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Bernstein Medical - Center for Hair Restoration
Hair Restoration Answers

What Problems Can Arise from Transplanting the Crown Too Early?

Q: What is the problem with transplanting the crown too early? — P.L., Newark, NJ

A: If a person’s hair loss continues –- which is almost always the case -– the crown will expand and leave the transplanted area isolated, i.e. looking like a pony-tail. The surgeon can perform additional hair transplant procedures to re-connect the transplanted area to the fringe, but this is a large area that can require a lot of hair, and it is often impossible to determine when a person is young if the donor supply will be adequate. View the full post to see a photo of a patient who had an early hair transplant to his crown.

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Bernstein Medical In The News

Hair Transplant Pioneer Dr. Robert M. Bernstein in New York Magazine “Best Doctors” for 12th Consecutive Year

NY Magazine - Best Doctors - 2011Dr. Robert M. Bernstein, pioneer of the follicular unit transplantation and follicular unit extraction hair transplant procedures, was selected as one of New York metropolitan area’s top physicians.

Of his being selected in the 2011 issue, Dr. Bernstein said, “My inclusion in the Best Doctors issue for the twelfth year in a row is a testament to the hard work and dedication of my staff, our consistently high quality of care, and our passion for treating patients who are struggling with hair loss.”

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Hair Restoration Answers

Can Body Hair Transplant be Negatively Affected by Finasteride?

After trading anecdotes with fellow hair loss physicians about how finasteride can reduce body hair in some patients, Dr. Sharon A. Keene asked whether finasteride might have a negative effect on patients who have body hair transplant (BHT) procedures. While the current research is inconclusive, her review sheds light on how to avoid any possible negative impact that finasteride might have on patients who have body hair transplant procedures.

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Hair Restoration Answers

Did Dr. Bernstein Explain Hair Transplantation on the Oprah Winfrey Show?

Q: Heard you were on Oprah with a hair transplant patient of yours. Is this true? — V.B., Chappaqua, N.Y.

A: Yes. Oprah wanted to know if hair transplants really worked, so I was asked to be on The Oprah Winfrey Show to explain the latest in hair restoration techniques.

They showed a film of me performing a follicular unit hair transplant and then brought the actual patient in the video on stage for a look at the results of his procedure.

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Hair Restoration Answers

Can a Hair Transplant Repair Scarring from Scalp Reduction Surgery?

Q: What’s the best way to camouflage a scar left behind from a scalp reduction that I had in 2001? I am currently wearing DermMatch to cover the area, but the hair parts like the “Red Sea” on top around the scar so the makeup does not look so good. I would like to fill in the area with hair but I am not sure if a hair transplant will grow into scar tissue.

A: Hair will grow in the scar but, as you allude to, the problem is often the abnormal hair direction rather than the scar itself.

Besides adding hair to the scar, if one transplants hair adjacent to the scar in a direction that causes it to lie over the scarred area, the visual affect of the “Red Sea” effect can be lessened.

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Hair Restoration Answers

What are Obstacles to Hair Cloning Techniques?

A: The main problem is that the cultured cells may lose their phenotype with multiple passages, i.e. lose their ability to differentiate into hair follicles after they have been multiplied.

Another problem of hair cloning is that the orientation of hair direction must be controlled. With mouse experiments, the hairs grow at all different directions. Scientists need to find a way to align the hair so that it grows in the right direction. Hair, of course, must also be of a quality that is cosmetically acceptable and matches the patient existing hair. And the hair should grow in follicular units. Individual hairs will not give the fullness or natural look of follicular units.

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Hair Restoration Answers

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

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

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

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

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Hair Restoration Answers

What is 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.

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Hair Restoration Answers

How Do You Determine Size of Hair Transplant Donor Strip?

Q: I am interested in FUT. How do you figure out how large a strip to use for the hair restoration when transplanting all follicular units? — P.K., New York City, N.Y.

A: The length of the donor strip incision is determined by the number of follicular unit grafts required for the hair restoration.

There are slightly less than 100 follicular units/cm2, so if a 1cm wide strip is used, a hair restoration procedure requiring 1800 grafts would need a strip that measured slightly more than 18cm in length.

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Hair Restoration Answers

Before Hair Transplant, How Long Should I Use Propecia?

Q: I am 28 years old and was told that I have early Norwood Class 3 hair loss. I want to have a hair transplant but my doctor told me to use Propecia for 6 months and then come back to discuss surgery. I don’t want to wait that long, what should I do? — L.B., Oyster Bay Cove, NY

A: Actually, you should wait a full year.

If you are an Early Norwood Class 3, the Propecia can work so well (in actually growing hair back) that you may not even need a hair transplant.

The important point is that Propecia only starts working at 3-6 months and during this time there may actually be some shedding as the new growing hair literally pushes out the old.

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Hair Restoration Answers

How Did Follicular Unit Transplantation and Follicular Unit Extraction Get Their Names?

Q: How did Follicular Unit Transplantation and Follicular Unit Extraction get their names? N.D. – Bergen, New Jersey

A: The first paper on Follicular Unit Hair Transplantation was published by Dr. Bernstein and Rassman in 1995 in the International Journal of Aesthetic and Restorative Surgery. The title of the paper used the abbreviated name Follicular Transplantation. The longer name “Follicular Unit Transplantation” was formalized by Bernstein et. al. in the paper “Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques.” This paper appeared in Dermatologic Surgery in 1998.

Follicular Unit Extraction derived its name from Rassman and Bernstein’s publication “Follicular Unit Extraction: Minimally invasive surgery for hair transplantation” that appeared in Dermatologic Surgery in 2002.

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Bernstein Medical In The News

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

In giving Dr. Bernstein the 2001 Platinum Follicle Award, the President of the ISHRS said:

“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.”

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Bernstein Medical In The News

Hair Transplant Surgeon of the Month Award to Dr. Bernstein

Dr. Robert M. BernsteinDr. Bernstein receives the Surgeon of the Month award given by the International Society of Hair Restoration Surgery. Dr. Bernstein introduced the concept of “follicular transplantation” in 1995 through a publication in the International Journal of Aesthetic and Restorative Surgery, where he recommended that in all hair transplant procedures the implants should consist of only the naturally occurring follicular units. The anatomic follicular units, seen clinically as the patient’s natural hair groupings, are different for each individual, and these differences should be reflected in the transplant plan. He has been a strong advocate of using follicular transplantation for the best possible cosmetic result, and has encouraged his colleagues to use this approach in his writings and lectures.

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