Bernstein Medical Blog

This page contains all posts in our News, Answers, Video, and Research sections.

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How Does the ARTAS System, or the Surgeon, Determine the Depth of the Incision, and Can it be Adjusted During Surgery?

February 13th, 2015

Q: How does the ARTAS robot control the depth of the incision in Robotic FUE? — B.V., Old Greenwich, CT

A: The ARTAS robotic system is equipped with advanced sensors that determine the precise depth of the sharp and blunt needles used both in the graft harvesting step and for recipient site creation. The robot automatically adjusts to the precise depth needed for the non-traumatic extraction of the grafts. The tip of the punching mechanism contains depth markings so that the physician can visually override the punch when he wants to fine-tune its action. While monitoring the procedure in real time, if it is observed that the punches are too superficial or too deep, punch depth can be modified using the robot’s computer system.

The physician can also use the ARTAS system to precisely control the depth of recipient sites. As with harvesting, the robot automatically adjusts the depth based on parameters set by the physician and the doctor can then make further adjustments, in real-time, during the procedure.

Click here to read more about Robotic Hair Transplantation

Can a Hair Transplant Treat an African-American Woman with Scarring Alopecia?

January 13th, 2015

Q: 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.

Is a Robotic FUE Hair Transplant Painful?

January 9th, 2015

Q: Does Follicular Unit Extraction performed by a robot hurt more than regular FUE? — R.T., Greenwich, CT

A: As with manual FUE, robotic FUE hair transplantation is an outpatient procedure performed under long-acting local anesthesia – a combination of lidocaine and bupivacaine. After the initial injections, the patient does not experience any pain or discomfort.

Before starting local anesthesia, we give most patients oral valium and intra-muscular midazolam (a very fast acting sedative that is very relaxing). While some patients doze off at the beginning of the procedure, others prefer to watch TV, a film, or just chat.

Local anesthesia generally wears off after 4-5 hours, so for transplant sessions lasting longer than this, we will give more anesthesia before the first wears off. With Robotic FUE, there is no discomfort once the procedure is completed and the anesthesia wears off. This is in stark contrast to an FUT strip procedure which can be uncomfortable in the donor area for days to weeks.

Can I Play Contact Sports Right After a FUE Procedure?

December 29th, 2014

Q: Can I play a contact sport, like football, right after having a FUE procedure? — C.N., Easton, P.A.

A: I performed a study (“Graft Anchoring in Hair Transplantation,” Dermatologic Surgery 2006; 32: 198-204) to answer a simple question, one that patients ask all the time: at what point are transplanted grafts so securely anchored in the scalp that they cannot be dislodged?

In the study, it was found that after 10 days the transplanted grafts become a permanent part of the body such that no amount of scrubbing or combing can dislodge them. So, while there are generally no limitations on strenuous exercise after a FUE procedure, we recommend waiting at least 10 days before playing any contact sport, like football, as the grafts could be dislodged if vigorously rubbed.

How Does Laser Therapy (LLLT) Actually Work to Grow Hair?

December 29th, 2014

Q: How does laser therapy work?

A: The actual mechanism by which Low Level Laser Therapy (LLLT) stimulates hair growth (i.e., increases the anagen phase of the hair cycle) is unknown, but possible mechanisms include the following: stimulation of growth factors, dilation of follicle blood vessels, or increasing the production of ATP (molecular energy).

Robotic Hair Transplant Case Study with Bernstein Medical Patient

December 3rd, 2014

Restoration Robotics, the company that developed the ARTAS® Robotic Hair Transplant system, has published a white paper case study on how Dr. Bernstein utilizes the robotic system’s tools to minimize scarring after Robotic FUE.

The case study illustrated that the ARTAS Robotic Hair Transplant system’s suite of tools can minimize the detectability of scars after an FUE hair transplant.

How Many Hair Transplants Will I Need?

November 17th, 2014

Q: 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:

Establishing a permanent frame to the face by creating, or reinforcing, the frontal hairline.
Providing coverage to the thinning, or bald, areas of the scalp with the hair transplant extending at least to the vertex transition point.
Adding sufficient density so that the result will look natural.

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.

Study: High Hair Yields, Low Hair Follicle Transection Rates with ARTAS Robotic System in Korean Patients

November 13th, 2014

Research study determines the characteristics of robotically harvested hair follicles and finds that robotic FUE is able to efficiently harvest follicular units containing multiple hair follicles.

Is Propecia and/or Rogaine Mandatory after a Hair Transplant?

November 3rd, 2014

Q: I’ve heard that using Propecia and/or Rogaine is a good idea after having a hair transplant, but are they mandatory? — B.M., Short Hill, N.J.

A: Neither finasteride (brand name: Propecia) nor minoxidil (brand name: Rogaine) will have any effect on transplanted hair. That said, while you don’t need them to protect your transplanted hair, you will likely have original hair interspersed among your transplanted hair that will continue to thin and fall out over time. This vulnerable hair can be protected by finasteride which has been shown to reduce future hair loss significantly; additionally, you can add Rogaine for extra benefit.

However, with Propecia, you should only use it if you can commit to it long-term because it takes up to a full year to see any effect. With Rogaine, you should only use it if you can commit to using it continually and regularly – you should not stop and start it.

How Many Follicles Can You Transplant With Robotic FUE?

November 3rd, 2014

Q: How many follicles can you transplant with robotic FUE compared to manual FUE? — R.V., Upper West Side, N.Y.

A: We can extract the same number of follicles robotically as we can manually.

That said, the goal of any hair transplant procedure is not to transplant as many hair follicles as possible but rather to achieve the best possible cosmetic result given your degree of hair loss and the number of hair follicles available in your donor area.

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