Bernstein Medical Blog

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

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Can Hair Transplant Procedure Remove Hair From One Person and Transplant to Another?

January 25th, 2006

Q: Can hair be transplanted from one person to another? M.Y. – Hoboken, New Jersey

A: A hair transplant between individuals can only be performed on identical twins, since they are genetically the same.

In all other cases, including non-identical siblings, the transplanted hair will be rejected.

We are often asked how it is that one can perform kidney transplants from one person to another, but not hair transplants. The reason is that the skin is more antigenic than a kidney i.e. it is more likely to be rejected. The reason is complex, but this makes sense considering that the skin is the first line of defense against foreign organisms.

How Did Follicular Unit Transplantation and Follicular Unit Extraction Get Their Names?

January 11th, 2006

Q: How did Follicular Unit Transplantation and Follicular Unit Extraction get their names? N.D. – Bergen, New Jersey

A: The first paper on Follicular Unit Hair Transplantation was published by Dr. Bernstein and Rassman in 1995 in the International Journal of Aesthetic and Restorative Surgery. The title of the paper used the abbreviated name Follicular Transplantation. The longer name “Follicular Unit Transplantation” was formalized by Bernstein et. al. in the paper “Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques.” This paper appeared in Dermatologic Surgery in 1998.

Follicular Unit Extraction derived its name from Rassman and Bernstein’s publication “Follicular Unit Extraction: Minimally invasive surgery for hair transplantation” that appeared in Dermatologic Surgery in 2002.

After Hair Transplant, Will Scalp Laxity Return to Normal and, if so, How Long After Transplant?

January 6th, 2006

Q: After a strip procedure, will the scalps laxity return to normal and how long after the hair transplant does it take? C.B. – Roanoke, Virginia

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.

What Factors Determine Hair Transplant Graft Count?

January 4th, 2006

Q: Is it possible to tell me roughly how many grafts would be left from donor area if one had a hair transplant of 2,500 grafts and had a density of around 2.0? G.H. – New York, NY

A: How much hair can be harvested in total depends upon a number of factors besides donor density. These include: scalp laxity, hair characteristics (such as hair shaft diameter, color and wave), and the actual dimensions of the permanent zone.

Every person is different, so all of these factors would need to be taken into account to determine the total number of grafts that would be available for the hair restoration.

How Long Until I See Growth from Hair Transplant into a Donor Scar?

December 29th, 2005

Q: I have had some grafts implanted into a donor scar. How long does it take to see the final result? B.K. – Newport, Rhode Island

A: In normal scalps, growth is generally complete by 10-12 months. Grafts placed in scar tissue may often take longer to grow.

What Causes ‘Graft Popping’ During Surgical Hair Restoration?

December 21st, 2005

Q: What causes graft popping during a hair transplant? G.K. – Carle Place, N.Y.

A: Popping, or the tendency for grafts to elevate after they have been placed into the recipient area, is caused by a number of factors including:

Packing the grafts too closely, particularly when they are placed on a very acute (sharp) angle with the skin
Rough placing techniques
Bleeding
Poor fit between the graft and recipient site
Natural characteristics of the patient’s skin, including the elasticity and stickiness of wound edges

The problem with popping is that it exposes grafts to drying (while they are elevated on the skin surface) and trauma (when they have to be re-inserted).

The judgment and experience of the surgeon performing hair transplants is extremely important in minimizing popping. It is important that the surgeon customize the site size to the different size follicular unit grafts and to test the recipient sites as they are made, to make sure that the “fit” is perfect.

Although it is important to place grafts close together to get the best cosmetic result possible, over-packing of the grafts risks popping and other factors (such as overwhelming the blood supply) that may lead to poor growth.

In the end, maximum growth of the transplanted hair should be the primary goal.

Can I Vary Dosage of Propecia in Treatment of Hair Loss?

December 14th, 2005

Q: I am not yet ready for a hair transplant but am considering Propecia. What is your opinion on the “optimal dose”? I know Merck recommends 1 mg, but could I get away with taking less? Or would I get a better result by taking more (2-3 mgs)? — V.B, Darien, CT

A: You may get away with 0.5 mg a day. However, there are published data by Roberts et. Al. in the JAAD in 1999 showing a dose-response between 0.2 and 1 mg/day, with the lower dose showing reduced efficacy, from controlled clinical trials.

There is little evidence that a higher dose helps, but I often double the dose if a patient has been on 1mg a day for 3-5 years and then stops responding. The hope is that this can postpone the need for surgical hair restoration, but there is no scientific data to support that it will.

Will Hair Transplant Grafts Grow in Scar Tissue on Scalp?

December 6th, 2005

Q: Can hair transplants grow in scars? P.N. – Westbury, N.Y.

A: Grafts will grow in scar tissue as long as the scar is not thickened. However, they cannot be placed as close together as in normal scalp because of decreased blood flow. When performing a hair transplant into scar tissue, it is often necessary to perform the hair restoration in multiple sessions to allow the area to gradually re-vascularize (allow the blood supply to return).

Do You Recommend Hair Transplant for Hair Thinning Over Entire Scalp?

November 25th, 2005

Q: I am 19 years old and seem to be thinning all over, including the sides. My father has all of his hair but my grandfather is totally bald. Should I have a hair transplant now or wait until I am older? — T.K., Garden City, NY

A: Most likely you have a type of androgenetic alopecia called Diffuse Unpatterned Alopecia (DUPA).

In this hereditary condition, hair thins all over rather than just on the front, top and back as in the more common male pattern baldness.

The fact that the back and sides of your scalp are thinning (the donor area) precludes you from being a candidate for surgery. The diagnosis can be made by observing a high degree of miniaturization (fine hair) in the donor area under a magnifier. This instrument is called a densitometer.

For further information, please read the article:

Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning, published in the journal Dermatologic Surgery in 1997. Specifically, read the last part of the article.

After Hair Transplant, Can Donor Hair Become Frizzy and Dry?

November 18th, 2005

Q: Why can donor hair become frizzy and dry once transplanted? — G.F., Stamford, C.T.

A: Frizzing and kinkiness is a temporary phenomenon that is part of the normal healing process after a follicular unit hair transplant.

During the healing process, the new collagen that forms around the grafts can alter their growth. Over time, usually within a year, this collagen matures and the hair quality usually returns to normal.

If grafts have been excessively traumatized or grafts larger than follicular units have been used, these changes are more likely to be permanent.

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