Bernstein Medical - Center for Hair Restoration - Hair Loss - Page 2
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Dr. Bernstein took part in a PRWeb podcast about hair transplantation in June 2007. Stream the discussion below or read the transcript:

Announcer: PRWebPodcast.com, visiting with newsmakers and industry experts.

Mario: This is Mario from PRWeb, and today it is a real pleasure to have with us Robert M. Bernstein, M.D. Dr. Bernstein is Associate Clinical Professor of Dermatology at Columbia University, and founder of New York City‑based Bernstein Medical – Center for Hair Restoration. Dr. Bernstein, it’s a pleasure to have you here on PRWeb.

Dr. Bernstein: Nice to be speaking with you.

Mario: Give us some understanding, sir, of your practice, the Bernstein Medical – Center for Hair Restoration. How long have you been around, where you guys are located, what is it you do there, please?

Dr. Bernstein: Bernstein Medical has evolved over the last ten years. It was set it up to do a specific procedure that I pioneered called “follicular unit hair transplantation.”

In this procedure, we dissect out hair follicles from the back of the scalp, exactly the way they grow in nature, so we are now able to perform hair transplants that essentially mimic nature.

This procedure is used by doctors around the world in hair restoration procedures. Our NY Hair Transplant Center is in midtown Manhattan and has been specifically designed for performing this hair transplantation technique.

Mario: You recently co‑authored an article, Dr. Bernstein, that appeared in the “Medical Journal of the International Society of Hair Restoration Surgery”. Now, you are well read and interviewed all over. This must be a bit exciting, something that was positive for you and your clinic. Tell us about the article, what it touched on, and some of the things that would be important for our listeners.

Dr. Bernstein: It sure was very exciting. The hair transplantation procedure has been around for many years, but a lot of it has been too much of an art and not enough of a science. What we’ve found is that doctors sometimes make these very general judgments about how bald the patient is going to become, how much hair they may need for the hair transplant or for the restoration.

We’ve found that by using a procedure called “densitometry”, where the hair is looked at under high magnification, we are able to get much more specific and useful information, both on the extent of how much someone is going to lose their hair, and also whether they are going to be a good candidate for hair restoration surgery.

One of the things that we’ve found is that when people start to thin, the hair first changes diameter before it’s lost, and this change in diameter may not necessarily be seen by the naked eye or be observed by another person.

But if you clip the hair very short and look at the base of the hair follicles under very high power, 30X magnification, you can actually see these very subtle, early changes, and these changes will anticipate future hair loss.

When we’re trying to decide whether a person should have hair transplant surgery, we can actually look at the donor area in the back and sides of the head, and see how stable these areas are. For example, someone that is becoming very bald, if the back and sides of their head show no change in the hair diameter, or no miniaturization, then we know that they may have very good hair for hair transplants; where a person with a similar degree of hair loss, whose sides and back are not stable, may not be a good hair transplantation candidate.

In a sense, by being able to measure things now, we’re able to have a much better sense of whether people are going to become very bald, possibly the rate of change of their hair loss, and then if they do need surgery, such as a hair transplant, we’re able to give much more specific information about what actually might be done.

Mario: We’re speaking to Dr. Robert M. Bernstein, M.D., an Associate Clinical Professor of Dermatology at Columbia University, and founder of New York‑based Bernstein Center for Hair Restoration.

Dr. Bernstein, give us some contact information where we can learn more about your services, and be able to end up taking advantage of them.

Dr. Bernstein: The best information can be found on our web site. The web address is www.BernsteinMedical.com.

Mario: Dr. Bernstein, it’s been a pleasure having you here on PRWeb podcasting with us. The best of luck to you, and congratulations again for that article in the “Medical Journal of the International Society of Hair Restoration Surgery.”

Dr. Bernstein: Thanks a lot, nice talking to you.

Announcer: Produced by PRWeb, the online visibility company.

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The Trustees of Columbia University have named Dr. Bernstein, hair transplant pioneer, the Clinical Professor of Dermatology. This promotion was based on Dr. Bernstein’s teaching, lectures, research, original scientific papers, and outstanding patient care.

Robert M. Bernstein, MD, FAAD, is an Attending at the New York Presbyterian Hospital and specializes in surgical hair restoration. Dr. Bernstein is the founder and director of Bernstein Medical – Center for Hair Restoration. His current research focuses on the refinement of Follicular Unit Transplantation, the revolutionary hair restoration procedure that he pioneered.

Dr. Bernstein graduated with honors from Tulane University in 1973, achieving the status of Tulane Scholar. In 1979 he received the degree of Doctor of Medicine at the University of Medicine and Dentistry of N.J. where he was given the Dr. Bleiberg Award for “Excellence in Dermatology”. Dr. Bernstein joined the staff at Columbia in 1982 as an Assistant in Clinical Dermatology, after completing his training as Resident and Chief Resident in Dermatology at the Albert Einstein College of Medicine, New York, N.Y. Dr. Bernstein was promoted to Associate Clinical Professor of Dermatology at Columbia University in 2000. Dr. Bernstein also holds an MBA from Columbia, a degree he received in 2004.

Dr. Bernstein is Board Certified in Dermatology and is a Diplomat of the American Board of Hair Restoration Surgery. He is a fellow of the American Academy of Dermatology. For his for his pioneering hair transplant techniques, Dr. Bernstein received the Platinum Follicle Award, the highest honor bestowed by the International Society of Hair Restoration Surgery.

