant Will Scars Be Visible in the Recipient Area?

December 12th, 2016

Q: I’ve read some information on your website about donor area scarring from FUT and FUE. Since I wear my hair longer in the back, I am not really concerned about that. But what about the recipient area where my hair is thin? Are any scars visible in the recipient area after a hair transplant? How long after a hair transplant will you be able to see redness, marks, or scars on the top of my scalp? — A.N., Chicago, IL

A: The marks and redness from a hair transplant should fade in about 10 days, although there is significant patient to patient variability. The tiny recipient sites that we use prevent visible scarring, pitting, or other surface irregularities as a result of the procedure.

Dr. Bernstein Named a Top 100 Influencer on Robotics

December 12th, 2016

Onalytica, a company that provides Influencer Relationship Management software and services, has named Dr. Bernstein one of the top influencers (#39 out of 100) on the topic of robotics due to his pioneering work in robotic hair transplant surgery with the ARTAS Robotic System.

Are Lab Tests Required Before Starting Propecia?

December 8th, 2016

Q: I had a good friend get a transplant at your practice and it seems that your practice is the industry leader in hair transplantation. I may one day be looking for one. That being said, my friend said I shouldn’t trust anyone else. I wanted to know if you may be able to tell me what tests/specific labs you have your patients do prior to starting Propecia. I am having my doctor put me on it but he does not recommend any labs but I don’t trust this. So I’m not looking for medical advice, just what your practice may advise a patient to get (in terms of labs/blood tests) prior to starting Propecia. I’m really hoping you can help as I have already contacted a number of other sources and can’t seem to get an answer. — M.B. ~ Upper East Side, N.Y.

A: Blood tests are not required before starting finasteride and we do not routinely perform them. If a patient requests test then Total and Free Testosterone, DHT, and Prolactin are reasonable to obtain, but there is no consensus on what the appropriate tests might be. If a patient requests tests because he has symptoms (i.e. such as lack of energy associated with low T), he should see his internist, urologist, or GP. That said, patients 50 and over (40 and over in patients with a high risk of developing prostate cancer) should have a PSA before starting finasteride.

If I Have Shock Loss After a Hair Transplant, How Long Until Hair Grows Back?

December 7th, 2016

Q: I had an FUE hair transplant three weeks ago and some of my existing non-transplanted hair has fallen out. I was a Norwood 3V, but now I look more like a 4 or 5 without the hair that used to help cover up my thinning area. Am I destined to look balder for the next few months? When can I expect to look like before? — T.M., New Haven, CT

A: You are describing shedding that is pretty typical following a hair transplant. The hair which is shed generally grows back together with the transplanted hair beginning at about three months. You should expect hair that is shaved for the FUE procedure to grow back right away at the normal rate of 1/2mm per day.

The shedding (also called shock hair loss) doesn’t mean permanent damage to the hair follicles. What it refers to is a physiological, or normal, response to trauma to the scalp which is caused by the hair restoration procedure. In general, only miniaturized hair (the hair that is affected by androgens and that has begun to decrease in diameter) is shed after a transplant. This hair would be lost in the near term anyway. Existing healthy hair is unlikely to shed, but if it were to shed, you could expect it to grow back as the transplanted hair grows in.

Why Is It Important to Wash My Scalp After a Hair Transplant?

November 17th, 2016

Q: Is it harmful if I do not rinse or wash my recipient area for 5 to 7 days after the hair transplant? — T.E., Yonkers, NY

A: The purpose of showering the day after the procedure is to remove scabs and dried blood. This will allow for quicker healing, less inflammation (redness), and a reduced incidence of infection. It will also shorten the time post-op where the procedure might be detectable. In our practice, patients are instructed to start showering and gently washing the recipient area the day after the surgery. The first day after surgery the patient will shower three times, and for the remainder of the week, showering will be twice daily. When showering, patients can clean the transplanted area with a special medicated shampoo that is gentle on grafts. The follicular unit grafts are made to fit snugly into the recipient sites and will not be dislodged in the shower, as long as the patient washes gently.

Can I Have Robotic FUE If I Have Gray Hair or Curly Hair?

November 15th, 2016

Q: I have read that the ARTAS System works best on straight black hair. Is this an option for gray hair? How about wavy or curly hair? – P.W., Fort Lee, NJ

A: The ARTAS robotic system can be used in patients with any hair color although in order for the robot to visualize white hair (or very light blond hair) the hair must be dyed. Curly hair is also not a problem as the donor hair in a robotic procedure is shaved to approximately 1 mm in length so a wave or curl is eliminated. In patients of African descent, where the hair below the surface of the skin may be curved, a slightly larger punch can be used. we have patients dye their hair the evening before or the day of the procedure. For convenience, only the hair in the donor area (back and sides) where the robot will be doing the harvesting needs to be dyed.

In patients who prefer not to shave or dye the entire back and sides of the scalp, we can perform the ARTAS robotic FUE using the long-hair technique. With this technique, you will grow your hair on the back and sides of the scalp a bit longer so it can cover the harvested area. On the day of the procedure, we will lift up the hair, clip a long thin band of donor hair and then extract follicular units from this limited region of the scalp. After the procedure, you can simply comb down your hair to cover the donor zone. The area that has been harvested (and possibly dyed depending on your hair color) will not be visible.

Dr. Robert M. Bernstein Presents “Graft Selection” Advance in ARTAS Robotic Hair Transplant System at ISHRS World Congress

October 7th, 2016

Dr. Bernstein presented results of his study, “Robotic Follicular Unit Graft Selection,” at the 2016 ISHRS World Congress held in Las Vegas, Nevada. Graft selection is a key advance in the ARTAS Robotic Hair Transplant System, a hardware and software suite that automates aspects of the Follicular Unit Extraction (FUE) hair transplant procedure. The enhancement makes Robotic FUE more efficient and improves patient outcomes.

Dr. Bernstein Interviewed by NY Japion Magazine on the Latest in Hair Transplant Surgery

October 6th, 2016

Dr. Bernstein was featured in a wide-ranging interview published in the New York City-based, Japanese language magazine NY Japion. Among the topics discussed were the differences between FUT and FUE hair transplants, updates on robotic hair transplant technology, the type of procedure most beneficial for Asian patients, criteria that determine candidacy for a hair transplant, and more.

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