Synopsis: With the latest version of the ARTAS platform, 9x, Restoration Robotics has designed a faster and more accurate system for hair transplantation. The improved accuracy of harvesting and shortened procedure time increases graft viability, while smaller needles reduce scarring and allow patients to wear shorter hairstyles. Many of the changes in this upgrade have been made as a response to specific physician feedback.
Posted by Updated 2019-04-01Synopsis: Since the publication of “What’s New in Robotic Hair Transplantation” (Hair Transplant Forum Int’l. 2017; 27(3):100-101), there have been important improvements to the robotic system in both its incision and recipient site creation capabilities. These advances fall into four overlapping categories:increased speed, increased accuracy, increased functionality, and improved artificial intelligence (AI). The overlap occurs since improvements in functionality, accuracy, and AI can also increase the overall speed of the procedure. A faster procedure decreases the time grafts are outside the body and allows the physician to perform larger cases without placing additional oxidative stress on the follicles.
Posted by Updated 2018-06-29Synopsis:There has been a change in the nomenclature of the FUE procedure. It will not be called Follicular Unit Excision, describing the two main components of an FUE procedure, incision (separatioin of the follicle from the tissue) and extraction (the removal of the follicular unit from the scalp once it is separated). Drs. Robert M. Bernstein and William R. Rassman’s commentary explains the importance of this change in terminology.
Posted by Updated 2018-05-15Synopsis: Hair restoration has advanced dramatically in the past 25 years, most recently with the growing popularity of FUE. The challenge of FUE is that the grafts are more fragile compared to the follicular units generated in traditional FUT/strip procedures. Innovations such as the ARTAS Robot and other devices attempt to address this problem. With the increasing participation of ISHRS members – now 1,200 strong – progression in this field should continue at an accelerating pace.
Posted by Updated 2018-01-22
Q: I was thinking of having an FUE 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 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.
Posted by Updated 2018-07-03Synopsis: Since the introduction of robotic FUE technology over five years ago, there have been numerous upgrades to the system. The current paper describes the most recent advances. These include a more user-friendly interface, the ability to select for larger follicular units, greater range-of-motion of the robotic arm, improved methods for stabilizing the scalp and newly designed needles for more accurate harvesting.
Posted by Updated 2018-06-29Q: My hair is starting to thin in the front, but it is not yet bald. I have been going back and forth about whether to get a hair transplant or use Propecia. I’m not sure what my first step should be. What do you think? — N.K. ~ Pleasantville, N.Y.
A: In general, patients who are thinning, but not actually bald, should begin with combined medical therapy (finasteride and minoxidil) for at least a year prior to considering surgery. In many cases, with this regiment, surgery can postponed or even avoided completely. Unfortunately, some patients cannot tolerate finasteride or choose not to take it due to concern about potential side effects. Minoxidil, although useful, does not significantly alter the long-term course of hair loss when used alone.
Posted by Updated 2018-07-03
Dr. Bernstein was featured in a wide-ranging interview published in the New York City-based, Japanese language magazine NY Japion. Among the topics discussed were the differences between FUT and FUE hair transplants, updates on robotic hair transplant technology, the type of procedure most beneficial for Asian patients, criteria that determine candidacy for a hair transplant, and more.
Q: How can I better understand how I will look after my hair transplant before I actually do the procedure? — E.M. ~ Wantagh, N.Y.
A: A key part of a hair loss evaluation is for the doctor to manage the patient’s expectations for possible benefits from both medication and surgery. The way we decide how to plan a hair transplant is through a careful history and examination, demarcating the extent of the hair transplant on the patient’s actual head and photographing it. When showing other photo results to patients, it is important to not only show before and after photos of the recipient area but also of the donor area; how the back of the head looks immediately after the procedure, at post-op intervals, and at different hair lengths. Most importantly, one should point out that every patient is different so that a picture of another person does not necessarily represent what you might achieve.
After years of jokes about his continually receding hair line, LeBron James, 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.
Folks are now asking – what the heck happened all of a sudden? Where, when and how did LeBron get that great new hair line?