Columbia University bestows honor upon its physicians in the form of new appointments and promotions within each department. The department of dermatology at the College of Physicians & Surgeons of Columbia University was one of the first academic units established in New York City and is a major center for basic science and clinical research. Its faculty has made numerous contributions to the development of dermatology including pioneering work in the early use of ionizing radiation, advancing the technique of photopheresis for cutaneous T-cell lymphoma and discovering the first human gene associated with hair loss.

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NY Japion - Dr. Robert M. Bernstein

NY Japion — a weekly newspaper in the Japanese language, published in the New York tri-state area, and distributed for free in the Japanese community — has featured Robert M. Bernstein, MD, in their series on hair loss in men and women. In the series, TV producer, Hideo Nakamura, who is bald himself, goes on a mission on behalf of fellow bald men. His column hopes to help others with hair loss to have a more fulfilled, fun life and to raise their self-esteem.

Nakamura interviewed Dr. Bernstein for this weekly series that began in October 2006. In issues No. 1 and 2, Dr. Bernstein explained the basic mechanism of balding for both men and women which are quite different in its causes, balding types, and progression of hair loss. The NY Japion’s readers were all very surprised by the fact that balding for men is actually related to genes on both the mother’s side as well as the father’s side of the family. Dr. Bernstein also shared his unique theory of why Japan’s Samurai had the uniformed bald look.

The column discussed post-op care after hair restoration surgery and explained the drug Propecia, a men’s oral hair growth treatment, minoxidil and some cosmetic hair products.

Reporter Nakamura was also examined by Dr. Bernstein and with the patient’s permission was allowed to observe a hair transplant surgery. Issues No. 3, 4, 5 are about the surgical hair restoration procedure known as Follicular Unit Hair Transplantation (FUT), a method that Dr. Bernstein helped to pioneer. By using the patient’s own hair, FUT can give totally natural looking results. The patient’s own hair starts growing where there was no hair before.

You can download a PDF version of the original series (in Japanese) at the link below:


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Q: I have been on Propecia for a year and my hair loss has not stopped or slowed down. How much longer should I give the drug? Can Propecia speed up hair loss in some patients? — N.V., East Hills, N.Y.

A: If you have not responded to Propecia in one year, it is unlikely that you will.

Finasteride may cause shedding in the first 6 months of treatment, but should not accelerate hair loss long-term. It is most likely that you have progression of your hair loss.

In addition, be sure that you have a correct diagnosis i.e. that you actually have androgenetic alopecia.

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Q: I am a 34 year woman with a patch of hair loss by my temple. I went to the salon to have my hair done and to my surprise my hairdresser told me that I have Alopecia? First time I’d heard of it, my G.P is not very concerned about it but having read so much about it on this site I am becoming a bit concerned. The rest of my hair is healthy any suggestions and diagnosis? — M.V., Williamsburg, Brooklyn

A: “Alopecia” is just a generic term for any kind of hair loss.

It sounds like you have a specific condition called alopecia areata. Alopecia areata is an autoimmune disease that presents with the sudden appearance of well localized bald spot(s) on the scalp or other parts of the body. The underlying skin is always normal.

The treatment is injections with cortisone. Hair transplant surgery is not indicated for this condition.

You should see a dermatologist to confirm the diagnosis and treat.

Other diagnoses to consider are triangular alopecia (which would have been present since childhood) and traction alopecia (that is cased by constant tugging on the hair).

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The International Society of Hair Restoration Surgery (ISHRS) has named Dr. Bernstein the ‘Pioneer of the Month’ in their official publication, the Hair Transplant Forum International.

Below is the article that appeared in the publication announcing Dr. Bernstein as the recipient of the honor. Dr. Bernstein is also a member of the society.

Hair Transplant Forum International
September-October 2006

Pioneer of the Month – Robert M. Bernstein, MD
by Jerry E. Cooley, MD Charlotte, North Carolina

Pioneer of the Month – Robert M. Bernstein, MDThe term “follicular unit transplantation” (FUT) has become so firmly embedded in our consciousness that we often consider it synonymous with hair transplantation in general. Surgeons new to the field may be unaware of its origin and how the concept evolved. In the 1980s, many separate clinics were developing total micrografting techniques to improve the naturalness of hair transplantation. In 1988, Dr. Bobby Limmer began developing a technique consisting of single strip harvesting with stereomicroscopic dissection of the hair follicles within the strip, which he published in 1994.

After observing histologic sections of scalp biopsies, dermatopathologist Dr. John Headington coined the term “follicular unit” in 1984 to describe the naturally occurring anatomic groupings of hair follicles. In 1995, a surgeon just entering the field of hair transplantation became aware of these natural “follicular units” and came to believe that they should be the building blocks for all hair transplants. His name was Bob Bernstein.

From 1995 to 2000, Bob and his colleague Dr. Bill Rassman articulated the rationale and benefits of FUT in dozens of publications and numerous lectures. Doubtlessly, Bob’s extraordinary effort advocating FUT in public forums during that time was critical to FUT’s rapid evolution and acceptance among surgeons.

Bob was born in New York City and raised on Long Island, New York. For college, Bob headed south to Tulane University in New Orleans. Next, he went to medical school in Newark at the University of Medicine and Dentistry of New Jersey. He then went on to a residency in dermatology at Albert Einstein College of Medicine, where he served as chief resident.

