Bernstein Medical
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The patient was in his late 40s. He chose not to take finasteride, although it was advised.
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I think Dr. B is a pioneer and very good but way too conservative IMO. Too many examples of NW 4+ starting out with 1200-1500 grafts when they clearly need a much bigger start. I have asked the question several stimes of Dr. B on this forum but have never gotten a response as to why such a ultra-conservative approach. SMG is also conservative but not too conservative and I would consider their philosophy pretty solid.
There is conservative, agressive, and then there is Dr. Bernstein.
Having said all that, it is a nice natural result and good coverage for the amount of grafts. Imagine if he did 3000.....
I transplanted this patient on March 7, 2000 (over 11 years ago) when we were using fewer grafts. I have been posting patient on the net since 1995 so a fair number of cases were done years ago. I would judge these cases by their naturalness. I agree, if transplanted today, I would have used significantly more follicular unit grafts - perhaps double this number.
That said, in my opinion, it is generally a mistake to value a transplant on the absolute number of grafts - with more being better than less. The "art" is to get the best cosmetic improvement while conserving the most donor hair for the future, particularly in a patient with limited hair loss. With well placed/positioned grafts and a high percentage of graft survival, sessions of 3,000 and up are often not needed and the more "conservative" proceedure has a lower risk of significant donor scarring, better graft survival and, of course, conserves hair for the future.
Sincerely,
Dr. Bernstein
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Bernstein Medical - Center for Hair Restoration Patient FEI was a Norwood Class 4A with medium weight, straight brown hair. Photo taken after one hair transplant session of 1,210 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After One Session
Detail of Hairline:
Note the different looks achieved with back vs. side-to-side grooming and the much greater appearance of fullness with the latter.
Left: Before Hair Transplant
Center-Left: Position of Hairline
Center-Right: After 1st Session, Combed Diagonally Back
Right: After 1st Session, Left to Right Grooming
Visit our Hair Transplant Gallery to view this patient's complete photo profile:
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Bernstein Medical - Center for Hair Restoration patient VSQ had multiple hair transplant procedures that left him with a frontal rim of plugs and marked central baldness that was difficult to camouflage, even with a comb-over. In addition, he had scarring at his frontal hairline and a substantially depleted donor supply. Four repair procedures were performed to remove the large grafts and redistribute them as individual follicular units in the front and mid-part of his scalp. In the fifth procedure, we transplanted an additional 1,184 follicular units from the donor area into the front and mid-portion of his scalp.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant Repair
Right: After Five Repair Sessions
Top View:
Although VSQ still relies on combed over hair to add fullness to the top part of his scalp, note the natural appearance of the restoration.
Left: Before Hair Transplant Repair
Right: After Five Repair Sessions
View this patient's complete photo profile on our website at Patient VSQ
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Bernstein Medical - Center for Hair Restoration patient JIH had 4 scalp reductions that resulted in a significant Y-shaped deformity on the top of his head, a partially depleted donor supply, and a tight scalp. This makes future hair transplantation procedures difficult by limiting the total number of grafts that can be transplanted. The “After” photo shows the results of one hair transplant session of 1,825 follicular unit grafts. A second procedure is planned to add more density. See thumbnails for a view of the top of JIH’s scalp.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant Repair
Right: After One Repair Session
Scalp Reduction Scars and Camouflage:
Four scalp reductions leave significant scarring on the top of the scalp in a geometric pattern and altered hair direction. This is camouflaged with the transplantation of 1,825 follicular unit grafts that are integrated with the existing hair. The density of the area will be increased in a future procedure.
Left: Y-shaped Scalp Reduction Scar
Center: Recipient Sites in 1st Repair Session
Right: After 1st Hair Transplant Repair Session
Detail of Hairline:
Note the natural looking hairline produced after just one session.
Left: Position of Hairline
Center: Recipient Sites
Right: After 1st Hair Transplant Repair Session
View this patient's complete photo profile on our website at Patient JIH
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Bernstein Medical - Center for Hair Restoration patient FKQ is an advanced Norwood Class 6 with straight, very fine, brown hair. Results after two hair transplantation procedures totaling 3,703 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After Two Sessions
Detail of Hairline:
Left: Hairline Position Marked
Center: After 1st Hair Transplant Session
Right: After 2nd Hair Transplant Session
View this patient's complete photo profile on our website at Patient FKQ
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Bernstein Medical - Center for Hair Restoration patient JAF is a Ludwig Class 2 pattern of hair loss, with diffuse thinning on the top of her scalp that is more significant towards the front. She has dyed brown, straight, medium fine hair with a donor density of 2.2. Results 13 months after one hair transplant session of 2,656 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After One Session
Detail of Hairline:
Left: Before Hair Transplant
Center: Hairline Position Marked
Right: After 1st Hair Transplant Session
Top View of Hair Restoration:
Left: Before Hair Transplant
Center: After 1st Hair Transplant Session
Visit our Women's Hair Transplant Gallery to view this patient's complete photo profile:
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Bernstein Medical - Center for Hair Restoration hair transplant patient BOI is an African-American female with hair loss confined to her frontal hairline and temples. This pattern, called Alopecia Marginalis, is relatively common and is often, but not always, caused by persistent traction on one’s hair. BOI has medium fine hair and a donor density of 1.8 hairs/mm2. Results after only one hair transplant session of 1,698 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After Two Sessions
Detail of Hairline:
Left: Before Hair Transplant
Center: Hairline Position Marked
Right: After 1st Hair Transplant Session
Right Side View of Hair Restoration:
Left: Before Hair Transplant
Center: Hairline Position Marked
Right: After 1st Hair Transplant Session
Left Side View of Hair Restoration:
Left: Before Hair Transplant
Center: Hairline Position Marked
Right: After 1st Hair Transplant Session
View this patient's before and after hair transplant photos and rate her results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient FBQ is a Norwood Class 6 with slightly wavy, light brown hair and a donor density of 1.5. He had an old plug procedure in 1972. The results shown are after the excision of 28 large grafts and two follicular unit hair transplants spaced one year apart. The FUT procedures consisted of 2,204 and 1,919 grafts each, totaling 4,123 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Detail of Hairline:
Note the large grafts in the first photo. These were removed, divided up under the microscope and re-implanted as individual follicular unit grafts. The second photo shows the patient after this procedure has healed and just prior to the first actual hair restoration.
