Bernstein Medical Blog

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

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GQ Turns to Dr. Bernstein for Explanation of Old “Pluggy” Hair Transplant Method

October 19th, 2010

GQ Magazine includes a quotation by Dr. Bernstein in their November 2010 issue. In the magazine’s “Manual” section, which outlines the latest style trends for men, there is a two-page article on hair transplant surgery. Dr. Bernstein’s help was recruited in discussing old hair transplant techniques where multiple follicular units were transplanted in “plugs.”

“In the old days, up until the early ’90s, they used to transplant multiple follicular units at once,” says Robert Bernstein, M.D., clinical professor of dermatology at Columbia University, “so what you got were those plugs, which look completely unnatural and gave the surgery a bad reputation.”

The article’s main protagonist is 27 year-old New Yorker, and hair transplant patient, Jordan Blackmore, but it also drops a few celebrity hair transplant names (Marc Jacobs, Ted Danson, Kevin Costner, and Matthew McConaughey). To read the article you’ll have to find the November 2010 issue at your local newsstand.

How Long Does Hair Transplant Surgery Take?

September 21st, 2010

Q: Is it correct that the hair transplant surgery lasts about eight hours or if there is a range, what is that generally? — M.R., Montclair, NJ

A: The range is about 5 to 8 hours. For a completely bald person, it would be in the higher range. Keep in mind that the person is just relaxing, watching TV or dozing off. The time goes by quickly for the patient. Since there is no general anesthesia, there is no medical risk for this relatively long procedure.

To review the procedure in more detail, please visit our Overview of FUT Hair Transplant Procedure section; which includes details for before, during, and after the hair transplant. View the Overview of FUE Hair Transplant Procedure section for details on the follicular unit extraction procedure.

Could Propecia Thin Out Body Hair Transplanted To My Scalp?

September 3rd, 2010

Q: If I had a body hair transplant to my scalp and then took Propecia to prevent further hair loss, could finasteride thin out the transplanted hair? — T.M., Yonkers, NY

A: In theory, yes!

You may be interested in a somewhat related question about the effects of finasteride on body hair. Read more posts on body hair.

Why Am I Losing Hair Despite Taking Avodart For Hair Loss?

September 1st, 2010

Q: I am currently taking Avodart and have done so for around 8 months. Last night I had a significant loss of hair after taking a shower, nothing like I have ever seen before and found it very distressing. Can you tell me if this is hair loss or could it be something known as shedding and could you please tell me what is the difference between hair loss and hair shedding? — M.S., New York, NY

A: Hair loss is a very general term that can refer loss of hair for any reason. Genetic hair loss is caused by the effects of DHT on hair follicles that result in miniaturization -– i.e. a slowly progressive change in hair diameter that starts with visible thinning and that may gradually end in complete baldness. Hair shedding is more sudden where hair falls out due to a rapid shift of hair from its growth phase into the resting phase. The medical term for this is telogen effluvium. This process is usually reversible when the offending problem is stopped. It can be due to stress, medication, or other issues. You should see a dermatologist to figure out which process is going on. Dutasteride can cause some shedding when it first starts to work, but it would be unusual to do this after being on treatment for eight months.

Should I Start Propecia Before Hair Loss Consultation?

August 31st, 2010

Q: I am a 34 year old male and my dermatologist prescribed Propecia for me today. Most of my hair loss is at the hairline, but there is some loss on top as well. It’s not bad, I just want to stay ahead of it. If I get a transplant I want to get it at your clinic, but I will give the Propecia a try first. I am going to be overseas for a couple of months starting this Sunday and I was wondering about the necessity or desirability of having someone measure my hair density prior to starting the Propecia. Would you advise waiting to start the Propecia until I come back in two months and having my density examined at your clinic? — M.R., Great Falls, Virginia

A: I would start Propecia as soon as possible. What is important for a hair transplant is the density in the donor area and this is not affected by Propecia (or minoxidil). Your donor density can be measured anytime at an evaluation prior to surgery. If you want to wait to see the effects of Propecia prior to the hair transplant, you really should wait a year; since growth, if any, can take this long. If you just want to have Propecia on board for the hair restoration procedure, or to make sure you don’t have side effects, then generally a month will do. If you would like to do a photo consult through our website to get some preliminary information about how many grafts you might need, you can do that at your leisure, but start Propecia now since the longer you wait the less effective it will be at regrowing hair.

Why Am I Shedding From Higher Dose Of Finasteride?

August 27th, 2010

Q: I have been taking one tablet of Propecia daily for the past 5 years, with good results, until May of this year. At that point I started to experience some hair loss and so you recommended that I switch from Propecia to generic finasteride and increase the dose to 1/2 of a 5 mg pill per day. I started taking the 1/2 tablet of finasteride daily one month ago, and for the past 2 weeks I have seen a lot of hair in the bathtub and on the towel after taking a shower. I have not made any other changes in my diet or my shampoo, and I do not have any conditions on my scalp. Please advise me on what needs to be done. — C.C., Floral Park, New York

A: Just continue the medication at the higher dose. Either the finasteride hasn’t started working yet or you are getting temporary shedding from the medication (which means that it is working).

What Length Is Hair After Transplant?

August 25th, 2010

Q: Is transplanted hair the same length as existing hair? — G.E., Buckinghamshire, UK

A: The hair is first clipped to about 1-mm before it is transplanted. The transplanted hair will look like stubble for the first few weeks after the hair restoration procedure. It is then shed and the newly transplanted follicles go into a resting phase for about two months.

Could Finasteride (Propecia) Remove Unwanted Body Hair?

August 23rd, 2010

Q: I’m concerned that finasteride might result in unwanted body hair on the arms, back, etc. Is there any truth to this? My thinking is that since finasteride blocks the enzyme 5 alpha-reductase which converts testosterone to its more active form, DHT (dihydrotestosterone), is it possible that it might actually have some effectiveness in ameliorating unwanted hair? — P.P., Stamford, CT

A: Yes, finasteride does have some ability to decrease body hair, since growth of body hair is stimulated by DHT. However, the effects of finasteride are mild and not observed by everyone, so if you have unwanted body hair you will probably need some other means to remove it such as waxing, laser hair removal or electrolysis. The important thing is that finasteride doesn’t increase body hair.

Can Propecia Or Rogaine Restore My Original Hair Density?

August 6th, 2010

Q: You mentioned that the hair at my crown and other areas where I now have baldness hasn’t really fallen off but has thinned to a great extent and that taking Rogaine and Propecia might help increase their thickness. If the medications do restore the hair thickness, I’m curious why you said that I could look like how I was 1 to 2 years ago. Technically, shouldn’t I be able to regain much more of my hair (and look like how I was longer than before that) since the follicles are all still there? — H.D., Park Slope, NY

A: Although Propecia is much more effective than Rogaine, even when used together, the medications are just not that effective in reversing the miniaturization process. They may bring you back to the way you were a few years ago, but will not restore your adolescent density.

Will Taking Propecia Improve Donor Area Density Enough To Allow Hair Transplant?

August 4th, 2010

Q: Is it recommended to wait for 1 year after starting Propecia, when the effect of the medication kicks in and improves density of donor area, and then perform the surgery? — Z.B., Bergen County, New Jersey

A: Propecia will not affect the donor area, as this area is generally not impacted by the miniaturizing (thinning) effects of DHT –- the hormone that Propecia blocks. The purpose of waiting the year is to possibly regrow hair in the recipient area. If regrowth is significant, a hair transplant may not be necessary. If a person’s hair loss is extensive and there is little chance that Propecia will grow a significant amount of hair back to give a satisfactory improvement, then waiting the year is unnecessary.

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