Bob performed some punch grafting procedures in residency and a few more when he started his cosmetically focused dermatology practice in 1982. Not liking the results, he didn’t perform another transplant for 12 years. In the summer of 1994, Bob saw a patient of Dr. Ron Shapiro for a dermatologic problem. Impressed with the results of the surgery, Bob began speaking with Ron about the changes in the field. Ron encouraged him to attend the next ISHRS meeting in Toronto, which he did. While there, he saw several of Dr. Rassman’s patients presented and was greatly impressed.

Soon after, he was in Bill’s office observing micrograft “megasessions.” One of the things that caught Bob’s attention was Bill’s use of the “densitometer” to quantify the patients’ hair density. Bob noticed that the hair surprisingly grew in small groups. Bill half jokingly told Bob that he should give up his dermatology practice and go into hair restoration and invited him back for a second visit. On the 5-hour plane ride to Los Angeles, Bob thought about the potential of only transplanting those small groups he saw with the densitometer, and wrote the outline of a paper entitled, “Follicular Transplantation” (published that same year). The second visit with Bill confirmed his interest in hair transplants and, in particular, developing this idea of FUT. He quickly transferred his dermatology practice to a colleague and joined Bill’s group, the New Hair Institute (NHI).

Over the next 10 years, Bob authored and coauthored over 50 papers on FUT addressing issues such as quantifying various aspects of FUs among patients, racial variations, graft sorting, as well as hairline aesthetics, corrective techniques, the use of special absorbable sutures, and FUE and its instrumentation. One of the concepts he emphasized was the recognition of Diffuse Patterned Alopecia (DPA) and Diffuse Unpatterned Alopecia (DUPA), which were originally described by Dr. O’Tar Norwood. Bob helped raise awareness that patients with DUPA and low donor density are not surgical candidates. For all of his many contributions to the field, Bob was awarded the 2001 Platinum Follicle Award.

Branching out in other directions, Bob decided to go to business school and received his MBA from Columbia University in 2004. He did this to learn how to better streamline the day-long hair transplant sessions and improve general management of his growing staff. In 2005, Bob formed his own practice, Bernstein Medical – Center for Hair Restoration. Looking to the future, Bob says, “I am excited about the accelerated rate of technical changes to the hair transplant procedure. This is due to an increasing number of really clever minds that have entered the field. Almost every aspect of the surgery is being tweaked and improved upon. It goes without saying that cloning will be the next really big thing—but I think it will take longer to develop than some are promising.” On the down side, he notes, “A concern I have is that, as hair transplant practices grow into big franchises with large marketing campaigns, many people are being directed toward surgery rather than being treated as patients with hair loss in need of an accurate diagnosis, medical treatment, emotional support, and surgery only when appropriate.”

Bob met his wife, Shizuka, who was born in Tokyo, when she was opening a dance studio in the East Village section of New York. She now owns a day spa in midtown Manhattan. Bob has three children; two are in college: Michael, 22, is studying mixed martial arts and foreign language; Taijiro, 21, is majoring in theoretical math. His daughter, Nikita, 12, is in 7th grade and plays on the basketball team. In addition to going to Nikita’s games, Bob enjoys skiing, piano, chess, basketball, philosophy, and music history.

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Q: How does a hair transplant prevent hair loss? — M.M., White Plains, N.Y.

A: It doesn’t. Surgical hair restoration does just what it says. It restores hair to an area where the hair has been lost (by borrowing it from an area of greater density that is less important cosmetically, such as the back of the scalp).

To prevent, or slow down, further balding one would need to receive treatment with hair loss medication such as finasteride (Propecia).

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Q: Why do some people have a full head of hair into their seventies or eighties and others start to go bald in their late teens or early twenties?

A: The cause is genetic and this poly-genetic trait can be inherited from the mother’s side, the father’s side, or both.

There is an old wives’ tale that it is inherited only from the mother’s parents. Although the inheritance can come from either side, it is actually greater from the mother’s side – but only slightly.

Read about Hair Loss Genetics

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Q: I heard that Proscar, the 5mg version of finasteride, is now generic. Is that correct and is Propecia going generic as well? — F.J., Red Hook, Brooklyn, NYC

A: Yes, Finasteride 5mg (Proscar) is now available in a generic formulation. It is my understanding that Finasteride 1mg (Propecia) will not be available generically until the year 2012.

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Q: I have a question about one of the products referenced under the Camouflage section of your website. As you suggested, I have begun to use DermMatch as an alternative to a hair transplant as I have diffuse thinning and been told that hair restoration is not an option right now. I have been very impressed with the results of DermMatch. However, I am concerned that the product might be damaging my existing hair or impeding future growth. Should I have any concerns about this product?

A: None of the well-known cosmetic camouflage products will damage hair or inhibit its growth.

The products come in a variety of forms, including sprays, creams, powders.

A list of these products, their descriptions, and the telephone number where you can obtain them can be found on the Cosmetic Camouflage Products page of the Bernstein Medical website.

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Q: I have read on numerous websites that Propecia and Minoxidil work synergistically, and that a hair loss sufferer will see better results using them together than either one alone. Do you believe this is the case, or do you think Propecia is enough treatment by itself for someone who just began to experience slight hair thinning and is too early for hair transplantation? — K.V., Hewlett Bay Park, New York

A: They may act synergistically since their mechanisms of action are different.

Rogaine (Minoxidil) stimulates the hair follicle directly, but Propecia (Finasteride 1 mg) permits hair growth by blocking the negative effects of DHT. Of the two, Propecia is far more effective. It is reasonable to use the two together as long as the medications are used regularly.

For patients contemplating surgical hair restoration, we generally have them continue Propecia only, since applying Minoxidil is too fussy and offers only incremental benefit.

