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Bernstein Medical In The News

“I Hated My Hairline, So I Got a New One”

A female hair transplant patient recounts her experience at Bernstein Medical.

Hair Transplant Racked Article by Bernstein Medical Patient

Like many women, Alden Wicker felt self-conscious about her naturally high hairline and burdened with the high-maintenance of trying to keep her bangs perfectly positioned to cover her forehead. Alden discovered an article on Dr. Robert M. Bernstein, founder of Bernstein Medical – Center for Hair Restoration and pioneer of Follicular Unit Transplantation, and decided to see if he could fix her hairline. In an article she contributed to Racked, an online magazine published by Vox Media, Ms. Wicker describes her experience with Bernstein Medical and how thrilled she is will the results of her hair transplant.

Since the age of 13, Alden wanted full, voluminous hair and a lower hairline. After 16 years of covering her forehead with bangs, she started researching how to fix her naturally high hairline. In the course of her research, she stumbled on a 2009 article in the New York Times that featured Dr. Bernstein’s work in treating women with receding hairlines. She decided to come to his NY office for a consultation.

After Dr. Bernstein explained that she was a good candidate for a hair transplant, Alden scheduled her procedure for a cold Friday in January. Alden describes the entire procedure, including how Dr. Bernstein removed the strip and made sure the aesthetic plan was followed to a “T”.

She speaks about her post-op recovery and positive lifestyle changes that resulted from her procedure:

“By Tuesday, I was easily able to cover my forehead with my bangs and use BB cream to cover the yellowish cast to my forehead, the last remnants of the swelling and bruising.”

“When I went in for a trim before Memorial Day weekend and showed my hairdresser the new hairline, he was thrilled and started plotting with me to grow out my bangs.”

Alden even recollects how the transformation affected her self-esteem on a very important day, her wedding day. She says, “My new hairline had grown in enough to let my hairdresser pull the new hair back on the sides into a loose half-up style.”

Her bottom line:

“I bought myself aesthetic freedom, a carefree attitude, more minutes in my day that I could focus on living instead of ironing my hair and cringing at photos. And in that sense, it was totally worth it. My only regret is that I didn’t do this earlier.”

The article is titled, “I Hated My Hairline, So I Got a New One.”

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Hair Restoration Research

Innovation and Quality in Hair Restoration Surgery

Robert M. Bernstein, MD, New York, NY, rbernstein@bernsteinmedical.com

The past 25 years have produced incredible advances in hair transplantation and these advances seem to be accelerating. The 1,200+ members of the ISHRS, many of whom are active in meetings, workshops, and publishing, are surely the driving force of this change. The Forum’s ability to distribute information quickly to its membership has been a great enabler in this regard. The inspiration for the recent advances seems to be a response to the challenges presented by follicular unit extraction (FUE), which now makes up over half of all hair transplants performed worldwide and whose popularity—mostly patient-driven—continues to rise.

The challenge of FUE is the fragility of the harvested grafts (compared to those that are microscopically dissected from a strip). The cause of the increased fragility can be divided into two, somewhat interrelated, categories. The first is intrinsic to the FUE process itself and the second is more technically dependent.

The first issue is that current FUE procedures separate the follicular units from the surrounding connective tissue on the sides, but not at the base. Therefore, when the follicular units are removed from the scalp, either by forceps or by suction, the bulbs of the grafts are often left exposed (the pant-leg phenomena). This can be mitigated with improved dissection techniques, but not entirely avoided, and the ability to manually free up (dissect) the base of the unit becomes more problematic with the trend towards smaller FUE grafts.

A solution for the first problem has been to protect the delicate FUE grafts better once they are outside of the body. Improved holding solutions have helped in this area. The main insight has come from the knowledge that the practice of chilling grafts in saline or lactated Ringer’s to slow their metabolism also shuts down the cell’s ATP pumps. This allows Na+ to freely flow into the cell risking injury from intracellular edema. The use of holding solutions containing macromolecules, which keep water out, and the addition of ATP to provide energy directly to the cells, can potentially increase the survival of these more fragile grafts.

Another way to protect these follicular units is with the use of mechanical implanters. Although first introduced several decades ago, the demand for FUE has created a revival in this technology. A recent study has attested to their effectiveness in protecting FUE grafts. Fortunately for patients, improved holding solutions and the use of implanters can benefit those having both FUE and FUT procedures.

The second problem in FUE is the reliance on the visual cues provided by the exiting hair and/or the “feel” of the tissue to estimate the position of the underlying follicles. These hairs not only curve and splay outward in the deep dermis and subcuticular space, but they also follow a different overall direction than the hair on the surface of the skin. The lack of visibility and the difficulty for the cutting tools to account for the variable path of follicles under the skin make transection a significant issue.

There have been a multitude of FUE devices created to solve the risk of transection. The development of the sharp/ blunt technique that became the basis of the S.A.F.E. System (and which was later incorporated into the ARTAS Robot) was a particularly creative way to overcome the problem. The Trumpet Punch, with its splayed distal end and oscillat- ing motion, was another clever technique designed to miti- gate transection. Some form of dermal illumination or other means of subcuticular “visualization” would, of course, be helpful as well.

With 1,200+ pairs of eyes now focused on these issues, progress in our field is sure to accelerate even more. Perhaps the technologies will eventually coalesce around a single solution that will solve the complex problems of hair restoration surgery or multiple techniques will remain. We look forward to reading the Forum over the next 25 years to find out!

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Would A Hair Transplant In Turkey Be Performed Just By Technicians?

Q: I was thinking of having an FUE hair transplant procedure done in Turkey, but I am concerned that it will be done with just technicians. Any thoughts? — E.E. ~ Mount Vernon, N.Y.

A: I do not have first-hand information on the clinics in Turkey, but there is a recent “Letter to the Editor” in Hair Transplant Forum International, the official publication of the “International Society of Hair Restoration Surgery” that you might find informative. From the article:

“In Turkey, there are 300 FUE clinics in Istanbul alone but, unfortunately, at only 20 of them are operations are done by doctors. We do not exactly know how many of those 300 clinics have legal permissions, but we know very well that an average of 500-1,000 FUE operations are done per day.”

If you would like to read the entire article, the reference is: A Report from Turkey – the situation in a top FUE destination. Hair Transplant Forum International July/August 2017 p 162.

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Bernstein Medical In The News

FUE Hair Transplant Most Likely Responsible for LeBron James’ New Hairline

After years of jokes about his continually receding hairline, LeBron James, basketball superstar and winner of two NBA championships and four NBA Most Valuable Player Awards, stunned the sports world on September 16th, 2014 when he revealed a newly restored hairline while promoting his new LeBron 12 shoe at Nike World Headquarters.

FUE Hair Transplant Most Likely Responsible for LeBron James’ New Hairline

Folks are now asking – where, when and how did LeBron get that great new hairline?

While no one knows for sure (and LeBron, so far, hasn’t said a word), Katie Nolan, the host of FoxSports.com’s No Filter, rejects the idea that LeBron’s new life in Cleveland is less stressful than it was in Miami and that’s what allowed his hairline to return. Instead, she strongly suspects that it is the result of an advanced surgical hair restoration technique called Follicular Unit Extraction, or FUE, which produces hair transplant outcomes that look completely natural.

She also suspects the use of low-level laser therapy (LLLT) which new research has shown to be an effective treatment for male and female pattern hair loss.

Katie Nolan breaks it all down for you in her No Filter segment below, “LeBron James unveils his new hair (and some shoes).”

