Coalition Surgeons

Pat - Publisher of this Community · #1 **Top** 04-11-2007, 09:33 AM

I'm pleased to present Dr. Bernie Nusbaum of Miami, Florida for potential membership in the Coalition of Independent Hair Restoration Physicians. Dr. Nusbaum has outstanding credentials and has been exclusively performing state of the art hair transplantation since 1985, with over 10,000 hair transplants performed.

He has been recommended on the Hair Transplant Network for over four years (click here to view his profile/recommendation) and has consistently garned excellent patient reviews on this and other discussion forums.

I have had the privelage of observing him and his staff perform ultra refined follicular unit grafting (see the photos and highlights on this forum). In my opinion Dr. Nusbaum, his staff and procedure are truly outstanding. He is also one of the most gracious, compassionate and humble men I've ever met, especially given his stature in the hair restoration profession.

As a hair transplant patient himself, Dr. Nusbaum has a keen sensitivity for patients that permeates his entire clinic and his surgical results. Dr. Nusbaum under went hair transplant surgery in the early 1980's to treat his own hair loss. He prides himself in having a one on one relationship with all his patients and giving his home number to all his patients.

Dr. Nusbaum has not only kept pace with improvements in hair transplant techniques but contributed his considerable skills and ideas in numerous international meetings and medical journals.

In recent years Dr. Nusbaum and his staff have incorporated the use of very tiny custom cut blades that enable them to make tiny dense packed incisions that are as small as .7 mm. His highly experienced staff of ten medical techs are capable of producing thousands of extremely refined grafts that are trimmed to fit in these tiny incisions. Dr. Nusbaum carefully orientates all the graft incisions in a manner to assure that the transplanted hair will grow out in at the proper angles and directions to maximize naturalness.

In my opinion, Dr. Nusbaum has all the "right stuff" to take his rightful place among the proven handful of truly elite and ethical physicians of the Coalition of Independent Hair Restoration Physicians.

However, prior to any physician being granted membership in the Coalition they must also gain approval from the active members of this patient community as well from the current physician members of the Coalition.

As part of this review process I requested that Dr. Nusbaum send me photos of at least ten cases, including immediate post op photos. The photos that he sent to me are now presented in four different photo albums on this forum:

Immediate post operative photos demonstrating ultra refined and minimally invasive techniques

Large mega sessions that demonstrate his clinic's capability to transplant a large number of hairs (over 7,000 hairs or aproximately 3,000 follicular unit grafts) successfully in a single session.

Expert repair/updating of hair transplants previously performed by other clinics

Other cases presenting temporal hairline restoration and treatment of traction alopecia

To see more impressive patient photos visit Dr. Nusbaum's photo gallery on his website.

Videos of him performing surgery are also available on his website at http://www.miamihair.com/videos.html

Please feel free to post any comments or suggestions regarding the potential Coalition membership of Dr. Nusbaum by replying below.

Thank you in advance for your input and opinions.

Patrick Hennessey - Patient Advocate for the Coalition of Independent Hair Restoration Physicians

the B spot · #2 **Top** 04-11-2007, 10:30 AM

I think Dr. Nusbaum is a very good HT doc.

I know that in past years he was not necessarily thought of as a top flite doc, but in viewing the post-op pics Pat has provided he seems to have discarded the use of mini-grafts and moved to using all refined follicular units on every patient.

I seem to recall some issues with Dr. Nusbaum and Spencer Kobren a few years back, but I cannot remember exact details.
(not that this means anything)

Anyway, I think Dr. Nusbaums inclusion into the Coalition is a natural step for those docs on our recommended list who meet or exceed Coalition criteria.

It is good to see that a Doc is striving to embrace a more labor intensive approach to meet the demands of today's educated consumer.

I think his work meets our expectations.

I would like to see many more African American patients before I am comfortable recommending him over other Coalition Docs in this particular category.

I would also like to see some FUE patients with donor shaved after surgery.

Thanks Pat,
J

spex · #3 **Top** 04-11-2007, 10:32 AM

spex · #4 **Top** 04-11-2007, 10:33 AM

I do not know a great deal about him but hopefully that will change and his patients can share their experiences etc here - it all appears to be Good stuff!

Bill - Managing Publisher · #5 **Top** 04-11-2007, 10:55 AM

I think everyone above has the right idea. I know he's been recommended for sometime now, and the pictures that I've seen so far (before/after/post-op), he does seem to do quality work.

Though this is seldom asked, I'd like to know approximately the maximum session size he's ever performed via strip and via FUE. Though obviously a lot depends on the patients individuality, it has been proven that some docs are simply more conservative and some are more liberal in terms of what they are comfortable extracting in a single session. I see from the mega-session link that the largest posted here is 3493 grafts...has he done larger and what conditions does a patient have to meet in his opinion to do a larger session? I dont want to paint the impression that I'm counting a 3493 session as a small session...but today that seems pretty average.

If possible, I'd also like to see some close-up shots of the scar from both FUE and Strip where the patient's hair is clipped short.

I would like to see either his clinic and especially his patients post here on a somewhat regular basis with their results...I'd actually like to see every coalition doctor's patients and/or clinic do this.

Other than the above, I don't see why he shouldn't be counted among the coalition doctors assuming that he continues to be consistent with his results.