Posted by Updated 2016-01-04
Robert M. Bernstein, MD, MBA, FAAD, a Clinical Professor of Dermatology at Columbia University in New York and a pioneer of modern hair transplant procedures, is honored to be included in New York Magazine’s annual ‘Best Doctors’ issue for the fifteenth consecutive year.
Dr. Bernstein’s two decades of innovation in surgical hair restoration and dedication to his patients at Bernstein Medical – Center for Hair Restoration have earned him placement in the 2014 edition of the peer-nominated ‘Best Doctors’ issue. The respect his colleagues have for his work stems from his leadership and dedication to advancing and improving surgical hair restoration procedures.
Posted by Updated 2014-06-17Q: I received radiation therapy to my scalp two years ago to treat a brain tumor. I lost my hair during treatment and it has not grown back. The doctors said that this treatment might result in permanent hair loss. Is a hair transplant a viable option after radiation treatment? — K.G., Darien, C.T.
A: Unlike chemotherapy which generally causes a reversible shedding of hair (called anagen effluvium), radiation therapy can cause both reversible shedding and the permanent loss of hair follicles (scarring alopecia). Hair can be successfully transplanted into these scarred areas – but there must be enough donor hair to do so. If the radiotherapy was localized, a hair transplant procedure is often quite effective – although several procedures may be required to achieve adequate coverage of the irradiated areas.
Posted by Updated 2017-12-01Q: I am having a facelift next month and also want to have a hair transplant soon after. How long should I wait between procedures? — S.H., Boston, M.A.
A: Although it would be possible to do a hair transplant as soon as a week after a face or brow lift, ideally one should wait at least three months between procedures for the following reasons: 1) there will be less tension in the donor area and, therefore, it will be possible to harvest more grafts, 2) if there is any shedding from the facelift it will make the planning of the hair transplant more difficult, 3) it will leave the option of adding hair, in or around, any problematic surgical scars, and 4) will provide the ability to add hair to any area of thinning that might result from the facelift.
Posted by Updated 2017-12-01
The 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.
Dr. Bernstein has been included in America’s Top Doctors for the past 12 consecutive years.
Posted by Updated 2015-03-24
Dr. Schweiger lends his expertise on hair loss in women and cosmetic hair extensions in a segment on PIX 11 television. The interview with Dr. Steve Salvatore focused on the pitfalls of using some types of hair extensions, or using them improperly.
Dr. 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.”
Posted by Updated 2014-01-07Q: I hear you leave staples in sometimes up to three weeks after a hair transplant. Why do you leave staples in that long? – M.C., Boca Raton, FL
A: My reason for leaving some staples in longer is that the tensile strength of the wound continues to increase (significantly) during the first three week period after surgery — actually, it will continue to gain strength for up to one year post-op. To give the wound the best chance to heal, on average, I take out alternating staples at 10 days and the remaining staples at 20 days.
Posted by Updated 2013-06-06Q: 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.
Posted by Updated 2015-12-04
Robert M. Bernstein, M.D., F.A.A.D., the renowned hair transplant surgeon and founder of Bernstein Medical – Center for Hair Restoration in New York, is studying four different applications of ACell MatriStem™ extracellular matrix in a type of hair cloning, called hair multiplication, as well as current hair restoration procedures. Click the link to read the whole press release.
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.
Posted by Updated 2015-12-15Q: I am considering having a hair transplant. Does my hair need to be cut? — I.S., New York, NY
A: In all hair transplant procedures, we are able to transplant into areas of existing hair without it having to be cut. The question of whether hair needs to be cut in the donor area depends upon the way the donor hair is obtained (harvested).
With a Follicular Unit Hair Transplant procedure using single strip harvesting method (FUT), only the strip of hair that is removed needs to be cut. When the procedure is finished, the hair above the incision lays down over the sutured area and it becomes undetectable.
In Follicular Unit Extraction (FUE), particularly in sessions over 600 grafts, large areas of the donor area must be clipped short (to about 1-2mm in length) in order to obtain enough donor hair.
Posted by Updated 2017-01-17Q: Can I sleep as I normally do after a hair transplant? — G.C., Los Angeles, CA
A: We ask that you sleep on your back, with your head elevated on a few pillows. By raising your head, the pillows decrease any swelling that normally occurs after the hair transplant. We also use a small injection of cortisone given in the arm to help decrease swelling.