Read about FUE Hair Transplants

View Before & After Photos of some of our hair transplant patients

Visit Bernstein Medical for a one-on-one hair loss consultation with one of our board certified physicians

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

‘America’s Top Doctors’ Book Includes Dr. Bernstein

America's Top Doctors - Castle ConnollyThe 12th edition of Castle Connolly’s America’s Top Doctors includes Dr. Bernstein for his work in hair transplant surgery and hair restoration. The list of doctors represents just the top 1% of medical specialists in America.

America’s Top Doctors is a national guide that identifies more than 6,800 of the top medical specialists in the United States. The physicians are listed within 63 medical specialties and subspecialties for the care and treatment of more than 1,600 diseases and medical conditions. Doctors are organized geographically within each specialty/subspecialty.

To develop the list of the best doctors in America, the publication surveyed over 230,000 medical specialists, department chairs, residency program directors, vice presidents of medical affairs and presidents of the nation’s leading medical centers and specialty hospitals. Any nominated physician then was subjected to a review process that included, among other factors, scrutiny of medical education, training, hospital appointments, administrative posts, professional achievements, and malpractice and disciplinary history.

Dr. Bernstein has been included in New York Magazine’s “Best Doctors” issue and Castle Connolly’s America’s Top Doctors for the past 12 consecutive years.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Discusses Robotic FUE In American Health & Beauty Article

Dr. Bernstein is quoted extensively in an article on robotic hair transplantation in the online magazine American Health & Beauty.

ARTAS Robotic FUE Imaging System
ARTAS Robotic FUE Imaging System
Click for larger version

In “ARTAS: A Faster and More Accurate Hair Transplant Using Robotics?” Dr. Bernstein explains the benefits of robotic FUE over traditional FUE hair transplant procedures. He describes how the new robotic device overcomes some important limitations of FUE when performed manually. To better understand the role of the new instrument, Dr. Bernstein simplifies the FUE procedure into four basic steps and discusses where the image-guided robotic system fits into this process.

Dr. Bernstein explains how the new technology enables the robotic device to preserve follicular units and minimize damage to grafts though its image-guided system.

“ARTAS allows us to do the FUE procedure with much less damage to the graft which means much healthier grafts. Grafted follicles extracted by ARTAS are not cut, which has been a problem with FUE, but the grafted follicular units are actually chunkier with more protective tissue around them, resulting in a better graft survival with the robotic FUE vs. doing FUE manually,” says Dr. Bernstein.

Follicular Unit Grafts Removed by ARTAS Robotic System

Follicular Unit Grafts Removed by
ARTAS Robotic System
Click for larger version

In addition to extracting grafts that have a higher chance of surviving the extraction and transplantation process, the article discusses the increased speed and accuracy of the automated procedure, as well as the safety mechanisms built into the robotic unit.

Always with an eye towards the future of hair transplantation, Dr. Bernstein predicts what he sees as an inevitable rise in the use of robotics in the field:

“I imagine that within a relatively short time, everybody will be offering the robot-assisted device when considering FUE procedures, because it’s just a better way of doing it: more accurate, quicker extraction and healthier grafts.”

The ARTAS System, developed by the California-based Restoration Robotics, Inc., will be available for FUE hair transplant procedures at Bernstein Medical – Center for Hair Restoration in November 2011.

Read the full version of the article.

You can read much more about the ARTAS System for FUE or Robotic FUE hair transplantation.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

What is the Latest in Hair Transplant Robotics?

Q: I have read your page on robotics in hair restoration and am interested in learning more. Are there any updates in the development of the system you mentioned? — W.T., London, UK

A: Restoration Robotics, Inc. — based in Mountain View, CA — has spent the last few years developing and testing a robotic hair transplant device for follicular unit extraction (FUE). The ARTAS™ robot system has recently received 510(k) approval from the Food and Drug Administration, meaning that the company may now begin marketing the system for use in hair restoration clinics.

The FDA classifies the device as a “computer assisted hair harvesting system” and describes it as being used to identify and extract follicular units and to help the surgeon do the same during hair transplantation.

The ARTAS™ robot consists of a computer assisted station with needle mechanism, force sensor, robotic arm, and video imaging system. The software that runs the instrument helps the surgeon target follicular units for extraction and also uses stereoscopic video images to guide the needle mechanism and robotic arm.

We will update you as more information becomes available about the ARTAS™ system and Restoration Robotics.

See a photo of the ARTAS robot and stay on top of developments by visiting our Robotic Hair Transplantation page

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Interviewed on Hair Loss by Spanish-language TV Channel Telemundo

Dr. Bernstein Interviewed on Telemundo 47

Telemundo47 — a Spanish-language media outlet based in New York City — interviewed Dr. Bernstein for a segment on hair loss and how hair treatments and styles can lead to long-term damage.

Here is the lead in Spanish:

Consejos para los tratamientos del pelo

Los tratamientos para el cabello la pueden dejar muy bella, pero pueden traer consecuencias a largo plazo y podrían ser desastrozas.

Now, in English:

Advice for the treatment of hair

Treatments for hair can leave it very beautiful, but they can bring consequences for a long period of time and can be disastrous.

Dr. Bernstein discusses how strong chemical treatments for hair can lead to hair damage and hair loss (pérdida del cabello). He also speaks to the issue of traction alopecia (alopecia por tracción) and how you can prevent hair loss by choosing to style your hair so that it is not tightly pulled back.

You can watch the complete video segment on the Telemundo website. [Update: the video is no longer available.]

Dr. Bernstein’s expertise in hair restoration (restauración del cabello) is appreciated around the world and by people who speak a wide variety of languages. Indeed, patients have come from all around the world to seek his advice and treatment for their hair loss.

Visit our Spanish language page on hair transplantation, Cirugía de Trasplante Capilar

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

How Will Hair Transplant Look If Donor Area Hair Is Dark And Recipient Area Hair Is Gray?

Q: If a person is graying on the top and sides and you do a hair transplant from the back, will the top look darker after the hair restoration? — W.C., Houston, TX

A: The hair is taken from the back and sides of the scalp and the follicular units, once dissected from the donor strip, are randomly inserted into the recipient area. That way, the color of the harvested hair will be mixed and will match perfectly.

Usually, people’s hair is lighter on the top because of the sun, so when you move the hair from the back and sides to the top, it will actually lighten to match the surrounding hair, if it didn’t match already.

For further reading on how your hair performs after a transplant, visit the Growth After Hair Transplant topic.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

How Are Follicular Unit Grafts Distributed in a Hair Transplant?

Q: How are grafts distributed in a hair transplant? Are they distributed evenly? — B.V., Jersey City, NJ

A: Actually, we don’t make the transplanted hair evenly distributed. It is usually front weighted, so that the hair restoration will look most full when looking at the person head on.

Framing the face is the most important part of the restoration. Covering the top is the next most important region and, if the patient has enough donor supply, then hair can be added to the crown.

For a more detailed discussion of this topic, view our page on recipient sites in a follicular unit hair transplant. Also, read the publication written by Dr. Bernstein in 1997 which became the industry benchmark for aesthetics in hair transplant surgery, “Aesthetics of Follicular Transplantation.”

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Tom Brady Balding Report On CBS News Features Dr. Bernstein

The Early Show - CBS NewsCBS News’ The Early Show has picked up the “balding buzz” that first started to grow when the National Enquirer reported that New England Patriots star quarterback Tom Brady is seeking advice on how to treat his hair loss.

Like the New York Daily News did recently, CBS turned to Dr. Bernstein for his expert medical opinion on Brady’s hair loss.

The Early Show website features the story. Here is a snippet:

Dr. Robert M. Bernstein, clinical professor of Dermatology at Columbia University, told CBS News, “It looks like Tom Brady is starting to comb his hair forward and he has some recession in his temples, so those are kinds of signs that he starting to lose his hair.”

