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Robotic Hair Transplants & Hair Restoration
Flagship: 110 East 55th Street, New York, NY
212-826-2400 - [email protected]
Bernstein Medical - Center for Hair Restoration
Hair Restoration Answers

Preventing Shock Hair Loss After Hair Transplant

Q: Can shock loss be eliminated by using special surgical techniques? — R.P., Short Hills, NJ

A: Although there have been no scientific studies proving this, shock hair loss can most likely be minimized by keeping the recipient sites parallel to the hair follicles, by not creating a transplanted density too great in areas of existing hair, and by using minimal epinephrine (adrenaline) in the anesthetic. We implement all of these techniques. Finasteride may also decrease shock hair loss, or at least help any (miniaturized) hair that is lost to re-grow. That said, some shock hair loss from a hair transplant is unavoidable regardless of the technique as it is a normal physiologic response to stress.

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Hair Restoration Answers

Is it Normal to be Shedding Three Months After a Hair Transplant?

Q: I am about 3 months post-op after my hair restoration procedure. I have noticed some hair shedding in the frontal part of my scalp. I have continued both Propecia and Minoxidil. Is there anything I can do and should I be concerned? — M.B., Chicago, IL

A: Shedding of some of the patient’s existing hair in, and around, the area of a hair transplant is a relatively common occurrence after a hair transplant and should not be a cause of concern. The mechanism appears to be a normal response of the body to the stress of the hair restoration surgery -– i.e., site creation, adrenaline in the anesthetic etc. Some doctors claim that their hair transplant techniques are so “impeccable” that their patients do not experience shedding. This is a false claim. Although using very small recipient sites and limiting the use of epinephrine may mitigate shedding somewhat, shedding is a normal part of the hair transplant process and the risk is unavoidable.

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Hair Restoration Answers

How Does Dr. Bernstein Use Midazolam (Versed) Sedative Drug?

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.

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Hair Restoration Answers

Is a Hair Transplant Painful and What Kind of Anesthesia do You Use?

Q: Dr. Bernstein, is a follicular unit hair transplant, the way you perform it, very painful? — M.C., Laguna Niguel, C.A.

A: We perform our hair transplant procedures using long-acting, local anesthesia, so after the initial injections, the patient doesn’t experience any pain or discomfort.

The local anesthesia (a combination of Lidocaine and Marcaine) lasts about 4-5 hours. For long sessions, we give additional anesthesia before the first wears off.

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Hair Restoration Answers

What is Tumescent Anesthesia and is it Used in a Hair Transplant Procedure?

Q: I have read about something called “tumescent anesthesia” but didn’t understand what it is. What exactly is it? — S.S., Hoboken, N.J.

A: Tumescent techniques were first popularized in liposuction surgery where large quantities of fluid containing adrenalin were injected into the person’s fat layer to decrease bleeding before the fat was literally sucked out of the body. Bleeding was minimized because the epinephrine (adrenaline) constricted blood vessels and the fluid compressed the blood flow in the smallest blood vessels called capillaries.

The technique allowed small liposuction procedures to be performed safely as an out-patient procedure. In surgical hair restoration, low concentrations of anesthetic fluid and adrenaline are injected into the fat layer in the back of the scalp.

In a hair transplant, besides decreasing the bleeding, the fluid makes the skin more rigid so that the incision can be more easily made without cutting hair follicles. It also helps the doctor avoid damage to the deeper blood vessels and nerves in the scalp.

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Hair Restoration Answers

Do You Use Anesthesia During a Hair Transplant?

Q: Will I be unconscious during the hair transplant procedure and do you use general anesthesia? – C.L., Boston, Massachusetts

A: All of the surgical hair restoration procedures at Bernstein Medical are performed under local anesthesia. The fact that general anesthesia is not needed is what makes hair transplant procedures – even though they are long – very safe.

Patients are given a sedative to help them relax, but they are not put to sleep. Most patients watch TV, see movies or just chat during the procedure.

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Bernstein Medical In The News

Dr. Bernstein and Hair Transplant Patient Featured on NBC’s ‘Today’ with Matt Lauer

“Over the past 10 years we’ve developed a new procedure called follicular unit transplantation, where hair is transplanted exactly the way it grows,” said Dr. Robert Bernstein […] This new technique replaces the plugs — groups of hairs inserted into round holes in the scalp — used in the early days of hair transplant procedures. It is now known that hair grows in groups of one to four hairs.

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