Posted by Updated 2013-06-06Q: After my hair transplant procedure I had some shock loss, and then after about 4 1/2 to 7 months I had tremendous growth — really thick. I was amazed actually. Now, at 8 months it has thinned again, quite a lot compared to the growth I had before. I just wondered if this was a normal growth pattern and whether further growth could be expected? — N.T., Brooklyn, NY
A: This is not the most common situation, but should not be a cause for concern. The newly transplanted hairs are initially synchronous when they first grow in — i.e. they tend to all grow in around the same time (with some variability). This is in contrast to normal hair, where every hair is on its own independent cycle. Sometimes the newly transplanted hair will shed at one time before the cycles of each hair become more varied asynchronous.
Posted by Updated 2013-12-26
CBS 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.
CBS turned to Dr. Bernstein for his expert medical opinion on Brady’s hair loss. View the post to watch the video and read some links on hair loss.
Posted by Updated 2017-01-26
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, or 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. Read the full post for quotations from the article and some links on hair loss genetics.
Posted by Updated 2013-05-10Q: I heard that there have been some new advances in hair cloning and that it may be available sooner than we thought. I was planning on doing a hair transplant soon. Considering that hair cloning may be available at some point in the future, should I do FUE or FUT, or wait for cloning? — K.R., Fort Lee, NJ
A: Although there has been a major development in hair cloning with the use of ACell, an extracellular matrix to simulate hair growth, the model, at this point, is still in its earliest stages of development. It is hard to know when the technology will reach a state where it can be useful in hair restoration.
With respect to which you should do FUE or FUT if, theoretically, cloning is around the corner, the answer would be FUT, since FUT will give you the fuller look.
If the goal is to eliminate any trace of the traditional hair transplant, again FUT will most likely be the best choice, since the single linear scar would be easy to camouflage with cloned hair. With FUE, this would be much more difficult, since there are literally thousands of tiny scars. However, neither FUE nor FUT will preclude a patient from fully benefiting from cloning if, and when, it becomes available.
Read more:
Posted by Updated 2016-04-22
Hair Loss & Replacement For Dummies, written by internationally renowned hair transplant pioneers Dr. Robert M. Bernstein and Dr. William R. Rassman and published in 2008, is one of the best hair loss and hair transplant resources available for the layperson.
Now it is also one of the best resources for the layperson… who owns a Kindle wireless reading device.
Posted by Updated 2015-05-22Q: Is it correct that the hair transplant surgery lasts about eight hours or if there is a range, what is that generally? — M.R., Montclair, NJ
A: The range is about 5 to 8 hours. For a completely bald person, it would be in the higher range. Keep in mind that the person is just relaxing, watching TV or dozing off. The time goes by quickly for the patient. Since there is no general anesthesia, there is no medical risk for this relatively long procedure.
To review the procedure in more detail, please visit our Overview of FUT Hair Transplant Procedure section; which includes details for before, during, and after the hair transplant. View the Overview of FUE Hair Transplant Procedure section for details on the follicular unit extraction procedure.
Posted by Updated 2013-06-07Q: 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 Updated 2017-12-11Q: 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.
Posted by Updated 2017-12-01Q: You said I was not a good candidate for a hair transplant because my donor area was too thin. Since finasteride and minoxidil can increase the thickness of the hair, could it make a hair transplant possible?
A: Unfortunately, the medication will not affect the donor area and, therefore, not make a person with low donor density a candidate for a hair transplant.
Posted by Updated 2015-12-15
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.
New 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.
Posted by Updated 2013-05-10Q: 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.
Posted by Updated 2017-12-01Q: I had a hair transplant 10 days ago and I lost some hair that looks like the hair fell out at the root. — R.A., Bronxville, N.Y.
A: When there is shedding after a hair transplant, it is the hair that is lost, not the follicle that contains the growth center (the follicle eventually produces the new hair).
Since the “hair” usually consists of a hair shaft and the inner and outer root sheaths, which creates a little bulb at the end of the hair, it looks like the hair is “falling out at the root.” Do not be concerned as this is not the growth center.
Posted by Updated 2017-12-01Q: 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.