And if Tom Brady is in fact “folically challenged,” he has plenty of company. By middle age, “Early Show” co-anchor Erica Hill reported, about 50 percent of men experience hair loss. And there are plenty of receding hair lines in Hollywood to comb through for advice. John Travolta is rumored to wear a hair piece, while Bruce Willis and tennis great Andre Agassi fully embrace their losses with clean-shaven heads. But for younger guys, like Prince William – only 28 and thinning – a bald head might not be the best bet.

Brady’s hair loss likely stems from androgenetic alopecia, or genetically inherited male pattern baldness.

If you are also “folically challenged,” then you are in good company. Check out some before and after hair transplant photos of patients at Bernstein Medical – Center for Hair Restoration or before and after hair restoration photos of our patients who are treating their hair loss exclusively with Propecia and/or Rogaine hair loss medications.

Read the report on The Early Show website.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Bernstein Boosts Buzz On Balding Brady

New England Patriots quarterback Tom Brady has a multimillion dollar contract, a supermodel wife, and not one, not two, but three Super Bowl rings.

He also has androgenetic alopecia, otherwise known as genetically inherited male pattern baldness, and future prospects of being a balding celebrity. Or does he?

An article in the New York Daily News reports that Mr. Brady has consulted with a hair transplant physician about his hair loss. The Daily News interviewed both Dr. Bernstein and a patient at Bernstein Medical – Center for Hair Restoration for the article. Here is a snippet:

“Look at me – I look awesome now,” said Bob, buttressing his claims with before-and-after pictures that show a full head of hair where once it grew only in patches.

Dr. Robert Bernstein restored Bob’s hair. The doc’s customers swear only their hairdressers know for sure they had it done.

Asked how Brady might fare, Bernstein said that judging by recent photos, it appears “he has good growth” and enough [donor] hair for a successful transplant.

When asked about why his results stand up to close scrutiny, Dr. Bernstein said:

“Hair grows in natural groupings of one to four hairs […] By following the way hair grows in nature, we can produce natural results.”

Read more about Hair Loss Genetics or some additional articles in Hair Loss Genetics News.

Read the full article at the Daily News.

Photo c/o: NY Daily News/Townson/AP

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Should I Start Propecia Before Hair Loss Consultation?

Q: I am a 34 year old male and my dermatologist prescribed Propecia for me today. Most of my hair loss is at the hairline, but there is some loss on top as well. It’s not bad, I just want to stay ahead of it. If I get a transplant I want to get it at your clinic, but I will give the Propecia a try first. I am going to be overseas for a couple of months starting this Sunday and I was wondering about the necessity or desirability of having someone measure my hair density prior to starting the Propecia. Would you advise waiting to start the Propecia until I come back in two months and having my density examined at your clinic? — M.R., Great Falls, Virginia

A: I would start Propecia as soon as possible. What is important for a hair transplant is the density in the donor area and this is not affected by Propecia (or minoxidil). Your donor density can be measured anytime at an evaluation prior to surgery. If you want to wait to see the effects of Propecia prior to the hair transplant, you really should wait a year; since growth, if any, can take this long. If you just want to have Propecia on board for the hair restoration procedure, or to make sure you don’t have side effects, then generally a month will do. If you would like to do a photo consult through our website to get some preliminary information about how many grafts you might need, you can do that at your leisure, but start Propecia now since the longer you wait the less effective it will be at regrowing hair.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

What Length Is Hair After Transplant?

Q: Is transplanted hair the same length as existing hair? — G.E., Buckinghamshire, UK

A: The hair is first clipped to about 1-mm before it is transplanted. The transplanted hair will look like stubble for the first few weeks after the hair restoration procedure. It is then shed and the newly transplanted follicles go into a resting phase for about two months.

At about 10 weeks after the hair transplant, the follicles will gradually start to produce new hair. They start out as fine hair and then gradually increase in thickness and in length. The process takes about 6 months, with full growth about one year after the hair restoration procedure.

For a more detailed overview of what to watch for in the days, weeks, and months after a hair transplant, view our After Hair Transplant Surgery page.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

What Is Best Way To Remove Hair Plugs: FUE, Electrolysis, Or Graft Excision?

Q: I had a hair transplant in 2004 of mostly plugs. The plugs are in an angle which doesn’t really look natural, far from it. I have lost a lot more hair since I did the hair restoration procedure. I regret ever doing a hair transplant. I prefer to reverse the surgery. I have read a lot about repair work on the net, and I have come to the conclusion that using FUE to take the plugs out, and put them back into the scar might be an option, but it may just make it worse on top. Also I can do electrolysis to remove the plugs, might be better because the possibility of scarring is smaller, and as I already have a lot.

A: If you had plugs, then a graft excision with suturing will generally give a better result than FUE, since a graft excision removes the underling scar tissue as well as the plug. FUE only removes the follicles, but leaves the underlying scar tissue. In addition, the shape of the follicles in scar tissue is often distorted, making extraction difficult and leading to more transaction (damage to follicles).

Electrolysis is very difficult in a scarred scalp and also would not remove scar tissue. Laser hair removal with a diode or Alexandrite laser is generally a better option than electrolysis (it is also faster and less expensive), but like electrolysis and FUE, they do nothing to improve the appearance of underlying scar issue.

For more information on this topic, see our pages on Graft Excision in Hair Transplant Repair and Follicular Unit Extraction (FUE).

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

NYC Hair Transplant Surgeon Named “Best Doctor” in New York Magazine for 11th Consecutive Year

Dr. Robert M. Bernstein, founder of Bernstein Medical – Center for Hair Restoration, was selected by Castle Connolly as one of the New York metropolitan area’s top physicians through a peer-review survey of medical professionals.

Best Doctors 2010 - NY MagazineNew York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the hair transplant techniques, Follicular Unit Transplantation and Follicular Unit Extraction, and founder of Bernstein Medical – Center for Hair Restoration in Manhattan, has been included in New York Magazine’s “Best Doctors” issue for the eleventh consecutive year.

Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York, said he was honored to be chosen by his peers for the magazine’s special annual issue. He said, “It is a privilege to be involved in the care of treating patients struggling with hair loss and an honor to be recognized by my peers for contributions that I have made to the rapidly evolving field of surgical hair restoration.”

Dr. Bernstein has performed hair transplant surgery at his state-of-the-art Center for Hair Restoration in New York City since 1995. The practice is solely devoted to the diagnosis and treatment of hair loss in men and women and specializes in both restorative and corrective hair transplants.

The list of physicians in the Best Doctors issue is based on an annual peer-review survey conducted by Castle Connolly Medical Ltd., a research company that publishes Top Doctors: New York Metro Area. Each year, Castle Connolly distributes 12,000 nomination forms to medical professionals in New York metropolitan area. These medical industry peers are asked to nominate their choice of best doctors in a particular field and to take into account not only professional qualifications and reputation, but also skill in diagnosing and treating patients.

Dr. Bernstein has appeared on such notable programs and channels as The Oprah Winfrey Show, The Dr. Oz Show, The Howard Stern Show, The Today Show, Good Morning America, ABC News, Fox News, Discovery Channel, and National Public Radio. He also appeared in New York Magazine’s special issue Best Beauty Docs in New York, where he was included for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction. He is co-author of Hair Loss & Replacement for Dummies: The Patient’s Guide to Hair Restoration, and numerous medical publications.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Can Scabs Harm Hair Transplant Two Weeks After Procedure?

Q: I had a hair transplant about a month ago and I had scabs and some dead skin until day 16 or 17. Will that endanger the growth of the hair restoration procedure? — S.P., Hoboken, N.J.

A: No, it will not. If follicular units were used for the hair transplant, the grafts should be permanent at 10 days. After this time, you can scrub as much as you need to get the scabs off.