Bill

hairbank · #6 **Top** 04-11-2007, 11:24 AM

I reviewed all pics posted here and took a look at the Docs website. I believe all pictures here show quality work with respect to small incisions, dense packing...overall undetectable results which is what you're looking for. I also would like to see some scar pics both FUE and STRIP if possible.

One thing I would mention about his website is that I didn't see graft counts with the before/after pics. IMO without this information, there's no way prospective HT patients can determine what exactly is being produced by the Doc............hopefully they can make this addition.

Pat- I trust your judgment................the only work I remember seeing from this Doc is what you've posted here. If you've researched him enough to feel comfortable adding him to the Coalition Surgeons, I agree he should be added. I see nothing posted that would shy me away from referring to him.

It would be great to see he and/or his clinic and Techs become involved on the forum.

nobuzz4me · #7 **Top** 04-11-2007, 02:39 PM

I will second Hairbank's post.

I think scar pics for all docs should be mandatory. Seems like the patients themselves are the only ones to provide them.

Pat - Publisher of this Community · #8 **Top** 04-11-2007, 08:00 PM

Community members,

Thank you for your thoughtful feedback and input regarding Dr. Nusbaum's potential membership in the Coalition.

Dr. Nusbaum has provided me with the hair counts for his various surgeries and I have added them in to his photo albums. He is also committed to providing complete hair counts for all his cases, including seperate counts for 3 and 4 hair grafts.

Dr. Nusbaum also read the above replies and asked that I post his response (see below).

Quote:

I would like to thank the members of the community for evaluating my results and for the excellent comments and suggestions. I would like to make some remarks to clarify some of the issues that have been raised.

First of all, as you can see from the hair counts which I have provided both in the immediate postoperative photos and the before and afters, I do not perform sub-follicular unit grafting. In fact, I am not a proponent of using single hair grafts at all, in areas such as the crown, where patients frequently complain of lack of density.

The maximum number of grafts that I have performed in one session is 4380 follicular unit grafts. My criteria for performing larger sessions include: a high density donor area, a well-established baldness pattern and donor areas with sufficient scalp laxity whereby large numbers of grafts can be obtained while still creating a fine donor scar (interestingly, it is well recognized that a small percentage of patients with very loose scalps, especially young patients, can heal with wider donor scars so, again, each patient has to be evaluated individually).

Although I do not perform sub- follicular unit grafting, I have been involved in the hair restoration field long enough (I performed my first procedure in 1980) to realize that one has to keep an open mind to different techniques and ideas. Sub- follicular unit grafting, in fact, may be appropriate for certain patients with coarse hair who wear very short buzz cuts -- giving these patients an even distribution of hair throughout the recipient area.

Again, I am not advocating this technique nor do I perform it. But I do want to make a point regarding the value of not totally rejecting certain concepts.

With regards to the comment referring to my use of mini-grafting, I am not here to defend the technique, but only to say that some of us who were performing transplants in the 1980s, utilized the technique with artistic sense. Nevertheless, I discarded that technique long-ago, having performed my first 1000 graft FUE session in 1996 and adopted exclusive follicular unit transplantation shortly thereafter, demonstrating the technique on the Discovery Channel in 1998.

Finally, I agree with those of you who feel that showing photos of donor scars is extremely important for patients -- as requested, I am looking forward to providing those photos as well as additional photos of procedures I performed in patients of African descent.

Again, I would like to thank you for your comments and sincerely welcome the opportunity to interact with you via this forum. I commend all of you for the great service that you provide individuals with hair loss.

Sincerely,

Bernie Nusbaum

Bill - Managing Publisher · #9 **Top** 04-12-2007, 05:51 PM

Pat,

Thank you for posting Dr. Nusbaum's well documented reply...he is certainly meeting the call of the forum by providing what we asked for...that is commendable without a doubt!

Dr. Nusbaum,

Thank you for the detailed reply. I have a few more comments for you if you'd oblige:

Quote:

In fact, I am not a proponent of using single hair grafts at all, in areas such as the crown, where patients frequently complain of lack of density.

Just so there is no confusion whatsover, you DO use single hair grafts for the hairline I assume? I believe, just as many doctor's do that it is imperative to use single hairs to recreate the hairline, making for a softer more natural appearance.

Being that you are not an advocate of sub-follicular unit grafting (I'm not either by the way), are there times where you MAY divide some FUs in order to create more singles needed for the hairline? I have seen cases where there are very few singles, and not enough needed to create the hairline. What is your stand on this? I know a lot of clinics do this and it is still not considered sub-follicular unit grafting since only a few grafts may be split.

4380 FU grafts is certainly a decent size session. Do you see a time in the future where you will be doing larger sessions? Obviously this is a very broad question because each patient has INDIVIDUAL characteristics and needs to be treated individually. But I know that there are a few hair transplant clinics that have pushed the envelope and do 5000+ FU graft megasessions IF the situation calls for it. Yet there are other clinics who feel that this type of session is too risky and therefore not safe. Just wondering where you stood on such an issue.

I look forward to seeing more pictures, especially those of the donor areas. Thank you for participating in this discussion and I look forward to seeing more from you and your patients on the forum.

Bill

Dr.Nusbaum · #10 **Top** 04-13-2007, 02:22 PM

Without question,I utilize single hair follicular units at the front edge of the hairline. I also separate follicular units to obtain the necessary number of single hairs when sufficient numbers are not available.

I am keeping an open mind on the issue of larger megasessions.

Dr.Nusbaum

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