Synopsis: This paper traced the beginnings of Follicular Unit Hair Transplantation from Headington’s histologic description of the follicular unit, Limmer’s single strip harvesting and stereo-microscopic dissection and then Bernstein’s idea to use the follicular unit as the sole graft type in the hair restoration process.
Synopsis: This writing stresses the importance of objective scientific measurements in patient evaluation and surgical planning prior to a hair transplant. Specifically, it explains, in mathematical terms, the greater contribution of hair shaft diameter as compared to the number of hairs in the appearance of fullness.
Dr. O’tar Norwood discusses the origin of follicular transplantation, and the influence that Dr. Bernstein’s research and publications have had on the evolution of the hair transplant procedure. Read a segment of the article:
The evolution of “follicular transplantation” can be attributed to three people. Dr. Robert Bernstein coined the phrase and advanced the concept. Dr. Bob Limmer introduced the use of the binocular microscope, providing the technology, and Dr. David Seager showed by direct hair counts, comparing the growth of grafts cut with and without the microscope, how the hair growth was improved when the follicular unit was kept intact.
Dr. Bernstein receives the Surgeon of the Month award given by the International Society of Hair Restoration Surgery. Dr. Bernstein introduced the concept of “follicular transplantation” in 1995 through a publication in the International Journal of Aesthetic and Restorative Surgery, where he recommended that in all hair transplant procedures the implants should consist of only the naturally occurring follicular units. The anatomic follicular units, seen clinically as the patient’s natural hair groupings, are different for each individual, and these differences should be reflected in the transplant plan. He has been a strong advocate of using follicular transplantation for the best possible cosmetic result, and has encouraged his colleagues to use this approach in his writings and lectures.
by O’Tar T. Norwood, MD, Oklahoma City, Oklahoma, USA Hair Transplant Forum International (July/August 1997 issue) NOTES FROM THE EDITOR EMERITUS The evolution of “follicular transplantation” can be attributed to three people. Dr. Robert Bernstein coined the phrase and advanced the concept. Dr. Bob Limmer ((Limmer B: Forum, Vol. 2, #2, 1991.)), ((Limmer B: J […]
by O’Tar T. Norwood, MD, Oklahoma City, Oklahoma, USA
Hair Transplant Forum International (May/June 1997 issue)
I just returned from visiting Dr. Bob Bernstein in New York, and was impressed with his operation and even more impressed with his thoughts, observations, and insights into hair transplant surgery. He applies scientific methods to his work, is academically honest, and has an almost eerie instinctive knowledge of hair transplant surgery. Of course he has Dr. Bill Rassman to work with, but it is still remarkable. Dr. Bernstein is best known for introducing follicular transplantation to hair transplant surgery, an idea Bob Limmer has been pushing for ten years with the use of the binocular microscope, but no one would listen to him. Dr. Limmer, however, never used the term follicular transplantation. Using the microscope, you automatically dissect the follicular units. It can’t be avoided if done properly.
The following is a portion of “An Idea Whose Time Has Come,” an editorial written by O’Tar T. Norwood, MD — founder of the Norwood Classification System for Hair Loss — and published in the May/June 1997 issue of “Hair Transplant Forum International”:
I just returned from visiting Dr. Bob Bernstein in New York, and was impressed with his operation and even more impressed with his thoughts, observations, and insights into hair transplant surgery. He applies scientific methods to his work, is academically honest, and has an almost eerie instinctive knowledge of hair transplant surgery. Of course he has Dr. Bill Rassman to work with, but it is still remarkable. Dr. Bernstein is best known for introducing follicular transplantation to hair transplant surgery, an idea Bob Limmer has been pushing for ten years with the use of the binocular microscope, but no one would listen to him. Dr. Limmer, however, never used the term follicular transplantation. Using the microscope, you automatically dissect the follicular units. It can’t be avoided if done properly.
Cosmetic Surgery Times features Dr. Bernstein’s presentation to the 55th annual meeting of the American Academy of Dermatology in their April 1997 issue.
The article describes Dr. Bernstein’s introduction of the concept of Follicular Unit Transplantation to the academy as well as the keys to making the technique successful. From the article:
“‘Hair doesn’t grow singly it grows in naturally occurring groups of from one to four hairs. In follicular transplantation, we use these naturally occurring groups as the unit of the transplant,’ he told CST.
Although the procedure is highly labor intensive, it can actually be less expensive than conventional hair replacement surgery, because it can be performed in a single, but lengthy, session.
‘It is also much more efficient and conserves donor hair much better than conventional hair transplants. Every time you make an incision in the person’s scalp you waste some hair and make the remaining hair more difficult to remove. Accessing the donor area just once or twice will increase the total amount of hair that is available for the transplant,’ Dr. Bernstein told CST.”
Synopsis: An editorial that challenges the assumption that insufficient blood supply in a hair transplant is the main contributor to delayed growth.
Synopsis: This editorial challenges those who claim to not have seen delayed growth to look more carefully, since large-graft hair transplants interrupt the blood supply to a greater extent than using large sessions of very small grafts.
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