Read more about caring for your hair transplant after your surgery.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

‘America’s Top Doctors’ Guide Includes Dr. Bernstein In Top 1% Of American Doctors

America's Top Doctors - Castle ConnollyThe American consumer’s best source for finding top medical specialists — Castle Connolly’s America’s Top Doctors — recently published its 8th Edition. Dr. Bernstein is included for his work in hair restoration and hair transplants.

The publication lists doctors who are not just top practitioners of medicine; but physicians, like Dr. Bernstein, who have continued to develop extensive expertise and knowledge in their specialty of choice. The list of doctors represents just the top 1% of medical specialists in America.

Since 2000, Castle Connolly’s physician-led team of researchers has developed and maintained a database of physicians from a wide variety of disciplines; updating the database based on doctors referred from other physicians, surveys of physicians, interviews with physicians, and extensive background checks of physicians’ disciplinary and license histories.

In addition to being considered a top doctor by being listed in Castle Connolly’s guide to medical specialists, Dr. Bernstein has been included in New York Magazine’s “Best Doctors” issue for each of the past 10 years. The doctors in the magazine’s special annual issue are selected from Castle Connolly’s America’s Top Doctors.

Posted by Robert M. Bernstein M.D.
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.
Hair Restoration Answers

Dr. Bernstein Answers Hair Restoration Questions From Bizymoms.com Readers

Bizymoms.com, the premier work-at-home community on the Internet with more than 5 million visitors per year, has interviewed Dr. Robert M. Bernstein in order to answer readers’ common questions about hair restoration and hair loss.

Below is a sample of the interview:

Q: Who would be a good candidate for hair transplant surgery?

In general, men and women age 30 and older can be candidates, but there are a host of factors that determine if a person is a good candidate…

Q: How does hair transplantation work?

Hair removed from the permanent zone in the back and sides of the scalp continues to grow when transplanted to the balding area in the front or top of one’s head…

Q: What can be done for people dissatisfied with previous mini/micrograft procedures?

If the grafts are too large they can be removed, divided into smaller units under a microscope, and re-implanted back into the scalp (the same day)…

Q: What are the possible harmful effects of Propecia and Rogaine?

The main side effect of Propecia (finasteride 1%) is sexual dysfunction, which occurs in about 2-4% of men taking the drug. Fortunately, these side effects are completely reversible when the medication is stopped. […] The main side effect of Rogaine (minoxidil) is scalp irritation. […] Both Propecia and Minoxidil can produce some hair shedding at the beginning of treatment, but this means that the medications are working…

Q: How many grafts/hairs are needed for hair transplant surgery?

An eyebrow restoration can require as few as 200 grafts, a hairline 800 and a scalp, with significant hair loss, 2,500 or more grafts. An equally important consideration is the donor supply…

Q: What are the advanced hair transplant techniques?

Follicular Unit Transplantation (FUT), where hair is transplanted exclusively in naturally occurring follicular units, is the state-of-the art. […] A more recent means of obtaining the donor hair, the follicular units are extracted individually from the back of the scalp. This procedure, called Follicular Unit Extraction (FUE) eliminates the need for a line-scar, but is a less efficient procedure for obtaining grafts…

Q: What are the new hair restoration treatments available for men and women?

Low-Level Laser Therapy (LLLT) utilizes cool lasers to stimulate hair growth and reduce shedding of hair. […] Latisse (Bimatoprost) is an FDA approved topical medication for eyelash growth.

Go to Bizymoms.com to read the full interview.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Eyebrow Transplant And Restoration Article Seeks Dr. Bernstein’s Advice On Aesthetics

Eyebrow transplant and restoration article - New York TimesEyebrow transplant procedures are growing in popularity. More women are realizing how much damage they can cause to their appearance by overplucking, shaping, and over-styling their eyebrows. Today, the New York Times reports on the trend of repairing eyebrows with hair transplant techniques and the use of camouflage products to cover up eyebrows that have been “tamed into oblivion.”

As the article’s headline declares, it is time to call in the professionals. The author of the article, Ms. Catherine St. Louis, turns to hair transplant pioneer Dr. Robert M. Bernstein for guidelines on performing a cosmetically-pleasing eyebrow transplant.

Here is a portion of the article:

Chronic repeated plucking is now a common reason why women have eyebrow transplants, which entail using hair from the scalp, arms or pubic area. A more timeless reason that spans the sexes is the gradual thinning, especially on the outer parts, as we age.

AND the number of such transplants is growing. In 2008, 3,484 eyebrow transplants were performed nationwide, up from 2,544 in 2004, the International Society of Hair Restoration Surgery says.

Dr. Robert M. Bernstein, a hair restoration specialist in Manhattan, said that the most natural-looking transplants for eyebrows followed a few rules. Hair has to lie flat; single-hair transplants, not units of multiple hairs, are used; hairs should follow a curve and be planted to account for changes in direction. (In general, Dr. Bernstein said, the upper hairs point down and lower ones face up slightly to create an interlocking ridge that gives brows their body.)

Visit our eyebrow transplant page for more information on eyebrow transplant and restoration procedures.

See another article by Ms. St. Louis on the topic of hair restoration and hair loss in women.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Celebrity Hair Transplant Procedures An Increasingly Hot Topic

by J. F. Fotrell

Celebrities – especially the men – are getting comfortable with the idea of surgical hair restoration and we are seeing more famous men embracing the concept every day. The truth is that the majority of men will eventually lose hair, so this is nothing to be embarrassed about. But most men don’t have to depend on their appearance to pay their mortgage bill, or to ensure that their career continues. Celebrities find themselves in a unique position in this respect, especially when the world is watching them grow up or grow old.

Celebrity Hair Transplants - Kevin Costner

Celebrity hair loss is becoming an increasingly hot topic in the media. The continuing demands on celebrities to keep their good looks, seems to be of great interest to the tabloids. This is evidenced by the recent interest in the hairlines of stars like John Cleese, Mel Gibson, John Travolta, Kevin Costner, Dennis Miller, Tom Arnold, Johnny Depp, Jude Law, David Beckham and many others.

For example, a Google search for “Mel Gibson hair loss” has almost 50,000 entries. This attests to the amount of attention the media – and the public – are paying to celebrity hair restoration.

Many celebrities don’t mind their hair loss when it comes to their own personal life, but they realize that appearance is paramount in the entertainment industry. Celebs worry that their looks are important to the fans, and they seem to be right.

Celebrity Hair Transplants - Mel Gibson

Chat rooms and fan sites are abuzz with the hair lines of the stars, not to mention the TV, magazines and newspapers which seem to always know when to get a picture at the right (or the wrong) time.

Often celebrities have hair transplant surgery only to satisfy the demands of their careers. Soap Opera stars for instance, need those wonderfully youthful hairlines, something that would not be in such demand with the general aging public. The hair transplant design required by someone in this profession, however, might not be appropriate for the average person.

Celebrity Hair Transplants - John Travolta

As a result, actors sometimes need to make some compromises on long-term results in order to achieve short-term career goals.

In order to create the illusion that time has simply stood still for people in the public eye, secrecy is paramount. Cosmetic surgeons for the stars are very meticulous about maintaining privacy, and understanding the special needs of their celebrity patients.

“Though the public tends to perceive celebrities as temperamental and demanding, I have not found that to be the case. Celebrities recognize the importance of cosmetic surgery to their careers and are very pragmatic about having it done – for most it simply goes with their job.” says Robert M. Bernstein M.D., Clinical Professor of Dermatology at Columbia University in New York and founder of Bernstein Medical – Center for Hair Restoration in Manhattan.

Interest in celebrity hair transplants is not just reserved for film and TV stars, but for all kinds of professions in the public eye. Sports celebrities like Tom Brady, politicians, fashion designers, musicians, and now even top business executives recognize the importance of hair to their image.