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Q: I recently turned 22 and have been on Propecia for about 2.5 years. The amount of hair that de-miniaturized with daily 1 mg peaked about a year ago and I have seen steady thinning since. I feel that I am too young for a hair transplant. My question is whether or not an increase in dosage of Propecia is indicated here or if I should seek other options entirely? — N.W., Portland, Oregon

A: At 22 years old, I would increase the dose of Propecia before considering hair restoration surgery. However, it is important to realize that there is no scientific evidence that increasing the dose will have any additional effects. There are published data by Roberts et al in the JAAD in 1999 demonstrating that 5 mg is no better than 1 mg from controlled clinical trials.

I usually increase the dose when someone has been on the same dose of medication for about three years, although there is no good data on how exactly to increase the dose, or that it will actually make a difference.

For this purpose, I generally use finasteride in the form of Proscar 5mg every other day (or Proscar 1/2 pill every day).

If you break up the pills, be mindful of the potential risk to pregnant women from handling crushed tablets.

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The following are excerpts from a recent interview with Dr. Bernstein. The oral text was modified for readability.

Part 1

Hair Loss in the Younger Person

More Hair Loss Q&A

Interviewer: I brought a fair number of questions related to aspects of androgenetic alopecia and hair transplantation, but I will also ask you some questions regarding two other types of hair loss, like alopecia areata and cicatricial alopecia. Most of our listeners are fairly educated about the different hair restoration options available to them, so I’ll tailor my questions primarily for this type of audience.

The first question that I want to direct here is the dilemma that many young people face when they’re losing their hair and are considering getting a hair transplant. They typically don’t know the degree to which their hair loss is going to progress. When you’re in your 20s and 30s, you want to have a decently low-running hairline and you want to have a crown that looks full. But given that you don’t know how far your hair loss is going to go, how would you address this scenario for people in that age range?

Dr. Bernstein: That is the main problem with treating younger people. We don’t really know how they’re going to progress. It is so important to wait, usually until the person is 23 to 25 before you can really get a sense of how much hair loss they are going to lose. And even at that age it’s sometimes very difficult to tell. That’s even after considering things such as family history.

A problem with treating a younger person with surgical hair restoration is that they often want things that are unrealistic. A person in their 20s is what we call “backward-looking.” They’re looking to when they were a teenager and they want their flat hairline back and all their old density. But hair transplants are forward-looking. We need to consider what they’re going to be like in ten or twenty years – not how they looked in the past.

A density and a transplanted hairline that would be appropriate for someone older, is obviously not going to be satisfactory for someone that is younger, so it’s really best to wait on hair transplant surgery. Fortunately, there are some other good hair restoration treatments, such as medication, and that’s what the focus should be on in a younger person.

Interviewer: A lot of people are in that situation and are considering hair transplants. I guess the hard thing to do is convey to them your point that they really should be forward-looking instead of backwards-looking and maybe they will have to settle for a somewhat higher one than they originally thought so that it will be good on the long-term.

The Donor Area in a Hair Transplant

With regards to the donor area, it’s sort of been spread as gospel that hair from this area is completely immune to thinning and hair loss. Is this really the case? For instance, there are people in their 50s and beyond who still have relatively thick hair in that area, the donor area still appears thinner than it was when they were younger. I look at my own father, for instance, as an example. His donor area is obviously still relatively thick, but he has less hair in that area. So when you’re young, and you transplant hair from that area, can you expect some of those transplanted hairs to fall out?

Dr. Bernstein: The donor area in hair transplantation, for most people is, in fact, permanent in that the hair that is transplanted will remain. What happens, though, is that in the course of one’s lifetime, that hair will change in quality. So the hair actually thins out over time. It’s not miniaturization in the sense that hair that’s being lost to genetic hair loss is miniaturized, but there’s a change that we call “senile alopecia” where the hair changes in diameter. It is more of a uniform change than we see in typical androgenetic change and so over time the donor area and, therefore, the transplanted area as well, will appear thinner.

That said, it’s still important to identify the fact that some patients will actually lose a significant amount of hair in the donor area. We call those people DUPA or diffuse unpatterned hair loss. What that means is that the androgenetic related process that is occurring on the front and top of the scalp is also affecting the back and the sides. It is really important to identify those patients because those with DUPA are not candidates for hair transplantation, since the hair transplants are only as good as the hair in the donor area. If the hair in the back and sides thins or falls out over time, so will the transplanted hair.

DUPA or diffuse unpatterned hair loss can be identified by Densitometry. Essentially what that is, is clipping a little bit of hair from the donor area and seeing if there are changes in hair shaft diameter at a young age. If the miniaturization (decrease in hair diameter) exceeds about thirty percent, it’s very suggestive of this type of hair loss. It’s also much easier to pick up this condition when someone is a little older, which is another argument for not performing a hair transplant on someone who is too young.

Interviewer: So how long does it take to determine if someone will have extensive hair loss and possibly not be a good candidate for a hair transplant. I mean, when you first take the initial sample, how long do you have to wait before you check again to see if it actually happens?

Dr. Bernstein: Generally, the first thing that a young person will notice is decreased hair volume. They will complain “I feel like I have less hair” or “when I go to the barber, he says I’m thinning,” or “when I run my fingers or comb through my hair, it seems like its thinner”. At this point, it is usually easily confirmable on densitometry. We can find increased miniaturization in the donor area. And this can sometimes occur as early as 14 or 15 years old. So it really can occur very early and, unfortunately, those patients are usually going to become very bald – usually at a young age.

