Q: Can a woman who is breastfeeding have a hair transplant? — M.R. ~ Long Beach, N.Y.
A: Since surgical hair restoration is an elective procedure, I would wait until 1 year after delivery and once breastfeeding has completed before considering a hair transplant. Often after pregnancy, there is a post-partum shedding that occurs as the hormones fluctuate and then return back to their normal levels. This active period of shedding can cause a few issues. The first issue is that active shedding can make it difficult for the surgeon to determine where best to place the grafts for the optimal long-term cosmetic result. Additionally, medications may be used during and after the procedure that can potentially appear in breast milk.
A female hair transplant patient recounts her experience at Bernstein Medical.
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.”
“Approximately 40 percent of women experience some form of hair loss in their lives, and stress is the second biggest cause after genetics,” says Dr. Robert Bernstein, a professor of dermatology at Columbia University and a hair restoration specialist with a Midtown practice. “Over the last five years there had been a 50 percent increase in the number of women coming to our office to seek help.”
The article discussed four women of varying ages who sought treatment for different hair loss conditions. Among the treatments discussed are Rogaine for Women and Laser Therapy.
Dr. Bernstein was interviewed for an article in NYCityWoman.com that ran the gamut of available treatments for hair loss in women. Read below for some select quotes on a wide range of topics related to hair loss in women and treatments for female patients with androgenetic alopecia (common genetic hair loss).
On the fading stigma of hair loss in women:
“Women today are more comfortable talking about their hair loss.”
On indicators of hormone-driven female hair loss:
“It is typical to have a positive family history of hair loss and the presence of miniaturization (short, fine hairs) in the thinning areas.”
On minoxidil for regrowth of thinning hair:
“Rogaine (minoxidil) can increase the quality (length and diameter) of hair that is just starting to thin.”
On the different strengths of Rogaine (minoxidil):
“I generally recommend the 5 percent for women and men. Although it’s sold in separate packages for men and women, the basic ingredients are essentially the same.”
On Rogaine Foam:
“It is an elegant mixture, made for compliance,” says Dr. Bernstein. “It is an aerosolized foam, so it is less irritating than liquid Rogaine, but can be more difficult to get directly on the scalp.”
On LaserComb vs. cap-based Low Level Laser Therapy (LLLT) devices:
“The cap is both easier to use and more effective for very thin hair, due to the greater number of lasers. But for higher-density hair, a laser comb or the LaserBand82 may be more effective, as it’s probably better at getting the laser therapy beam to the scalp.”
The 2015 hair restoration practice census, published by the International Society of Hair Restoration Surgery (ISHRS), showed that hair transplantation is an increasingly popular treatment for hair loss. The biennial survey found that 397,048 procedures were performed in 2014, an estimated increase of 28% over the previous survey, published in 2012. Three prior surveys found increases of up to 12%, so the rate of surgical hair restoration seems to be accelerating.
Since 2006, the number of procedures worldwide has increased 76%, with the estimated global hair restoration market now valued at approximately $2.5 billion annually.
Age
Over half of all men and women treated were younger than 50. Men aged 30-39 made up the biggest percentile at 31.7%, followed by those aged 40-49 (26.9%). It was the inverse for women, however, with those aged 40-49 making up the biggest percentile at 27.7%, followed by women in the 30-39 year old bracket (27.0%).
Procedure
While Follicular Unit Transplant (FUT) procedures accounted for over half of all hair transplants, Follicular Unit Extraction (FUE) is gaining rapidly, with a 51% increase over the 2012 results (from 32.2% in 2012 to 48.5% in 2014). See the chart:
On Bernstein Medical – Center for Hair Restoration:
The Manhattan office of Bob Bernstein, just steps from Park Avenue, is the kind of space that makes successful men feel at home — a good thing for one of the country’s foremost specialists in hair restoration (and the co-author of Hair Loss for Dummies). The layout is part design statement, part science lab, slick with granite, slate, and glass and full of microscopes and high tech gizmos. Among the space’s most noteworthy gadgets is one of only twelve robots in the world programmed to help perform hair transplants, which has a home in Dr. Bernstein’s office.