Celebrity Hair Transplants - David Beckham

Busy celebrities often have their PR people or handlers try to discover what their treatment options may be, but often the proper research is not done. After all, PR people are influenced by the media just like the rest of us. The far better route is the more time consuming one, where academic credentials and hospital affiliations are checked and medical publications are reviewed. Without this level of research, the search for a hair transplant surgeon can lead to some pretty bad results.

According to Dr. Robert Bernstein of the Bernstein Medical – Center for Hair Restoration in Manhattan, “Most Celebrities aren’t as concerned with how the process is done; they simply want it to be taken care of. One high profile patient of ours, however, was so curious about the process, that he actually left the surgical chair during his procedure so that he could watch how the graft dissection was done.”

In this very competitive society, youth and beauty are highly coveted bargaining chips.

Celebrity Hair Transplants - Matt Lauer

One without the other can seem to be a considerable handicap. However, in the world of the rich and famous, where ones livelihood depends on physical image the stakes are even higher.

Fortunately, with modern medical breakthroughs, the image that is conveyed by a full, healthy head of hair is something that can be achieved, even by people who are not so genetically fortunate.

View before & after hair transplant photos of our patients

Read about hair transplant procedures

Read about medical hair restoration

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Can You Have a Hair Transplant to the Crown Before the Front or Top of Scalp?

Q: Can the crown be transplanted first instead of frontal area? Why is the crown the last choice? Any reasons behind it? — H.H., Ladue, M.I.

A: The crown can be transplanted first in patients who have very good donor reserves (i.e., high density and good scalp laxity). Otherwise, after a hair restoration procedure to the crown you may not be left with enough hair to complete the front and top if those areas were to bald.

Cosmetically, the front and top are much more important to restore than the back. A careful examination by a trained hair restoration surgeon can tell how much donor hair there is available for a hair transplant.

For more information on this topic, see my publication on surgical planning of hair transplants, “Follicular Transplantation: Patient Evaluation and Surgical Planning.”

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

After an FUE Hair Transplant at the Hairline, Will Bumps Go Away?

Q: I have had a hair transplant done in the hairline of 1,000 or so FUE grafts. However, as the hair sheds, under natural light the recipient skin seems bumpy with incisions and holes that are noticeable. Do these tend to go away with time once they have healed? — S.S., Glencoe, I.L.

A: If a follicular unit transplant is performed properly (using either extraction or a strip) there should be no bumps or surface irregularities. When the hair restoration is totally healed, the recipient area should be appear as normal looking skin.

With FUE it is important to sort out the grafts under a microscope, to make sure that all of the grafts placed at the hairline are 1-hair grafts and that the larger grafts are place behind the hairline. They should not be planted without first being sorted under a microscope.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein in New York Magazine ‘Best Doctors’ Issue for 10th Year

New York Magazine - Best Doctors 2009 - Dr. BernsteinDr. Bernstein has been selected to be in the New York Magazine‘s “Best Doctors” issue for 2009.

His selection as one of New York’s best doctors for 2009 marks the tenth year in a row that he has been included in the list of prominent physicians.

The annual issue of New York Magazine presents the findings of Castle Connolly Medical Ltd. — publishers of the guidebook, Top Doctors: New York Metro Area.

Dr. Bernstein is the only hair restoration surgeon to be honored for ten consecutive years.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Talks About Hair Loss in Women with New York Times

New York Times - Hair TransplantThe New York Times interviewed Dr. Bernstein for a full-length article on hair loss and hair transplant options for women interested in hair restoration. The article – titled, “Tricks and Transplants for Women’s Hair Loss” – covered modern hair transplantation techniques, hair transplant costs, camouflage techniques, and more.

Read below for some excerpts of the article:

Exploring Your Options:

Hairstylists, impressed with how realistic the “new” transplanted hair looks, recommend doctors to clients who are tired of hiding their hair loss with layers or high- and lowlights. “I’ve seen bad jobs,” said Seiji Kitazato, the creative director at Frédéric Fekkai on Fifth Avenue, who refers clients to a few surgeons. “But now you can’t even tell.”

Still, not every woman of the millions who suffer from hair loss is a candidate. Underlying conditions, including anemia and thyroid problems, that are temporary, treatable or affect the scalp rather than the hair, must be dealt with before a transplant can be considered. If a transplant is ruled out, sufferers must rely on wigs, hairpieces or styling tricks.

What’s more, “most medications can cause hair loss, some more frequently than others,” said Dr. Robert M. Bernstein, a clinical professor of dermatology at Columbia University who has a restoration center in Manhattan.

A transplant is an option only for a woman who has a thick enough area of hair from the back and sides to “donate” to a more paltry part of her scalp. But many women don’t experience this kind of localized balding; instead their entire head of hair thins out during menopause or as they age.

Buyer Beware:

So the incentive to treat any and all comers is high. “It’s a big problem,” Dr. Bernstein said. “You shouldn’t go to someone who will give a transplant to anyone who walks in the door.” If your condition is not properly assessed, you could permanently shed more hair after surgery than you gained, he warned, or if the hair transplanted wasn’t stable, “it would disappear.”

Before Hair Transplant Surgery:

If you’re suffering hair loss, see a dermatologist first, not hair transplant surgeons, said Dr. Robert M. Bernstein, a dermatologist in Manhattan who specializes in hair restoration. After determining a cause, dermatologists can offer advice about options from the medical to the surgical. Many women with hair loss try Women’s Rogaine, a solution with 2 percent minoxidil that is applied to the scalp, twice daily. Others prefer Rogaine’s foam for men, because it has 5 percent minodixil, dries quickly and feels less greasy. (But even the women’s formulation warns to discontinue use if facial-hair growth occurs.)

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

ABC News Hair Transplant Video Diary Features Dr. Bernstein’s Patient

Patient JAZ before and after hair transplant photo

Bernstein Medical patient before (left) and after (right) hair transplant

We all know that hair loss is common among both men and women, and that hair transplant and hair restoration procedures are becoming more and more popular around the world. But what thoughts go through the head of your average hair loss sufferer before, during, and after a hair transplant?

The answer to that question may now be revealed. ABC News correspondent Cari Nierenberg and associate producer Ryan Stevenson take us directly into the mind and life of Bernstein Medical patient Adam Khoudja in a diary and feature on hair loss and hair restoration.

View each article at ABCNews.com:

You can also see the patient’s full before/after photoset in our Hair Transplant Photos gallery

Learn more about the hair transplant procedure and visit our own hair transplant photo journal.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Podcast Transcript: Hair Loss & Replacement for Dummies

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

Interviewer: I am here today with Dr. Robert M. Bernstein, Clinical Professor of Dermatology at Columbia University and founder of Bernstein Medical – Center for Hair Restoration in New York. Dr. Bernstein is the co-author of the highly anticipated Hair Loss & Replacement for Dummies book. Welcome, Dr. Bernstein.

Dr. Bernstein: Good morning, thank you for having me.

Interviewer: Dr. Bernstein, why don’t you tell us a little bit about the book?

Dr. Bernstein: Sure. We wrote Hair Loss & Replacement for Dummies for anyone who wants to learn more about hair loss and its treatment. In the book, Dr. Rassman and I not only discuss common balding, but we cover a host of other conditions that can all lead to the loss of one’s hair. In the book, we give readers a basic understanding of hair and offer tips for taking better care of both the hair and scalp. Most importantly, the book describes the most up-to-date treatments for both male and female pattern hair loss.

Interviewer: This sounds interesting, why did you and Dr. Rassman decide to write the book?

