Bernstein Medical - Center for Hair Restoration - Hair Style
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Q: For patients who intend to keep their hair parted on the left side, do you follow any rule of making the left side more dense then the right or is it distributed evenly? — M.S., Simi Valley, C.A.

A: On a first hair transplant procedure, I generally place the sites/grafts symmetrically, even if a patient combs his hair to one side. The reason is that the person may change his styling after the procedure and I like to have the first hair transplant symmetrical for maximum flexibility. An exception would be a person with limited donor reserves. In this case, weighting on the part side is appropriate in the first procedure. Once the first hair transplant grows in and the person decides how he wants to wear his hair long-term a second transplant can be weighted to accommodate this. Weighting can be done in one, or both, of two ways: 1) by placing the sites closer together on the part side or 2) by placing slightly larger follicular units on the part side.

If a person decides to comb his hair back, then forward weighting is used. For greater details on this, please see some of my publications where I address the aesthetics of hair transplantation:

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

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

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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

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Q: I am a 33 year old women and am just starting to thin on the top of my scalp behind my frontal hairline. What should I do? Should I have a hair transplant?

A: There are a number of things that you should consider that can be effective in early hair loss. These include minoxidil (Rogaine), laser therapy, and using cosmetics specifically made to make the hair appear fuller. Lightening or streaking the hair, as well as parting the hair off to the side, will also make the hair appear fuller.

If a surgical hair restoration is performed too early and there is still a lot of existing hair in the area, the hair transplant may actually accelerate hair loss. Surgery should not be performed prematurely.

Also, it is important that the doctor check the stability of the donor area, using densitometry, to make sure that the procedure is even possible. For those women who are good candidates, and if it is done at the appropriate time, a follicular unit hair transplant is a great procedure that can produce really natural results.

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Q: I am a 45 year old woman and I am beginning to thin on the top of my scalp. I don’t want to use medications and I don’t think that I am quite ready for surgery. Is there anything else I can do? — E.H., Rye, NY

A: There are a number of things that you can do that can make you hair look more full and help disguise the thinning. Lightening ones hair will allow the hair to reflect more light and appear thicker. In lighter-skinned races it will have the additional advantage of decreasing the contrast between the hair and skin and thus the skin will essentially act as a filler between the strands of hair.

Streaking the hair is also helpful to make the hair look thicker. Waving or perming will help as well, as it will give the appearance of more volume. Normally, the hair tends to fall into a natural part where it is the thinnest. If you part your hair in the thickest area (usually the side opposite from where you are used to, or slightly lower on the same side) this will make the hair appear fuller and less see-through.

Finally, there are a number of cosmetic products that can make you look like you have more hair.

Visit the Cosmetics for Hair Loss page on the Bernstein Medical – Center for Hair Restoration website.

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Q: I was at a party the other day and some women were talking about their boyfriend’s hair. I heard one refer to her ex-boyfriend as having a “bar code.” What is that? — B.A., New Albany, Ohio

A: A “bar code” is slang term used in Japan for a comb over.

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Hair loss has a variety of causes. Diagnosis and treatment is best determined by a board-certified dermatologist. We offer both in-person and online photo consults.

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