Sara Lyles, 62, whose hair loss was caused by a styling technique, said that when Dr. Bernstein performed her hair transplant 12 years ago, the subject was taboo. “Women never talked about it, and I was so embarrassed that I avoided all social functions,” she recalls. “I’m African American and I slept in large tight rollers to keep frizzing under control. The traction destroyed my frontal hairline.”
At the time, she would have been mortified if someone found out she had undergone a transplant. “Even my hairdresser had no clue,” she says. “Dr. Bernstein not only gave me my hair back, he gave me my life back.”
Dr. Bernstein on the amazing progress of the hair restoration industry:
As Dr. Bernstein emerges from his operating room, sporting green scrubs and green Nikes that match the room’s tiles, he shakes his head and sighs. “When I went into practice back in the eighties, transplantation was almost barbaric and Rogaine was the only alternative,” he remembers. He marvels at the advances and choices he and others now have to over. “I never would have thought I would be working with robots, lasers, and cloning.”
Hair transplantation for women is in vogue. As a pioneer in the surgical treatment for female hair loss, Dr. Bernstein was featured in an article in the ‘Beauty’ section of the October 2012 issue of British Vogue.
After describing a visit to Bernstein Medical – Center for Hair Restoration in New York City and giving readers a primer on hair transplant surgery, the article turns to Dr. Bernstein to describe the surge in popularity of the treatment of hair loss in women.
“A quarter of my consults are women. It was 10 per cent five years ago,” says Dr Bernstein. “These improved [hair transplant] techniques work especially well for female hair loss, where it is usually localised patches of thinning that need attention.” And while in the chair, you can even have your eyebrows boosted to Arizona Muse quality, too, if they’ve also taken an ageing hit.
Dr. Bernstein speaks to the difficulty of being a woman suffering from hair loss:
“This is life-changing. Bald men are commonplace, but to have less than a full head of hair for a woman can be isolating. Although there are more tricks women can use to disguise the problem.”
The article also discusses a variety of products and techniques to boost hair volume or camouflage hair loss. Among these are: Kérastase, Nicky Clarke’s ‘Tease Me’ powder, Viviscal Hair Nutrition, laser stimulation, Michaeljohn’s ‘Fine Hair Clinic’, and Touché by Flavien.
Reference
“Hold Onto Your Hair”, Vogue Magazine, October 2012; p375-6.
Q: Is the hair transplant for women different from the one for men? Anything easier? Anything more difficult?
A: Women’s hairlines are far more complex than men’s as the hair in a women’s hairline often creates subtle swirls and directional changes. These must be mimicked in the surgical design for the hair transplant to look natural.
In women, we are more often working in and around existing hair, as most women that seek hair transplantation are thinning rather than bald. This slows down the graft insertion steps and makes the procedure take a bit longer compared to men.
Dr. Bernstein discusses the technique of follicular unit hair transplantation in a Fox News segment on hair loss and hair transplantation. In the video, he discusses the use of the Follicular Unit Transplant (FUT) procedure to correct hair loss and camouflage scarring that resulted from the surgical removal of a large skin cancer on the patient’s scalp. You can see this patient’s before and after photos in our Women’s Gallery.
Q: I’ve been losing my hair just around the front of my scalp for years, but now it’s bad enough that I need to wear a wig to hide the top and back. Do you transplant women?
A: If you have thinning in such a broad area, most likely your donor area is also thin and you would not be a good candidate for surgery.
An examination can determine this and also determine if there is some other cause of your hair loss other than genetics.
Q: I am female and thinning can I be a candidate for a Follicular Unit Hair Transplant?
A: If it turns out that you have female pattern hair loss, you may be a candidate a hair transplant, but would need to be evaluated by a doctor who specializes in surgical hair restoration.
In the evaluation, you should have your degree of hair loss assessed and donor supply measured, using an instrument called a densitometer, to be certain that you have enough permanent donor hair to meet your desired goals. For more information about hair loss in women, please see the Diagnosis of Hair Loss in Women page of the Bernstein Medical – Center for Hair Restoration website.
If you are thinking about your hair loss and would like to be evaluated, go to the physician consult page to schedule a consultation.
As the taboo of 
Dr. Bernstein discusses the technique of follicular unit 