The good thing is that if you have very thin hair all over, it often doesn’t look as bad as having dense hair on the back and sides with a bald top. So even though people with diffuse unpatterned hair loss can lose lots of hair, they actually don’t do so badly since their hair is uniformly thin. And they sometimes respond well to medications, such as Propecia. Although this is not a permanent cure, it may at least get them through the critical years of their teens and early 20s.

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The Secrets to Hiding Celebrities' Hair Loss - The Bergen RecordIn a recent article “The Secrets to Hiding Celebrities’ Hair Loss,” published in the New Jersey newspaper, The Bergen Record, author Abigail Leichman pondered the variety of techniques used by celebrities to battle hair loss. Articles such as these put a spotlight on the fairly recent phenomenon of celebrity hairline watching that has sprouted up in the media and on the web.

Chat rooms are filled with speculation about the seeming rise and fall (and sometimes rise again) of follicles for such stars as Matt Lauer, Mel Gibson and Jude Law. And for sports figures like Tiger Woods and Pete Sampras.

Ms. Leichman comments that such stars as Johnny Depp, Owen Wilson, and Matt Damon must increasingly depend upon their stylists to avoid bad hair days.

In her article, Ms. Leichman names Follicular Unit Transplantation “a hair-transplant procedure pioneered by a Fort Lee physician” as one of the secrets to Hollywood’s ability to reverse the effects of thinning hair. The article features Dr. Bernstein as a surgeon who’s list of patients “more than 5,000 male and female patients – he can’t name names – has included major players in theater, politics and high finance.”

With recent trends showing that more and more men are becoming comfortable with the idea of electing to receive cosmetic surgery and with the leap in successful results using new techniques mastered by doctors such as Robert M. Bernstein MD, men and women are looking to the rich and famous to help them decide where to go for procedures such as surgical hair restoration.

Bernstein Medical is meticulous about protecting the privacy of all of our patients. At Bernstein Medical every patient is treated with the same attention and care that the movers and shakers in Washington, Hollywood and Broadway receive.

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Follicular Unit Forum - Bernstein Medical - Center for Hair RestorationFollicular Unit Forum is unique in that it affords visitors an opportunity to anonymously ask questions about the “ins and outs” of hair transplant surgery, of those who actually have had the state-of-the-art Follicular Unit Hair Transplant procedures.

Questions are posted to people who have actually undergone hair restoration procedures. Individuals who are considering a surgical solution to their hereditary baldness are able to search through “threads” or conversations that will answer their most pressing concerns such as; what to expect before, during and after a hair transplant, and what kind of procedure one should have.

The focus of this new online health resource is Follicular Unit Transplantation and Follicular Unit Extraction, two procedures that are universally considered to be the most up-to-date approach to surgical hair restoration. Follicular Unit Transplantation is a surgical technique that transplants hair in naturally occurring groups of 1-4 hairs. These groups (called follicular units) are taken from a single donor strip of skin and dissected using a microscope. Follicular Unit Extraction is a method that obtains the tiny follicular unit grafts from the donor area by using an instrument which removes them one-by-one directly from the scalp.

Patients who have received hair transplants with undesirable results (such as the typical pluggy “dolls hair” look) can also benefit from monitoring the site. FollicularUnitForum.com has posts from patients who have had unnatural looking grafts removed and re-implanted in a more natural way – as follicular units – to produce the most best results.

“We wanted to create a consumer-to-consumer forum that exclusively addressed the topic of Follicular Unit Hair Transplantation – the procedure that is now considered to be the gold standard in surgical hair restoration” said Robert M. Bernstein M.D., founder of Bernstein Medical – Center for Hair Restoration and sponsor of the site. “There are some great forums for hair loss out there but we felt that there was room for one that was created specifically for people who had done their preliminary research but now wanted to hear more first hand experience with FUT or FUE”.

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Dr. Bernstein — and a Bernstein Medical – Center for Hair Restoration hair transplant patient — were featured on NBC television’s “Today” program with Matt Lauer. The segment, which mostly covered hair transplant repair procedures and hair restoration, was one of a three-part series on hair loss.

Visit NBCNews.com for breaking news, world news, and news about the economy

Read below for a portion of the transcript:

What men will do for a few more strands of hair

Recent changes in transplant surgery have led to more natural-looking results and a boost of self confidence for some balding men

Hair transplants are one of the top five cosmetic procedures for men in the U.S., with more than 19,000 performed last year, according to the American Society for Aesthetic Plastic Surgery. But is it worth it? As part of a three-part series on hair loss, “Today” spoke with two men who underwent the procedure.

Allen Appleblatt has made a big change in his life. He works out, spends time with family and stays busy with work. And when it comes to his appearance, he’s feeling good about his new head of hair.

“I kind of felt like I was an idiot looking at myself in the mirror,” said Appleblatt. “Whenever I took a shower, at the end of the shower I found a clump of hair at the bottom of the drain. And there was no way of stopping it.”

So Appleblatt had two hair transplants. His partner, Shirley Garofano, likes what she sees.

“I liked him both ways. But I like him better now. He looks great, he’s very positive, he’s happier,” she said.

Happier, but he still wants thicker hair. “Today” followed him while he underwent his third hair transplant, taking advantage of the latest techniques.

“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, an associate clinical professor of dermatology at New York’s Columbia University.

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.

“So follicular unit transplantation is a transplantation of hair in its naturally occurring groups,” said Bernstein. “We’re really just transplanting the root.”

