Q: You said I was not a good candidate for a hair transplant because my donor area was too thin. Since finasteride and minoxidil can increase the thickness of the hair, could it make a hair transplant possible?
A: Unfortunately, the medication will not affect the donor area and, therefore, not make a person with low donor density a candidate for a hair transplant.
Q: I have read that a lot of doctors today administer Midazolam (Versed) to sedate the patient. I have two questions in reference to this drug: 1) How does the doctor determine how much of a dose to administer to the patient and 2) is the drug administered all at once, or intermittently throughout the procedure? — D.D., Bronxville, NY
A: Each doctor has a different protocol, so it is hard to generalize. At Bernstein Medical we usually use Versed 2 to 4 mg IM one time 10 minutes prior to giving the local anesthesia. The dose is not repeated.
We also use Valium 5-15mg by mouth. I determine the dose of each based on body weight and history of sensitivity to sedatives.
Q: I had a hair transplant in 2004 of mostly plugs. The plugs are in an angle which doesn’t really look natural, far from it. I have lost a lot more hair since I did the hair restoration procedure. I regret ever doing a hair transplant. I prefer to reverse the surgery. I have read a lot about repair work on the net, and I have come to the conclusion that using FUE to take the plugs out, and put them back into the scar might be an option, but it may just make it worse on top. Also I can do electrolysis to remove the plugs, might be better because the possibility of scarring is smaller, and as I already have a lot.
A: If you had plugs, then a graft excision with suturing will generally give a better result than FUE, since a graft excision removes the underling scar tissue as well as the plug. FUE only removes the follicles, but leaves the underlying scar tissue. In addition, the shape of the follicles in scar tissue is often distorted, making extraction difficult and leading to more transaction (damage to follicles).
Q: If I want to use a laser to try and stimulate my hair to grow, should I use one of the hand-held units, such as the LaserComb or X5 Laser, or use a helmet?
A: Of the hand-held lasers, I feel the LaserComb is most effective. With the helmet units used in salons or doctor’s offices, we recommend the Revage. There is no evidence that the helmet lasers works any better than the LaserComb.
Some patients prefer a helmet, such as the Revage, since they can just relax and don’t have to worry about using it correctly or concentrating on reaching every spot. Others prefer the hand-held unit since it is less expensive and can be used at home.
Q: I recently saw an episode of the Rachel Ray Show where her guest, Dr. Anthony Youn, said that the Neograft machine for Follicular Unit Extraction is painless and uses a vacuum rather than surgery to remove the grafts. Can this be true? — A.B., Old Greenwich, C.T.
A: Follicular Unit Extraction (FUE) using the Neograft machine is not painless and, while it does not produce a linear scar, it is surgery and there is significant scarring in the form of thousands of tiny holes that heal with round white marks.
Q: What happens to hair diameter when you age? — K.L., Greenville NY
A: From infancy to puberty, hair gets progressively thicker. From adulthood to old age the hair becomes thinner again and this is exacerbated by the effects of DTH in susceptible persons. The later process is called androgenetic alopecia (common baldness) and is characterized by miniaturization – the progressive decrease in hair diameter and lengths as a result of DHT.
However, even without the effects of DHT, hair gradually thins over time in many people.
Dr. Robert M. Bernstein, founder of Bernstein Medical – Center for Hair Restoration, was selected by Castle Connolly as one of the New York metropolitan area’s top physicians through a peer-review survey of medical professionals.
New York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the hair transplant techniques, Follicular Unit Transplantation and Follicular Unit Extraction, and founder of Bernstein Medical – Center for Hair Restoration in Manhattan, has been included in New York Magazine’s “Best Doctors” issue for the eleventh consecutive year.
Q: I am currently 28. I have been taking Propecia for 6 years and recently began to grow sparse chest hair for the first time in my life. Is the Propecia causing these effects? — H.L., Gowanus, Brooklyn, NY
A: DHT causes male pattern baldness and stimulates the growth of body hair. The use of Finasteride, a DHT blocker, will permit scalp hair to grown and inhibit the growth of body hair, not stimulate it.
However, the effects on body hair are quite small, so your natural tendency to grow chest hair over time is probably not being blocked by the treatment.
Q: I had a hair transplant about a month ago and I had scabs and some dead skin until day 16 or 17. Will that endanger the growth of the hair restoration procedure? — S.P., Hoboken, N.J.
A: No, it will not. If follicular units were used for the hair transplant, the grafts should be permanent at 10 days. After this time, you can scrub as much as you need to get the scabs off.
Q: It seems like my hair is thicker in the summer. Can this be true? –R.B., West University Place, TX
A: Hair will increase in diameter when there is more humidity, as it absorbs moisture, and will actually be thicker in the more humid summer environment.
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