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Q: Can you use a hair transplant to treat radiation-induced permanent hair loss in pediatric patients? A: Yes, but there are a number of things to consider: As in adults, if the hair loss from radiation is extensive, or involves the permanent zone of the scalp, there would not be enough donor hair to make […]
Posted by on 2020-02-25 Updated on 2024-08-20Q: I am preparing for FUT surgery and read about scalp laxity exercises. Will they better prepare me for my hair transplant? – O.U. A: For the majority of patients, there is enough scalp laxity so that exercises are unnecessary. If a patient’s scalp becomes too tight for FUT, we would switch to FUE. On […]
Posted by on 2019-12-04 Updated on 2024-08-20Q: 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.
Posted by on 2019-03-05 Updated on 2019-03-05Q: 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 on 2017-08-15 Updated on 2018-07-03Q: I’m a 42 year old African-American woman and I’m losing hair on the crown of my head. Would I be a good candidate for a hair transplant? — E.E., Philadelphia, P.A.
A: Hair loss in the crown of an African American female can have several different etiologies, so the first thing to do is to make the right diagnosis. The most common causes of hair loss are androgenic alopecia (AGA) and scarring alopecia, also called ‘Central Centrifugal Cicatricial Alopecia,’ or CCCA. A biopsy is often useful to differentiate these two causes of hair loss when the diagnosis is unclear. A biopsy can also identify other, but less common, causes of crown hair loss.
Patients with central centrifugal cicatricial (scarring) alopecia are generally not candidates for a hair transplant procedure since the body may reject the transplanted hair. This condition is better treated with oral and injectable anti-inflammatory medications.
Posted by on 2015-01-13 Updated on 2024-08-17Q: How Many Hair Transplants Will I Need? — E.E., New York, N.Y.
A: The first session of a hair transplant should be designed as a stand-alone procedure with the following three goals:
Achieving all of these goals will allow the first procedure to stand on its own.
Because of this, many people feel one hair transplant is sufficient.
Reasons for Second Hair Transplant
While the first session of a hair transplant is designed to stand on its own, there are several reasons why one would want a second hair transplant, such as increasing the density in a previously transplanted area; refining the hairline created in the first transplant; focusing on increased crown coverage, when appropriate; or addressing further hair loss that’s occurred after the first transplant.
Posted by on 2014-11-17 Updated on 2017-12-01Q: I have a significant amount of hair loss. Can a hair transplant make me look exactly the way I did before I lost my hair? — V.S., Fairfield, C.T.
A: In most cases, the answer is no. All surgical hair restoration procedures move hair – they cannot create new hair. Specifically, surgical hair transplantation takes existing hair from the donor area (located in the back and on the sides of the scalp) and moves (transplants) them to the part of the scalp that has lost hair. It is usually the case that there is not enough hair in one’s donor area to replace all lost hair. That said, in persons with extensive hair loss, the restoration can often produce a dramatic improvement in one’s appearance.
Posted by on 2014-05-15 Updated on 2024-08-20Q: My hair is thinning, but I’ve been told I have too much existing hair to warrant a hair transplant. I heard that transplanting new hair into my thinned areas will lead to a loss of existing hair follicles. I was told to delay a hair transplant procedure until my density has further decreased. Is this true? — M.S., Maple Glen, P.A.
A: It is possible that you simply don’t need a hair transplant at this time one. If you have early thinning, it may be best treated with medication, or not at all. As you age, we will have a better idea of your thinning pattern and, at that time, a hair transplant may be more appropriate.
A hair transplant does not cause loss of hair follicles in the recipient area. The procedure may cause a temporary “shock” loss of the hair. Shock hair loss is a physiologic response to the trauma to the scalp which is caused by a hair transplant. Hair that is healthy is going to come back after some period of time – generally 6 months. Hair that may be near the end of its lifespan may not return. When a hair transplant is performed at the proper time, in the proper candidate, shock hair loss should just be an incidental issue.
Posted by on 2014-05-08 Updated on 2018-07-03Q: I know Dr. Bernstein is one of the leading hair restoration surgeons in the country but what about his medical assistants? How experienced are the hair restoration technicians that help him during surgery? — E.N., Redding, C.T.
A: My medical assistants and technicians are full time employees, and many of them have worked closely with me for many years; in fact, many of them have been with me since the inception of FUT, the procedure I pioneered way back in 1995. I do not hire, nor have I ever hired, per diem technicians.
All my hair restoration technicians are highly skilled and experienced in stereo-microscopic dissection and follicular unit graft placement. Even with Robotic FUE, being highly skilled and experienced in stereo-microscopic dissection is important since every graft that the robot harvests is examined, counted, and, when necessary, trimmed to ensure they are of the highest quality before being implanted into the scalp.
Because of the intense in-house training of our staff, we have received national accreditation from the “Accreditation Association for Ambulatory Health Care” (AAAHC/Accreditation Association) for maintaining rigorous standards in patient care.
Read more about how we train our surgical staff.
Posted by on 2014-03-24 Updated on 2020-10-21Q: 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 on 2014-03-18 Updated on 2017-12-01Q: Can you do a hair transplant using someone else’s hair? — K.K., Garden City, N.Y.
A: Unfortunately, this is not possible because your body would reject the hair transplant without the use of immunosuppressive drugs. The problem with immune suppressants is that they will lower your natural immune response, increasing your susceptibility to infections and even cancer, and you’ll have to take them for the rest of your life.
A transplant using someone else’s hair is also not desirable for aesthetic reasons. There’s the style of the hair, its texture, thickness, color, etc. Trying to find the perfect donor whose hair would complement and flatter your particular features and blend in with your remaining hair would be a significant, if not impossible, challenge. It would be possible, however, to transplant the hair from one identical twin to another, but most likely if one went bald, so would the other.
Posted by on 2014-02-18 Updated on 2017-12-01Q: 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:
Posted by on 2014-01-24 Updated on 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 on 2013-07-25 Updated on 2024-08-14Q: 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“.
Posted by on 2013-07-01 Updated on 2024-08-14Q: I have seen through forums that a hair transplant gives severe shock loss in the donor zone (especially behind ears) after the surgery. Doctors say it is temporary and can last about six months or more. Frankly, do you believe in this? Will the donor shocked hair recover? — M.D., Darien, C.T.
A: It depends if you are speaking about follicular unit hair transplantation using strip harvesting (FUT) or Follicular Unit Extraction (FUE). With FUT, it is extremely uncommon to have any shock hair loss in the donor area. This could occur if the hair transplant procedure was done improperly, i.e. the donor area was closed too tightly. In this case, some hair loss may be permanent. This is one of the reasons that very large hair transplant sessions are unwise. Shock hair loss in FUE is more common, but is generally not significant and should eventually recover completely.
That said, some shock hair loss in the recipient area is quite common with either hair restoration procedure (FUT or FUE). This is particularly the case if there is a lot of existing miniaturized hair (hair that is starting to thin) in the transplanted area.
Posted by on 2013-04-23 Updated on 2017-12-01
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