Appleblatt is given valium and local anesthesia, and then a donor strip is removed from the back of the head where hair is not genetically programmed to fall out.

“We have a team of people dissecting the grafts. They divide it into individual follicular units,” said Bernstein.

The units are then transplanted into the balding area. And 10 to 12 months later, the new hair will be in place.

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Robert M. Bernstein M.D. was asked to provide expert medical commentary in two hair transplant videos produced by Healthology. The topics included “Hair Transplantation Techniques” and “Using Cloning Techniques in Hair Transplantation”.

Healthology, the leading producer of broadcast and webcast programming that provides consumers with direct access to top medical experts, produced an important series of videos on hair loss. As Associate Clinical Professor of Dermatology, Columbia University College of Physicians and Surgeons, Dr. Bernstein was a vital part of the interview series.

Hair Transplantation Techniques

The first video that Dr. Bernstein was invited to take part in, focused on the various techniques used in surgical hair restoration. As a pioneer of Follicular Unit Transplantation, the filmmakers were eager to hear Dr. Bernstein’s thoughts on FUT:

“A major breakthrough in hair restoration came via identification that hair didn’t grow individually, but actually in small groups called follicular units. And these follicular units are naturally occurring groups of hair from one to four” Dr. Bernstein explained, “in modern hair transplantation, a procedure we call Follicular Unit Transplantation is used; we transplant the hair the way it actually grows in nature.”

This Healthology segment explored how the Follicular Unit Transplantation technique is also helping patients who want to improve the appearance of old transplants or scars.

“What we can do now is remove the old grafts, sew the holes closed where they’re transplanted, place those grafts under a microscope, divide them into individual follicular units and then place them back in the scalp the same day.” said Dr. Bernstein.

In addition to covering surgical hair restoration, the segment touched on the issue of medications for hair loss. Though some patients think getting a hair transplant means they can stop taking hair loss medications, Dr Bernstein illustrated why most physicians recommend using medicine along with surgery:

“Hair transplantation and medications do essentially different things. The main benefit of a transplant is to restore hair that’s been lost. The main benefit of medication is to prevent further hair loss.”

Using Cloning Techniques in Hair Transplantation

In this second Healthology video segment, on hair cloning, they invited Dr. Bernstein to take part in the discussion along with other distinguished guests; including Angela Christiano, PhD an Associate Professor of Dermatology and Genetics & Development at Columbia University.

This interesting segment explored how researchers are trying to find ways to make more follicles for hair transplant surgeons to work with. Research into cloning techniques shows it may be possible to create a virtually limitless supply of new follicles in the not too distant future. Dr. Bernstein provided some insights as to how hair restoration doctors might approach hair cloning in the future:

“The actual role of cloning in hair transplantation will depend upon how the cloning technology actually evolves. Initially, cloning may be used to supplement a regular hair transplant. We would use Follicular Unit Transplantation to give definition to a hairline and frame the face. Cloning would then be used to give the hair transplant bulk, by placing the cloned hair (which may not look as natural as normal hair) behind the transplanted hair.”

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The highly-rated CBS television program “The Early Show” interviewed Dr. Bernstein as part of a three-part series on hair loss in women. View a clip of the video here:

Watch the video at YouTube or go to the Bernstein Medical YouTube Channel to see more videos on hair loss in women and other hair restoration topics.

Read the full transcript here:

Julie Chen: There are many treatments available for serious hair loss including surgical options like hair transplants. That may sound scary, but for one woman, it was the answer she’d been waiting for.

Narrator: Marian Malloy is used to being in control. As the duty manager for an international terminal at Newark Airport, it’s her job. But Marian wasn’t always so self-confident. Due to a condition called alopecia areata, Marian began losing her hair back in college.

Marian Malloy: I was on my own for the very first time and I was learning about life and learning about my hair loss. And it just devastated me. So I started out picking out methods to improve my hairline. Initially, I went to a dermatologists who put me on a prescription of injections, actually. I would go over weekly and he injected my head, and I got results, but I also started growing facial hair, which wasn’t something that I wanted. After that, I decided to start with the Rogaine and once again I saw results, but Rogaine was something that I had to do every day for the rest of my life, and I just didn’t want to be that dependent on a medication.

Narrator: Marian continued to search for an acceptable treatment to her condition, even trying hair plugs, until she heard about Dr. Robert Bernstein’s new method of Follicular Unit Transplantation, or in layman’s terms, a hair transplant.

Marian Malloy: I wasn’t scared at all. I was desperate, so that overrode everything.

Julie Chen: Marian Malloy is here along with her hair transplant surgeon, Dr. Robert Bernstein, to help us look at some of the medical options that are available to women suffering from this affliction.

Good morning to both of you.

Dr. Bernstein: Good morning.

Marian Malloy: Good morning.

Julie Chen: Marian, thank you for speaking out about this very private problem. How has your life changed since getting the hair transplant?

Marian Malloy: Well, I just feel better about my appearance, and appearance is very important to me in my line of work. I just feel a lot better and I think I look better. My hairline looks better.

Julie Chen: Boost in the self-confidence department?

Marian Malloy: Actually, yes.

Julie Chen: And your friends and family see a difference in it?

Marian Malloy: You know, my friends and family really didn’t notice a difference before, and they thought I was crazy for harping on it the way that I did.

Julie Chen: But if you see it, that’s all that —

Marian Malloy: And it was all about me. It’s not about my family and friends. It’s about how I feel.

Julie Chen: Right.

Marian Malloy: Yes.

