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July 6th, 2007

Q: I am a 21 yrs old male having serious hair loss over the last few years. I also have very little facial hair. Since Propecia is a DHT blocker can it inhibit beard growth? — E.M., Astoria, N.Y.

A: As you suggest, it would be reasonable to assume that since DHT stimulates beard growth, blocking DHT (with finasteride) would tend to inhibit its growth. In practice, this does not seem to be the case, i.e. we don’t find that Propecia has any effect on facial hair. The reason is not clear.

July 5th, 2007

Q: It had been 5 months since my hair transplant. I only see minimal growth of maybe a few hundred fine hairs. My transplant consisted of 2,217 grafts. Could you give me your opinion if this is normal or is it a failed hair transplant? — L.D., Miami, F.L.

A: It is too early to tell. Hair grows in very gradually with great variability from person to person.

Some patients only have a little fuzz at five months and then have great growth by one year.

You really need to wait the full 12 months to evaluate the success of the hair restoration.

June 25th, 2007

Q: I heard that a smaller per cent of women are candidates for hair transplants compared to men. Is this true?

A: Yes, that is true. Women more commonly have diffuse hair loss where the thinning is all over the scalp. This means that the donor area (the back and sides of the scalp) are thinning as well.

If the donor area is not stable, then there is no point in doing a hair transplant, since the transplanted hair will continue to fall out. Remember, the transplanted hair is no better than the area where is comes from.

On the other hand, women with stable donor areas can be great candidates for surgical hair restoration. The stability of the donor area can be assessed using a procedure called densitometry and should be part of the hair loss evaluation when you see your physician.

June 25th, 2007

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.

June 12th, 2007

Q: I have seen some incredible photos on some websites. In some cases, they seem too good to be true. Are they real? — P.V., Jersey City, N.J.

A: Evaluating results is more complicated than simply looking at photos – even if they are un-retouched and not studio shots.

For example, if 4,000 grafts were used to make a young person’s hair line look very dense, you might say that was a spectacular result. However, if he only has a total of 6,000 follicular units in his donor area (the average), then he is going to have many problems as he continues to bald, since there will be only 2,000 grafts left for the rest of his head.

June 11th, 2007

New York Magazine - Best Doctors 2007 - Dr. BernsteinRobert M. Bernstein, MD has been selected as one of New York Magazine’s “Best Doctors” for the eighth year in a row. He is the only hair restoration surgeon honored to be included in this list of prominent physicians for eight consecutive years.

The physicians are chosen through a peer review process by Castle Connolly Medical, Ltd., publishers of the guidebook Top Doctors.

June 10th, 2007

Q: Dr. Bernstein, why have you not had a hair transplant? I’m sure this question gets asked a lot. Thanks. — I.L., Kentfield, CA

A: Yes, all the time.

My donor area is very thin (so I am not a good candidate) and I have gotten used to being bald. It has been years.

June 9th, 2007

Q: Can dermabrasion help eliminate the circular edges of raised plug grafts caused by old hair transplants? Is this similar to the suturing and excision look?

A: Although dermabrasion can flatten elevated edges, it will not eliminate the round, white, circular scars that result from old punch graft hair transplants. The scarring in these procedures goes all the way through the dermis to the fat. Dermabrasion can only go down to the upper part of the dermis without causing further scarring.

Graft excision with suturing removes the plug as well as the underlying scar and eliminates the tell-tale circular marks of the older hair restoration procedures.

June 8th, 2007

Q: I was looking at the hair transplant photos on the Bernstein Medical website. I noticed that you and the NHI website have some of the same pictures. Did you both perform surgeries on these people? — B.B., Columbus Circle, N.Y.

A: All of the patients that appear on the Bernstein Medical website were operated on by me personally. My own staff assisted me in these procedures.

I worked with Dr. Rassman at NHI from 1995 to 2004. Photos of patients that I operated on during this period may therefore also appear on the NHI website.



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