Moderator: How one can tell the difference between hair loss from hormonal imbalances and common baldness?
Dr. Bernstein: Measuring hormone levels alone, although important for medical management, does not necessarily reveal whether the cause of the hair loss is actually hormone related or is genetic. The diagnosis is made by examining the scalp and looking at the hair under close magnification using an instrument called a “Densitometer.”
Q: What exactly is compression in a hair transplant? — D.O., Short Hills, N.J.
A: Compression refers to the visible tufting of grafts due to the contraction of the grafts from the normal elasticity of skin around it, after it has been inserted into the recipient site.
Compression is most commonly seen when minigrafts are used in the hair restoration (minigrafts contain more than four hairs each).
Follicular units don’t show visible compression, since they are already naturally compact. However, if more than one follicular unit is placed into the same site, it can exhibit this phenomenon.
In a new article appearing on the cover of Hair Transplant Forum International, the official publication of The International Society of Hair Transplant Surgeons (ISHRS), pioneering hair transplant surgeon Robert M. Bernstein MD, along with his colleague Dr. William R. Rassman, recently revealed details about a “New Instrumentation for Three-Step Follicular Unit Extraction.”
Q: What is your opinion on having a hair transplant to restore the hairline and then wearing a hair system behind it to regain the appearance of a full head of hair? K.Y. – Hackensack, New Jersey
A: It is my personal feeling that one should not use a hair transplant to supplement a hair system, especially at a young age. We have occasionally performed this procedure in older men and women.
In my view, a main purpose of a hair transplant is for it to be low maintenance. The combination of a hair transplant and a hairpiece is extremely fussy.
Synopsis: Three-step FUE is a hair transplant technique that uses blunt dissection to prevent damage during the process of separating the follicular unit from the surrounding tissue. The 3 steps are: scoring, blunt dissection, and extraction. Performing Follicular Unit Extraction with a 3-step technique allows the surgeon to minimize damage to follicles and to keep follicular units intact. A disadvantage is the development of buried grafts, but this can be reduced by modifying the technique and using specially designed instrumentation.
Synopsis: The partial or complete loss of one’s eyebrows is a relatively common problem and can be caused by disease, accidents, the normal aging process, or can be been self-induced. This paper discusses the importance of eyebrows to one’s appearance and explains the special techniques and surgical skills required for eyebrow restoration.
Robert M. Bernstein, MD, New York, NY and William R. Rassman, MD, Los Angeles, CA Dermatol Surg 2006; 32: 198-204. Background Since it is not known precisely how long it will take for grafts to be securely anchored after a hair transplant, the advice that the medical profession has offered patients regarding post-op care has […]
Synopsis: This study determined exactly how long it takes after a hair transplant for the grafts to be securely anchored in the recipient area, so that they cannot be dislodged. This information is important in guiding the patient’s post-op care after a hair restoration procedure. The study also showed that preventing the formation of crusts following a hair transplant would shorten the time patients are at risk of dislodging grafts. It would also allow them to return to their normal hair care routines more rapidly.
Synopsis: This paper discusses the state-of-the-art in follicular unit extraction. It focuses on the new Three-Step Technique in which a sharp punch is used to cut the epidermis and then a dull punch is used to dissect the follicular unit from the surrounding tissue. The third step being the extraction itself. The “blunt” step significantly reduces follicular transaction, but creates a potential new problem, that of buried grafts. The Three-Step technique increases the number of patients in whom FUE is possible; however, other limitations of the procedure – particularly the lower total yield compared to strip harvesting – remain.
Synopsis: This writing discusses the current status of Follicular Unit Transplantation and some controversial issues regarding this procedure. These issues include: strip harvesting vs. follicular unit extraction, lateral vs. vertical slit recipient sites, which holding solution is best for grafts, the ideal density and the optimal number of grafts that should be performed in one hair transplant session.
Moderator: How one can tell the difference between hair loss from hormonal imbalances and common baldness?