Dr. Bernstein: Well, hair loss affects so many men and women. There is lots of information available on the web, but much of it is unreliable and the medical literature is often a bit too technical for the average reader. We wanted to provide a resource that was factual and comprehensive but, at the same time, very easy to understand. Hopefully, this book will allow those experiencing hair loss to be able to get straightforward, honest information and be able to make informed decisions if they require treatment.

Interviewer: That is a very good idea. I understand that you are a key figure in the development of the modern hair transplant procedure called Follicular Unit Hair Transplantation. Why don’t you tell us about it?

Dr. Bernstein: The Follicular Unit Hair Transplantation procedure I pioneered is based on the fact that human hairs do not grow singly, but rather in tiny bundles of one to four hairs that we call follicular units. While evaluating patients for surgery using an instrument called a densitometer developed by Dr. Rassman, we were able to visualize these naturally occurring groups. It just made sense to me to perform the entire transplant using these tiny follicular bundles, as this would allow us to actually mimic nature. It also would enable us to safely transplant thousands of grafts in a single procedure and to complete the entire restoration in just one or two treatment sessions. Unlike the older hair restoration procedures, follicular unit transplantation is quite exacting and a large part of it is performed using special stereo-microscopes designed specifically for this new technique.

Interviewer: In your book, you mention the importance of checking a person’s hair density when considering a hair transplant. Why is this important?

Dr. Bernstein: For hair restoration surgery to be successful, the person must have an adequate supply of permanent donor hair. This can be determined by evaluating the hair on the back and sides of a person’s scalp under magnification to see if the areas are stable. The fact that more men have stable donor hair than women, explains why a higher percentage of men experiencing hair loss are good candidates for hair transplantation. Fortunately, those women with stable donor areas do make excellent candidates for surgery.

Interviewer: In the book, you discuss the ten common myths of hair loss. Can you tell us about one of them?

Dr. Bernstein: One of the most frequent concerns I hear from patients is that wearing hats all the time causes hair loss. This is based on their belief that hats cut off the air supply to the scalp and actually prevent the scalp from breathing. What they are overlooking, of course, is that hair follicles lie deep in the skin and get their oxygen from the bloodstream, so you can’t suffocate your follicles just by wearing a baseball cap.

Interviewer: Very interesting. I also understand that the Hair Loss for Dummies book will not be your first publication. Where can our listeners find other material that you have authored?

Dr. Bernstein: If you go to BernsteinMedical.com you will find the links to all of my medical publications. Like our new book, the site has a lot of useful information about hair loss written in layman’s terms.

Interviewer: Your new contribution to the Dummies Series sounds really helpful for those who want to do something about their hair loss – or just to learn more. Where can they purchase the book?

Dr. Bernstein: You can find it at any bookseller, on Amazon, or through our web site, bernsteinmedical.com.

Interviewer: It was good to have you on the program.

Dr. Bernstein: Thank you.

Announcer: Produced by PRWeb, the online visibility company.

For further reading see the Hair Loss & Replacement for Dummies summary, the original press release, or purchase the book at Amazon.com.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Drs. Bernstein, Rassman, Schweiger Release ‘Hair Loss & Replacement For Dummies’

Hair Loss & Replacement for DummiesJohn Wiley & Sons – creators of the hugely-popular For Dummies series of books – published on December 3 the definitive book on hair restoration: Hair Loss & Replacement For Dummies, written by internationally-respected hair transplant pioneers Dr. William R. Rassman and Dr. Robert M. Bernstein with Dr. Eric Schweiger.

Hair Loss & Replacement for Dummies is filled with important information for men and women of virtually all ages anxious to preserve their full head of hair, put the brakes on balding, or explore the safest and most reliable hair replacement techniques currently available. The book offers readers not only the full gamut of modern-day hair-care options but crucial tips on how to avoid unscrupulous hair transplant doctors and potentially harmful products as well.

Topics include:

  • Getting To Know Your Hair – What Causes Hair Loss; The Devastation Of Hair Loss In Women; Undergoing Hair Restoration Surgery
  • Splitting Hairs – How Hair Grows; Aging Hair; Hair & Ethnicity, Maintaining Self-Esteem in the Face of Hair Loss;
  • Taking Better Care Of Your Hair – Washing & Drying Your Hair Correctly; Avoiding Hair Damage; Caring For Childrens’ Hair
  • Understanding The How & Why Of Hair Loss – Stress & Hair Loss; Environmental Issues; Male Pattern Thinning In Men and Women; Diseases & Disorders That Cause Hair Loss
  • Creative Techniques For Concealing Hair Loss – A Brief History of “Rugs”; Today’s Toupees
  • Taking Prescription Medications For Hair Loss – Being Aware of Side Effects
  • Supplementing Your Diet To Help Slow Hair Loss – Pumping Up Proteins; Minding Your Mineral Intake
  • Hair Transplant Surgery – Do You Really Need A Hair Transplant; Psychological Considerations; Choosing A Doctor; Possible Complications; Heading Home With A New Head Of Hair!

For further reading see the transcript of an interview with Dr. Bernstein about the book, the original press release, or purchase the book at Amazon.com.

Posted by Robert M. Bernstein M.D.
Hair Restoration Research

Strategies for Follicular Cell Implantation

by Jeff Teumer, PhD
Hair Transplant International Forum, Volume 18, Number 3, May/June 2008

Follicular cell implantation (FCI) is based on the ability of the dermal papilla (DP) cells, found at the bottom of hair follicles, to stimulate new hairs to form. DP cells can be grown and multiplied in a culture so that a very small number of cells can produce enough follicles to cover an entire bald scalp.

In order to produce new follicles, two types of cells must be present. The first is Keratinocytes, the major cell type in the hair follicle, and the second are dermal papillae cells (DP) which lie in the upper part of the dermis, just below the hair follicle. It appears that the DP cells can induce the overlying keratinocytes to form hair follicles. There are a number of proposed techniques for hair regeneration that use combinations of cells that are implanted in the skin. The two major techniques involve either transplanting dermal papillae cells by themselves into the skin or implanting them with keratinocytes. These techniques can be used with or without an associated matrix used to help orient the newly forming follicles.

Implanting Dermal Papillae Cells Alone

  1. Implanting DP cells by themselves into the dermis, with the hope that they will cause the overlying skin cells (keratinocytes) to be transformed from normal skin cells into hair follicles. This method is called “follicular neo-genesis” since new hair is formed where none previously existed.
  2. Cells of the dermal papillae are placed alongside miniaturized follicles. The transplanted cells would induce the keratinocytes of the miniaturized follicles to grow into a terminal hair. A potential advantage of this technique is that the existing miniaturized follicles already have the proper structure and orientation to produce a natural look growth.

Implanting Dermal Papillae with Keratinocytes

  1. A mixed suspension of cultured keratinocytes and DP cells are implanted into the skin.
  2. Keratinocytes and DP cells are cultured together such that full or partial hair formation takes place in a culture dish. These culture-grown hairs, or “proto-hairs,” are then implanted into the patient. The advantage of using a proto-hair is that there would be better control over the direction of hair growth because of the structural orientation of the proto-hair.

Cell Implantation using a Matrix

  1. A variation of the above techniques is to use a matrix to help orient the implanted cells. This could be either an artificial matrix composed of materials such Dacron or it could be a biological matrix composed of collagen or other tissue components. The matrix would act like a scaffold to help cells organize to form a follicle. If the matrix were filamentous (like a hair) it could help direct the growth of the growing follicle. A matrix could be used with dermal papillae cells alone or in combination with cultured keratinocytes.