Read more about hair loss in women or see before/after photos in our Women’s Hair Transplant Gallery.
Posted by Updated 2013-06-06Q: I have been reading about hair transplantation and I have a question concerning FUT (strip-harvesting). I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) will not a patient’s hairline also be shifted? That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me. — M.M., Great Falls, V.A.
A: The hair bearing area is much more distensible (stretchable) than the bald area and just stretches out after the procedure. As a result, the density of the hair in the donor area will decrease with each hair transplant session, but the position of the upper and lower margins of the donor area don’t move much – if at all. As a result, the major limitation of how much donor hair can be removed is the decreasing hair density, rather than a decrease in the size of the donor area.
Posted by Updated 2017-12-01
Our friends at the Hair Transplant Network have posted a 3-part video interview with Dr. Bernstein on YouTube. Click here to watch.
The 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.
Posted by Updated 2013-05-10Q: 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 Updated 2017-12-01
O, The Oprah Magazine has a feature on hair loss in women in their March 2010 issue. Dr. Bernstein was consulted for the article and discussed female hair transplantation.
Posted by Updated 2019-05-02“Since female hair loss is often diffuse, only about 20 percent of female patients with thinning hair are candidates, says Robert Bernstein, MD, a New York City dermatologist who specializes in these surgeries.”
Q: At what level of thinning should the hair transplant be done? — V.K., London, UK
A: A hair transplant should be considered in an area of thinning when:
Other factors that are important include:
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.
Posted by Updated 2013-06-06Q: When can patients go in the sun after a hair transplant? — S.M., Glencoe, I.L.
A: Following a hair transplant, patients should protect their scalps from the sun for about a month.
This does not mean one needs to stay indoors. It just means that after a hair restoration surgery you should wear a hat or a good sunscreen when outdoors.
Sunburns on the scalp should be avoided, not just for persons having a hair transplant, but for everyone.
Posted by Updated 2017-12-01Q: It has been over a month after my hair transplant procedure and I am starting to get nervous. When can I expect to see some growth? — J.N., Winnetka, I.L.
A: Transplanted hair begins to grow, on average, about 10 weeks after the procedure, although this number can vary. Hair tends to grow in waves and occasionally some new hair may start to grow as long as a year after your procedure. In general, growth is a bit slower with each hair transplant procedure, although the reason for this is not fully understood.
Posted by Updated 2017-12-01
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, Matt Lauer, Tiger Woods, Tom Brady, and many others.
Interest in celebrity hair transplants is not just reserved for film and TV stars, but for all kinds of professions in the public eye. Read on for the full article about celebrity hair transplant procedures.
Posted by Updated 2015-08-17Follicular unit extraction is a technique of removing one follicular unit at a time from the donor region. The most important limitation of this hair transplant procedure is a high transection rate during the extraction process. In this clinical study, the authors transplanted different parts of transected hair follicle when harvesting with the Follicular Unit Extraction (FUE) technique. Five male patients participated in the study.
In each patient, three boxes of 1 cm2 were marked at both donor and recipient sites. The proximal one-third, one-half, and two-thirds of 15 hair follicles are extracted from each defined box and transplanted in recipient boxes. The density is determined at 12 months after the procedure.
The authors concluded that the survival rate of the transected hair follicles was directly related to the level of transection. The authors demonstrated that even though some of the transected parts of the follicles can survive after being transplanted to the recipient site, the growth rate is not satisfactory and the hair is thinner than the original follicles. As a result of this study, the researchers recommend that the hair transplant surgeon does not transplant the sectioned parts and that they should be careful with the patients whose transection rate is high during Follicular Unit Extraction procedures.
Posted by Updated 2017-04-21Q: When can patients resume physical training? — T.M., Mineola, N.Y.
A: Moderate exercise may be resumed two days after the hair transplant.
The main limitation is to avoid putting direct pressure on the donor area and to avoid stretching the back of the scalp (neck flexion) as this will increase the chance of stretching the donor scar after a strip procedure.
There is no such limitation with follicular unit extraction (FUE). However, in general, contact sports should be avoided for at least 10 days with FUE and a month after a strip procedure.
Posted by Updated 2017-12-01