Julie Chen: Dr. Bernstein, I want to go through all the options that are available for women, but what is the difference between female and male hair loss option-wise. What can we do to treat it?

Dr. Bernstein: The main difference medically is that women have hair loss often from hormonal changes and it’s due to an imbalance between progesterones and estrogens. That equilibrium can be reestablished with medication. Often birth control pills can do that.

Julie Chen: So that’s one option.

Dr. Bernstein: One option. For the most common cause of hair loss, genetic hair loss, Minoxidil can be used for both men and women, but the most effective medication for men, Propecia, can’t be used in women. And the reason –

Julie Chen: Why not?

Dr. Bernstein: The reason is that it causes birth defects if taken during pregnancy and postmenopausally it doesn’t seem to work.

Julie Chen: Oh, okay. So talk to me about Minoxidil, also known as Rogaine .Just as successful for women as in men?

Dr. Bernstein: It seems to be similarly successful, but the success rate is not very good, and one of the problems with its use in women is that you can get hair at the hairline on the forehead. So the usefulness is a little bit limited.

Julie Chen: So is it promoting hair growth if it does work, the Rogaine, or is it just making your existing hair grow in thicker? I’ve heard both.

Dr. Bernstein: It actually stimulates the growth of existing hair.

Julie Chen: Okay so you got to be really careful topically what you touch after you’re rubbing it into your scalp.

Dr. Bernstein: Yes.

Julie Chen: Another option is topical Cortisone and Cortisone injection.

Dr. Bernstein: Yes many people think that Cortisone can be used for genetic hair loss or common hair loss and it really can’t. It’s a good treatment for specific types of diseases, the most common one is alopecia areata. In that condition, the body actually fights off its own hair follicles. And then the Cortisone is used to suppress the immune system and actually allows the body to permit the hair to grow back.

Julie Chen: Now, Marian tried these options that we’re talking about. You weren’t satisfied, so you had a hair transplant.

Marian Malloy: Yes.

Julie Chen: Describe exactly what you did for Marian.

Dr. Bernstein: In the past, hair transplantation was not a good option for women because hair was transplanted in little clumps. With Follicular Unit Transplantation, we can now transplant hair exactly the way it grows, which is in little tiny bundles of one to four hairs. With Marian we took a strip from the back of her head, in other words, right from the back of the scalp where you can’t see it.

Julie Chen: Where there’s more hair?

Dr. Bernstein: Yes, we remove that strip and place it under a microscope and dissect out the individual follicular units – the hair is transplanted exactly the way it grows in nature. And that hair is then put in needle-poke incisions all along the hairline, and because the grafts are so small, you can actually mimic the swirls and the change in hair direction exactly the way the hair grows naturally.

Julie Chen: And it stays?

Dr. Bernstein: Yes, it stays. We make a very snug fit between the graft and the needle-poke incision. And so it really holds on to the grafts well. In fact, the patients can shower the next morning.

Julie Chen: The next morning? Marian, what was your experience like having this hair transplant? No problems since?

Marian Malloy: No problems, absolutely no problems.

Julie Chen: Did insurance cover any of this?

Marian Malloy: No, absolutely not.

Julie Chen: How costly is this?

Dr. Bernstein: The average procedure is about $7,000.

Julie Chen: And it’s one procedure and you’re done?

Dr. Bernstein: Usually one to two procedures.

Julie Chen: $7,000 a pop. Well, you found it was worth your money, is that right, Marian?

Marian Malloy: Absolutely, yes.

Julie Chen: Dr. Bernstein, Marian Malloy, thank you both for coming on the show talking about this.

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The Discovery Channel interviews Dr. Bernstein for a piece on hair transplant repair. View the segment, which includes footage of Dr. Bernstein speaking about hair transplant surgery and performing a procedure, below:

Read the full transcript of the segment:

These days, more and more men who want to compete in the marketplace are seeking cosmetic surgery because they see it as giving them a competitive advantage.

With over 35 million American men affected by hair loss, it’s not surprising that hair restoration ranks high on the list of most popular procedures, generating two billion dollars in revenue each year.

Forty two year-old New York composer Ken Gold started losing his hair 20 years ago.

Ken Gold: In your 20s, you know, everyone is more image-conscious and you don’t want to lose your hair in your 20s.

Ken is not alone. 20% of men in their 20s experience hair loss. In their 30s, the odds jump to 30%, and by the time a man is in his 50s, there is a 50% chance he will be losing some hair.

Ken Gold: Once you’ve lost your hair, you look older. And you don’t want to be 22 and look 35, you know?

Determined to stay youthful, Ken investigated his options and decided to undergo a series of hair transplant procedures beginning in 1981.

Ken Gold: One of the guys I was doing business with, he had a very thick full head of hair. And he said, “Well, I’ve got a hair transplant,” and I was just astonished.

But after five years and four painful, expensive procedures, Ken still didn’t have the full head of hair he wanted.

Ken Gold: My head was a mess. You only had to lift up the hair in the back and you could see what they call the Swiss cheese scalp, just this huge massive scar tissue with little round holes, you know.

Dr. Bernstein: When hair transplants were first started, they thought in order to get enough fullness, you had to move the hair in large clumps, and that’s traditionally known as plugs. And much of our practice is still devoted to hair transplant repair.

Ken despaired of ever finding the solution to his problem until he found the New Hair Institute in Fort Lee, New Jersey.

Dr. Bernstein: When I first saw Ken in 1995. He still had the traditional plugs, and I would say on a scale of one to ten, he was maybe a seven, with ten being the worst. We performed a procedure called follicular unit transplantation where hair is transplanted in exactly the way it grows in nature, which are little tiny groups of one to four hairs.