With all of the varied approaches for FCI, the aim is to combine keratinocytes and DP cells to efficiently and reproducibly generate thousands of follicles for hair restoration. In some cases, cells are combined in vivo and all of the hair formation must take place in the body after implantation, while in others, some hair formation takes place in culture before implantation.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein One of NY Magazine’s ‘Best Doctors’ for Eighth Consecutive Year

New York Magazine - Best Doctors 2007 - Dr. BernsteinRobert M. Bernstein, MD has been selected as one of New York Magazine’s “Best Doctors” for the eighth year in a row.

The annual issue of New York Magazine, published on June 11, 2007, presents the findings of Castle Connolly Medical Ltd. — publishers of the guidebook, Top Doctors: New York Metro Area.

Dr. Bernstein is the only hair restoration surgeon honored to be included in this list of prominent physicians for eight consecutive years.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Discusses Hair Transplantation and Densitometry in PRWeb Podcast

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.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Columbia University Names Dr. Bernstein Clinical Professor of Dermatology

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.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Hair Restoration Series in NY Japion Features Dr. Bernstein

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:


Posted by Robert M. Bernstein M.D.
Hair Restoration Research

New Methodology and Instrumentation for Follicular Unit Extraction

In this paper, Dr. James Harris presents a blunt tip instrument to be used in a 3-step FUE hair transplant procedure. The instrument is described as a 1-mm dissecting punch that has a tapered blunt edge. After scoring the skin with a sharp punch, the dissecting punch is advanced to a depth of approximately 4-mm.

This instrument is similar to the one recently described by Bernstein and Rassman in New Instrumentation for Three-Step Follicular Unit Extraction, recently published in Hair Transplant forum International New Instrumentation. Dr. Bernstein’s instrument was, in turn, based upon ideas presented in a paper written by Dr. Harris in 2004.

Although Follicular Unit Extraction (FUE) has potential advantages, such as faster surgical recovery, less postoperative discomfort, less noticeable scarring, and possible expansion of the hair transplant patient’s donor area, the acceptance of the technique is limited because it is technically demanding, has limited patient candidacy, and can potentially result in high rates of follicle transection. There are also problems of buried grafts, the inability to transplant large sessions at one time and inefficient use of the mid-portion of the donor area. The proposed methodology and instrumentation may allow more widespread use of the technique.

In the current study, using the SAFE System for surgical hair restoration, the average follicle transection rate was 6.14%, with a range of 1.7 to 15%. The only adverse reaction was the occurrence of two buried grafts, resulting in inflammatory subcutaneous cysts requiring excision.

Dr. Harris calls the procedure using this instrument, the SAFE (Surgically Advanced Follicular Extraction) System. Interestingly, in an editorial commentary by Dr. Walter Unger that follows this article, Dr. Unger suggests that the SAFE system should be more appropriately called the “SAFER technique,” since it is better than traditional 2-step FUE, but it has not eliminated the issue of follicular transection or some of the other problems of follicular extraction.

Harris JA. New Methodology and Instrumentation for Follicular Unit Extraction: Lower Follicle Transection Rates and Expanded Patient Candidacy. Dermatol Surg 2006; 32: 56-62

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Can I Treat Hair Loss Using Rogaine and Propecia Together?

Q Do Rogaine and Propecia work synergistically? — N.W., Chappaqua, N.Y.

A: They are synergistic, since the mechanisms of action are different.

Rogaine directly stimulates hair growth, while Propecia is permissive for hair growth by blocking DHT, the byproduct of testosterone that causes hair to miniaturize and eventually disappear.

The important thing to remember, however, is that for most people, Propecia is far more effective.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

What is the History of Hair Transplant Procedures?

Q: Dr. Bernstein, I remember Senator William Proxmire. He was one of the first sort of high-profile people who had a hair transplant probably, what, thirty years ago, and to be honest with you, it wasn’t all that great. It looked kind of funny. Have we made any progress in the last twenty-five, thirty years? — A.E., Fort Lee, N.J.

A: When hair transplant surgery was first developed in the late 1950s, early 1960s, everybody was so ecstatic that it grew – that one could actually move hair from the back of the head to the top, and it would grow – that no one really considered either the long-term implications or the aesthetic aspects of the procedure. And the fact that the hair grew is actually a problem because it never went away when it was transplanted poorly.

Over the years the grafts have gotten smaller and smaller. So where in the ’60s and ’70s they were the size of pencil erasers, they gradually decreased in size until doctors were performing hair transplants using just a few hairs at a time. The major breakthrough came in the mid 1990s when we realized that hair doesn’t grow individually but grows in little tiny groups and these groups are called follicular units.

In modern hair transplant surgery (which began in 1995) hair is taken from the back of the scalp and moved to the front and top of the scalp in these individual groups of one to four hairs.

In this way the results can completely mimic the way hair grows in nature.

See the Follicular Unit Transplant (FUT) section for more information.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Is Propecia Necessary for Hair Transplant?

Q: I am 35 years old and have been using Propecia for the last 3 years, waiting to save enough money for a hair transplant. I no longer feel comfortable using it due to side effects. Can hair transplantation still be effective even without continuing to take this drug afterwards? — Y.C., Matinecock, New York

A: Many people choose not to take Propecia or choose not to take it due to side effects and the surgical hair restoration is just as effective. The only difference is that medications can prevent further hair loss whereas surgery cannot.

Medications are not needed for the hair transplant to be successful or the transplanted hair to grow and be permanent.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Do Propecia and Rogaine Act Synergistically?

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.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Makes “Best Doctors” in New York Magazine for Seventh Consecutive Year

Best Doctors in NY - New York MagazineRobert M. Bernstein, MD has been selected as one of New York Magazine’s “Best Doctors” for the seventh year in a row.

This special annual issue in New York Magazine, June 13, 2006, presents the findings of Castle Connolly Medical Ltd., publishers of the guidebook, Top Doctors: New York Metro Area.

Dr. Bernstein is the only hair restoration surgeon honored to be included in this list of prominent physicians for seven consecutive years.

Posted by Robert M. Bernstein M.D.
Hair Restoration Answers

Which Gives More Donor Hair: FUT or FUE Hair Transplant?

Q: I am Norwood Class 6 and have read about both Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT). Which will give me more hair? — D.D., Highland Park, T.X.

A: In general, FUT will give you more hair since, in FUT, the best hair from the mid-portion of the permanent zone of the scalp (also called the “sweet spot”) can be utilized in the hair transplant.

With FUE, since only the hair follicles are extracted and not the surrounding bald skin, if too much hair is removed, the donor area will begin to look thin as hair is removed. This will limit the amount of hair that can be harvested.

Although in FUE additional areas of the scalp can be utilized to some degree, this will generally not compensate for the inability to access all of the hair in the mid-permanent zone and the total amount available for the hair restoration will be less.

Read about Follicular Unit Extraction (FUE)

Read about Follicular Unit Transplantation (FUT)

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

NPR Interviews Dr. Bernstein on Hair Transplantation and Hair Loss

Hair transplant surgeon Robert M. Bernstein M.D. was recently interviewed on the National Public Radio program The People’s Pharmacy. Invited to speak about hair loss, Dr. Bernstein offered insights about the causes of hereditary baldness and it’s solutions, including hair transplantation.

The show was entitled “Dealing with Hair Loss” and addressed issues such as the importance of hair to our sense of well being.

The full hour radio interview was filled with informative facts about male pattern baldness, cultural attitudes toward hair loss and surgical hair restoration. For example, Dr. Bernstein was asked about his pioneering work in follicular unit hair transplantation and host of other questions ranging from the causes of hair loss to the psychological effects of balding. Here is one exchange from the interview:

Moderator: How one can tell the difference between hair loss from hormonal imbalances and common baldness?

