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Bernstein Medical - Center for Hair Restoration

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Hair Restoration Answers

Does Surgeon Determine Angle of Hair In Hair Transplant?

Q: I notice that some patients end up with hair that seems to stand straight up while others have hair that flows to one side or the other. Does the angle at which you place the follicles in the scalp ultimately determine how the hair will lie? Is there some artistic talent needed when placing these follicles so that patients end up with hair that lies flat or sticks straight up? What determines this? Do we have control over it? — H.B., Fort Lauderdale, F.L.

A: Great question. You are correct, the angle of the recipient sites largely determines the hair direction. Hair should be planted the way it grows (i.e., in a forward and horizontal direction at the frontal hairline.) It is extremely important that it is transplanted that way to look natural. The body will alter the angle a bit as it heals, usually elevating it slightly and re-creating any prior wave (yes, waves are determined by the scalp, rather than by the hair follicles per se). In a properly performed hair transplant, a straight-up appearance should be due to grooming, it should not have been a result of the actual procedure. Hair should never be transplanted perpendicular to the scalp. I discussed these important concepts way back in my 1997 paper “The Aesthetics of Follicular Transplantation“.

Posted by Robert M. Bernstein M.D. Updated 2017-12-01
Hair Restoration Answers

Does ARTAS FUE Robot Work with African-American (Very Curly) Hair?

Q: I am an African-American man with tight curly hair. Will the FUE robot be able to work on curly hair? — E.O., Manhattan, N.Y.

A: Yes, the ARTAS robot for FUE can be adapted for African-American hair when performing follicular unit extraction. We use a punch that is 0.1mm wider in diameter than the instrument used for Caucasians. It allows us to incorporate the slightly larger volume of tissue that results from the curved hair and enables us to accomplish the hair transplant with less in jury to follicles than if a smaller instrument were used.

Posted by Robert M. Bernstein M.D. Updated 2017-12-11
Hair Restoration Answers

Does the ARTAS FUE Robot Work with Dark Hair?

Q: I read on your blog that the ARTAS robot doesn’t work well in patients who want FUE but have blond hair. I have dark skin and hair, does that present a problem for the machine? — J.S., London, England, U.K.

A: The ARTAS Robot performs follicular unit extraction just as well with blond hair as dark hair, but not white hair. It is simple to just to dye the white donor hair prior to the procedure. This donor hair will be clipped very short the morning of surgery removed anyway, so it will not present too much of a cosmetic issue.

Posted by Robert M. Bernstein M.D. Updated 2019-05-02
Hair Restoration Answers

Is Hair Thicker In The Summer?

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.

Posted by Robert M. Bernstein M.D. Updated 2017-12-12
Hair Restoration Answers

What Color Hair Is The Thickest Or Most Dense?

Q: What color hair is the thickest? I thought it was brown, followed by red then blonde? But I am also reading that red is the thickest but redheads have the fewest hairs. –S.F., Cook, Illionis

A: In very general terms, the darker the hair, the thicker it is and the lower the density (hairs per area). For example, Asians have the darkest hair, the highest hair diameter and the lowest density. Scandinavian blonds have very high hair density and the fine (diameter) hair. But there are many exceptions, African Americans have black hair, but it is usually very fine and of low density. I have seen red heads in all categories.

Posted by Robert M. Bernstein M.D. Updated 2019-05-02
Hair Restoration Answers

When Will I See Full Results Of Hair Transplant?

Q: I understand that seeing the result of a hair transplant is a process – what can I expect? — L.L., Highland Park, T.X.

A: It generally takes a year to see the full results of a hair transplant. Growth usually begins around 2 1/2 to 3 months and at 6-8 months the hair transplant starts to become comb-able.

Over the course of a year, the hair will gain in thickness and in length and may also change in character. During this time, hair will often become silkier, less kinky or take on a wave, depending upon the original characteristics of the patient’s hair.

In subsequent hair restoration procedures, growth can be slower.

Posted by Robert M. Bernstein M.D. Updated 2017-12-01
Hair Restoration Answers

Does a Hair Transplant Affect the Quality of Your Hair?

Q: I would be so grateful if you could give me some idea on how the quality of the hair that is transplanted is affected by its new ‘home’ and the native neighboring hair. — D.C., Flatiron, N.Y.

Is it likely all the hair that is going to be able to come back to life with Propecia will also mature fully eventually? At the moment there is a big visual difference between the front section and rest of hair. (I understand hair count per cm2 may differ more drastically- I’m thinking here just of the hair shaft thickness.) Also, when I have hair transplants – as I intend to when Propecia has done all it can – will the hairs from the back of my head (thick) stay that thick regardless or will they take on the properties of the new surrounding hair?

A: Hair that responds to Propecia doesn’t always regain the full character of the original hair, so the area may still look thin.

The transplanted hair, however, will look like the original hair and maintain, over time, the same character as the hair in the donor area (where it came from).

Posted by Robert M. Bernstein M.D. Updated 2017-12-01
Hair Restoration Answers

Do You Use Digital Imaging to Forecast Hair Transplant Results?