Ken Gold: After the first surgery I was just ecstatic because I was actually able to look at myself in the mirror.

Almost 20 years and $40,000 later, Ken has finally achieved the natural-looking hair he wanted. But there are alternatives to hair transplant surgery.

Dr. Bernstein: Probably the best thing to do if you’re noticing hair loss is to have a diagnosis of male pattern hair loss to make sure there is not some other treatable condition, and then to use a medication, such as Propecia, which actually can prevent hair loss if it is taken early enough.

But Ken Gold is convinced he’s found the right solution for him.

Ken Gold: I’m very happy now. I wasn’t happy five years ago. When I look in the mirror now, I see someone with hair and I’m able to comb it back and say, yeah, this looks okay.

Watch more videos on hair transplantation and hair transplant repair in our Hair Transplant Videos section

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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 entitled, “Follicular Transplants Mimic Natural Hair Growth Patterns,” describes Dr. Bernstein’s introduction of his new procedure, Follicular Unit Transplantation, to the academy as well as the keys to making the technique successful. Find the complete article below:

Form Follows Function: Follicular Transplants Mimic Natural Hair Growth Patterns

By Neil Osterweil
Contributing Editor

SAN FRANCISCO – In recent years, many hair replacement surgeons have adopted the modem architecture philosophy that “less is more,” moving from the use of hair plugs, to split grafts, to minigrafts and, finally, micrografts. But at least one hair transplant specialist contends that a more appropriate architectural dictum is “form follows function.”

In other words, the surgeon should let the technique fit the head, and not the other way around, suggested Robert M. Bernstein, MD, at the 55th annual meeting of the American Academy of Dermatology.

Dr. Bernstein is an assistant clinical professor of dermatology at the College of Physicians and Surgeons, Columbia University in New York. He described his “follicular transplantation” technique in a meeting presentation and in an interview with COSMETIC SURGERY TIMES.

Natural Hair Groups Used

Dr. Robert M. Bernstein“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.

The typical follicular unit consists of one to four terminal hairs, one or two vellus hairs, sebaceous glands, subcutaneous fat and a band of collagen which circumscribes and defines the unit. In the follicular transplant technique, the follicular unit is carefully dissected and removed, and then the intervening skin is discarded. This enables the donor site to be small, allowing implantation through a small needle poke. Because trauma to the recipient sites is minimal, the entire procedure can be performed at one time. Dr. Bernstein and colleagues have implanted as many as 3,900 follicular units in a single, 1 day session.

Keys to the follicular transplant technique are:

Identify the patient’s natural hair groupings and isolate the individual follicular units – Hair groupings are assessed with an instrument called a densitometer, and the average size of a person’s groups can be easily calculated. This information is critical in the planning of the transplant. The density of hairs in an individual measured as the number of hairs per square millimeter of skin is quite variable, but the density of follicular units is relatively constant within individual races.

Most people of Caucasian ancestry have a density of approximately one group per millimeter; people of Asian and African descent tend to have slightly less dense growth patterns, although the characteristics of the person’s hair (such as wavy or wiry hair), can give a full appearance even with low density.

If a patient has an average hair density of two, he will receive mostly two hair implants, with some one-hair and three hair implants mixed in. “If you try to make the groups larger than they occur naturally, they will look pluggy. If you try to make them smaller than they naturally occur, they’re not going to grow as well, because each group is actually a little biologic machine that makes the hair — it’s an anatomic unit. If you break it up it just doesn’t grow as well,” Dr. Bernstein observed.

Form Follows Function: Follicular Transplants Mimic Natural Hair Growth Patterns
A 38-year old man with a Norwood Class 5A/6 hair loss pattern undergoes a single procedure of 2,500 follicular implants. The result 11 months later. (Photos courtesy of Robert M. Bernstein, MD)

Harvest meticulously – The acquisition and preparation of grafts must be carefully performed to ensure success for this demanding technique. Highly trained, skilled assistants are essential to the success of the procedure. Dr. Bernstein noted that he uses a highly trained team of up to 10 assistants to produce the implants for a single case. “The assistants, who range from medical technicians to registered nurses, are such an integral part of the procedure that they must become expert in their specific tasks for the surgery to be successful.” The physician must be able to skillfully harvest the donor strip and must be able to make accurate judgments about the size of grafts intra-operatively and adjust the technique accordingly. Dissection and placing of the follicular units is the most labor intensive part of the procedure.

Design the recipient area well – The recipient sites are carefully distributed so that a natural looking pattern is maintained throughout the recipient area. An important consideration for this stage of the procedure is to “frame the face and spare the crown” so those facial features are kept in correct proportion. A common mistake in hair replacement, said Dr. Bernstein, is to create a hairline that is too high thereby elongating the forehead and accentuating, rather than minimizing, the patient’s baldness. It is also important to avoid or eliminate contrast between the implants and surrounding skin by creating a soft transition zone of single hairs and to have the hair emerge from the scalp at natural angles.

Procedure Lowers Cost

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.

“In the very near future, the procedure will be improved and made more affordable with automated instruments that will enable the surgeon to make sites and implant the hair in a single motion. This will also decrease the possibility of injury to the implants by reducing handling and keeping the grafts uniformly cool and moist. It is possible that someday hair follicles may be cloned to provide a virtually unlimited supply of custom follicular units, but until then the finite nature of a person’s donor supply must be respected,” concluded the doctor.

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