Dr. Bernstein: Measuring hormone levels alone, although important for medical management, does not necessarily reveal whether the cause of the hair loss is actually hormone related or is genetic. The diagnosis is made by examining the scalp and looking at the hair under close magnification using an instrument called a “Densitometer.” If the hair shafts are of different calibers, this is relatively diagnostic of female patterned genetic hair loss and in this case hormone levels are often normal. Hormonal changes or imbalances, on the other hand, may cause alterations in hair texture (such as in thyroid disease) or a generalized shedding that can occur after childbirth (called telogen effluvium). In telogen effluvium, the hair can l actually fall out in clumps – you can literally get handfuls of hair, but the hair often returns over time. In genetic hair loss, however, it is not a question of the hair falling out any faster, but the hair being replaced with thinner, finer hair in each hair cycle, until the hair gradually disappears.

Posted by Robert M. Bernstein M.D.
Hair Restoration Research

Comparison of Different Instruments to Make Recipient Sites: Needles vs. Blades

David Perez-Meza, MD, Melvin Mayer, MD

SUMMARY of Dr. Perez-Meza’s Abstract from his presentation at the International Society of Hair Restoration Surgery, 2005 – Sidney, Australia

There have been great advances in hair restoration surgery over the past decade. New surgical techniques, instruments and medications have been developed to treat patients with hair loss. Some surgeons use needles to create the recipient sites and others use blades – both groups obtaining great results. There is some controversy, however, about the “ideal” instrument to make the recipient sites.

The objective of this study was to evaluate three different blades and three different needles used to make sites in the recipient area and to compare the wound healing and hair growth after the hair transplant.

Recipient sites were made using the following instruments: 18-, 19- and, 20-gauge needles, Sharpoint 22.5º, Minde 1.3 mm and Custom blades. Each instrument was used to make sites at a depth of 4 mm and at an angle of 30-45º. Two-hair follicular units were placed in pre-made incisions.

We evaluated intra-operative bleeding from the recipient sites (bleeding makes it more difficult to place the grafts). We also examined the patient at 10 days post-op for redness, swelling and scabbing, and at 6 and 12 months for terminal hair counts.

The results showed that there were no differences between the two groups with respect to intra-operative bleeding and, at 10 days, there was similar healing for each of the instruments. In addition, at 6 and 12 months, the hair counts were similar.

Our conclusions were that all of the instruments produced similar hair growth and survival. None of the instruments produced cysts, ingrown hairs, pitting or cobblestoning. There was similar naturalness, quality of hair and cosmesis. In sum, if one uses very small instruments in the hair transplant, similar results will be observed regardless of the specific type of instrument used.

Posted by Robert M. Bernstein M.D.
Hair Restoration Research

Follicular Unit Growth at Four Different Hair Transplant Densities

Michael L. Beehner, M.D.
Saratoga Hair Transplant Center, Saratoga Springs, NY, USA.

SUMMARY of Dr. Beehner’s Abstract from his presentation at the International Society of Hair Restoration Surgery, 2005 – Sidney, Australia

There is a need to find the “threshold” density at which follicular unit (FU) graft recipient sites may be placed and yield excellent survival following a hair transplant. It also needs to be determined whether or not a smaller recipient site makes a difference in graft survival. This study looks at hair survival in two patients 18 months after they were each transplanted with four different densities.

The objective of the study was to determine the optimal density for “dense packing” FU grafts without causing loss of hair from vascular compromise or other factors that can affect graft growth during hair restoration surgery.

In the study, two male patients, both with Norwood Class VI patterns of hair loss, were examined. Two-hair FUs were planted respectively at densities of 20, 30, 40, and 50 FUs per cm2. 19g needles were used for the boxes with 20 and 30 grafts per box, and 20g needles were used for the boxes with 40 and 50 grafts/cm2. The grafts were placed using a “stick-and-place” method.

% Hair survival

Recipient Site Density 20/cm2 30/cm2 40/cm2 50/cm2
Patient I (18 Months) 95 93 70 67
Patient II (13 Months) 88 92 100 93

The author concluded that both patients had excellent growth of the transplanted hair at densities of 30/cm2. However, one patient had decreased density at 40/cm2 and 50/cm2. Based upon this very limited study, the researcher suggested that there are probably individual factors unique to each patient which affect graft survival of transplanted hairs at high densities.

The author proposes that the patient to patient variation at high densities may be due to variations in 1) scalp thickness, vasculature (atherosclerotic changes or differences in collateral circulation), presence of past transplant work or surgery with resultant “micro-scarring”, amount of epinephrine used in recipient area, or technique and care to grafts by cutters and placers.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Discusses Hair Transplant Repair In Discovery Channel Interview

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

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

‘Platinum Follicle Award’ for Outstanding Achievement in Hair Restoration Goes to Dr. Bernstein

The Platinum Follicle Award is given by the International Society of Hair Restoration Surgery (ISHRS) for “Outstanding achievement in basic scientific or clinically-related research in hair pathophysiology or anatomy as it relates to hair restoration.” It was presented to Dr. Bernstein at the 9th Annual Meeting of the ISHRS, October 18-22, 2001; in Puerta Vallarta, Mexico.

The award is the highest honor given by the International Society of Hair Restoration Surgery. At the ceremony, Dr. Marcelo Gandelman, the President of the ISHRS, stated:

“I proudly present the 2001 Platinum Follicle Award to Robert M. Bernstein, MD. Dr. Bernstein has contributed to the field of hair transplantation in dramatic and substantial ways, revolutionizing the advancement of Follicular Unit Hair Transplantation. His published articles have become ‘Bibles’ for this methodology. Dr. Bernstein’s contributions extend beyond the application of Follicular Unit Transplantation, such as studies in examining the power of sorting grafts for density, yield by method of graft production, local anesthetic use, and suture materials. These studies have added to the specialty’s depth and breadth of knowledge applicable to traditional mini-micrografting techniques as well as Follicular Unit Transplantation.”

Read more about the Platinum Follicle Award

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

HairSite.com Award for Excellence Goes to Dr. Bernstein

Dr. Bernstein received the 2001 HairSite.com award for excellence in hair transplantation. Here is the statement they made in giving Dr. Bernstein the annual award:

Dr. Bernstein is one of the most sought after hair transplant surgeons in the United States. He is one of the very few in the industry who is still involved in scientific and clinically related hair restoration research while engaging in hair transplant practice.

Dr. Bernstein is the author of numerous scientific journals related to hair restoration, currently the most widely published author on the subject of Follicular Unit Transplantation. Since HairSite was founded in 1997, we have no received one single email or correspondence from a dissatisfied patient of Dr. Bernstein.

Dr. Bernstein’s passion in hair restoration research has substantially elevated the standards in hair transplant industry over the years. Dr. Bernstein is also named one of the best hair transplant doctors by New York magazine and is the recipient of the 2001 “Platinum Follicle Award” at the International Society of Hair Restoration Surgery 9th Annual Meeting in Puerta Vallarta Mexico.

Dr. Bernstein performs surgical hair restoration at his offices in New York, NY and Fort Lee, NJ.

Posted by Robert M. Bernstein M.D.
Bernstein Medical In The News

Dr. Bernstein Emphasizes Standardizing Hair Transplant Terminology in ‘Cosmetic Surgery Times’ Article

Dr. Bernstein - Cosmetic Surgery Times - May 1999“We felt it was necessary to clearly define follicular unit hair transplantation and mini-micrografting cut to size,” explained Dr. Bernstein, Assistant Clinical Professor of Dermatology, College of Physicians and Surgeons, Columbia University, New York. “Follicular unit transplantation has many theoretical advantages… having standardized definitions of these hair transplantation techniques will allow us to make valid comparisons.”

Dr. Bernstein said the elements defining follicular unit hair transplantation include exclusive transplantation of hair in its naturally occurring individual follicular units.

Read the full article

Posted by Robert M. Bernstein M.D.

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