Q: Do you use computer type imaging to create the best way to ensure you (or any hair transplant surgeon) have the same goal or target “picture” of the particular patient’s restoration as that particular patient has as his “picture?” –F.D., Laude, Missouri

A: I prefer not to do imaging since it tends to oversell the hair restoration procedure.

In addition, the technology is unable to accurately represent what the hair transplant will really look like as there are many hair characteristics that it can’t take into account.

Seeing lots of actual photos of hair transplant patients is much more instructive – and more honest (if the photos are taken correctly). At the time of the consult I design the hairline and photograph it.

Posted by Robert M. Bernstein M.D. Updated 2017-12-12
Hair Restoration Answers

What Makes Eyebrow Transplant Different From Other Hair Transplants?

Q: I have had thinning eyebrows since my early twenties (I am now 32) and they have gotten to the point that I can’t make them look good with mascara anymore. I am considering an eyebrow hair transplant, how is it different from other hair transplants? — C.C., Williamsburg, N.Y.

A: Eyebrow hair restoration procedures are similar to hair transplants to the scalp in that the hair, once transplanted, is permanent. They differ both in the techniques used to perform them and in the results.

Posted by Robert M. Bernstein M.D. Updated 2017-12-01
Hair Restoration Answers

Can Hair Loss in Women be Caused by Pregnancy, Prozac, or Hyperactive Thyroid?

Q: I had a baby 12 weeks ago and have recently been diagnosed with a hyperactive thyroid, although only slightly. I was also taking Prozac for 7-10 days. I am 27 and have been experiencing a significant amount of hair loss from all over my scalp. What are the chances that this would be permanent?

A: Based upon your history, you have three possible reasons for having a type of hair loss called telogen effluvium; thyroid disease, medication induced (Prozac) and pregnancy.

Telogen effluvium is diagnosed by a hair pull test and observing club hairs under the microscope. It is generally a reversible condition, regardless of the cause. Telogen effluvium most often occurs 2-3 months after the inducing event, so your pregnancy is the most likely cause. Prozac would less likely be the problem since you have only been on it for a short time. Besides causing Telogen effluvium, thyroid disease can also alter your hair characteristics, which can make your hair appear thinner.

Other causes of hair loss, such as genetic female pattern hair alopecia, must be ruled out. Please see the Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website for more information.

Posted by Robert M. Bernstein M.D. Updated 2015-11-23
Hair Restoration Answers

What are Typical Hair Transplant Results?

Q: I know that I can’t get all of my hair back, but what can I realistically expect from the best hair transplants? — S.A., Santa Monica, C.A.

A: You can expect the follicular unit hair transplant procedure to be perfectly natural, that the hair restoration will be completed in one or two sessions and you should anticipate a quick and easy post-op course.

The amount of coverage and density will depend upon your Norwood (balding) class, your donor reserves and your hair characteristics.

Posted by Robert M. Bernstein M.D. Updated 2017-12-01
Hair Restoration Answers

Can You Perform Hair Transplant with Curly Hair?

Q: I have curly hair with thinning on top and strong, but less curly hair on the sides and back. My hairline is receding, but it is really the area on top I am concerned about. Does hair replacement work with curly hair and will it match? — E.B., Sanibel, F.L.

A: Yes, curly hair grows as well after a hair transplant surgery as straight hair.

After the hair restoration, the transplanted hair will take on the characteristics of the hair that was originally in the area, so it will match perfectly with respect to curl and wave.

Posted by Robert M. Bernstein M.D. Updated 2017-12-01
Hair Restoration Answers

Can Hair Loss be Caused by Thyroid Problems or Fluctuations in Hormones?

Q: One of the things that I have noticed as a person who has needed to take thyroid medication for a long, long time, is that when my thyroid gets a little bit out of balance – when I’m not getting quite enough, I begin to notice is that my hair starts falling out. What about the role of thyroid for hair loss? — T.K., Mineola, NY

A: Both increases and decreases in thyroid levels can cause hair loss and changes in the levels of thyroid hormone can change the consistency of one’s hair. Elevated hormone levels cause scalp hair to be fine and soft, with diffuse thinning being relatively characteristic.

When thyroid hormone levels are low, the hair becomes dry, coarse, and brittle. Hair loss can be either patchy or diffuse (involving the entire scalp).

Posted by Robert M. Bernstein M.D. Updated 2017-12-12
Hair Restoration Answers

What Factors Determine Hair Transplant Graft Count?

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.

Posted by Robert M. Bernstein M.D. Updated 2017-04-11
Hair Restoration Answers

Can I Have an FUE Hair Transplant Using Beard Hair?

Q: Can you use beard hair for a hair transplant using Follicular Unit Extraction? — A.C., San Francisco, CA

A: It is possible to use beard hair for a hair transplant, but there are three main differences between harvesting from the donor area and harvesting from the beard that should be taken into account. These are: 1) scarring 2) ease of extraction and 3) hair quality. Let’s explore these differences in turn.

Posted by Robert M. Bernstein M.D. Updated 2017-12-11



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