Left: Before Plug Excision
Center: After Plug Excision Phase of Procedure
Right: Position of Planned New Hairline
Left: After 1st Hair Transplant Session
Right: After 2nd Hair Transplant Session
View this patient's before and after hair transplant photos and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient ABI is a Norwood Class 3 with black, medium coarse hair and a donor density of 2.8. Results after three hair transplants totaling 2,046 follicular unit grafts. Please excuse the poor quality of his before photo. It was taken with a Polaroid at the time of his first consult.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After Three Sessions
Detail of Hairline:
Note how the original hairline was planned with some temporal recession. ABI decided that he preferred a broader hairline and this was accomplished in the following sessions.
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
View this patient's before and after photos and rate his hair transplant results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient LAB is a Norwood Class 6 with slightly wavy, brown hair and a donor density of 2.2. He had two hair transplants to the frontal area spaced one year apart consisting of 2,429 and 2,004 grafts each and totaling 4,433 follicular unit grafts over the two hair restoration sessions.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Detail of Hairline
Left: Before Hair Transplant
Center: Position of Hairline
Right: After 1st Hair Transplant Session
Left: Position of Hairline for 2nd Hair Transplant
Right: After 2nd Hair Transplant Session
View this patient's before and after photos and rate his hair transplant results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient HND is a Norwood Class 5A/Early 6 with wavy, medium weight, salt and brown hair and below average donor density. Results after two hair restoration sessions totaling 3,160 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Change In Appearance Over Two Hair Transplant Sessions:
Patient HND after one session showing a thin, but natural look and after two sessions with more fullness.
Left: Position of Hairline
Center: After 1st Hair Transplant Session
Right: After 2nd Hair Transplant Session
View this patient's hair transplant surgery pictures and rate his hair restoration results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient FMI is a Norwood Class 5a with curly, light brown hair. Results after one hair restoration procedure of 2,477 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Positioning the Hairline
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Top View
Left: Before Hair Transplant
Center: Hairline Position
Right: After 1st Hair Transplant Session
View this patient's pictures and rate his hair restoration results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient RKS is a thinning Norwood Class 3V with straight, brown hair and a donor density of 2.3 hairs/mm2. Results after one hair transplant with grafts distributed over the front and top of his scalp and his crown. Of the 2,298 follicular unit grafts transplanted in this session, 620 of these were placed in his crown.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Restoration of Hairline
Left: Before Hairline Restoration
Right: After Hairline Restoration
Top View
Left: Before Hairline Restoration
Right: After Hairline Restoration
Back View
Left: Before Crown Restoration
Right: After Crown Restoration
View this patient's hairline and crown transplant photos and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient EJA is a Norwood Class 6 with brown, straight fine hair and a donor density of 2.0. Results after two hair transplant sessions totaling 2,949 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Detail of Hairline:
Hairline position and results after two sessions. In photo after 2nd session, note that pinkness at hairline is from a recent sunburn.
Left: Before Hair Transplant
Center: Position of Hairline
Right: After 2nd Hair Transplant Session
Top View:
Top view before and after two sessions.
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Change In Appearance Over Two Hair Transplant Sessions:
In a person with fine hair and only one session, combing the hair straight back will not take advantage of layering and will appear thin, although natural. Compare this to the photo after two sessions with the hair combed to the side. In photo after 2nd session, note that pinkness at hairline is from a recent sunburn.
Left: Before Hair Transplant
Center: After 1st Hair Transplant Session
Right: After 2nd Hair Transplant Session
View this patient's photos and rate his before and after hair transplant results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient GEL is a Norwood Class 4A with straight brown hair and a donor density of 2.5 hairs/mm2. He had one hair transplant to the frontal area consisting of 2,010 grafts. Photos were taken before and then one year after the hair restoration.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Detail of Hairline
Results in a patient with relatively high donor density.
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Top View
Hair restoration from above.
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
View this patient's hair loss surgery pictures and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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This is obviously a home run result regardless of charetceristics. How in the world were you able to achieve such a result with only 2336 grafts? Can you by any chance post graft placement info, grfats per sq/cm, etc.
Well done!!
"Can't decide," thank you for the compliments.
I have posted more details on this case in response to your question, along with a link to my paper “The Aesthetics of Follicular Transplantation."
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Bernstein Medical - Center for Hair Restoration patient UAR is a Norwood Class 6 with slightly wavy, black hair and a donor density of 1.5 hairs/mm2. He had one hair transplant consisting of 2,336 follicular unit grafts. Photos were taken before and then one year after the hair restoration.
The patient had 2,336 follicular unit grafts placed over an area of approximately 150cm2; therefore, the average density is just under 16 grafts per cm2. The reason why the patient’s transplant looks so full is first, because he has wonderful hair characteristics — i.e. dark, wavy, coarse hair on dark skin — and second, I forward weighted the hair transplant so that in the frontal forelock (an area of about 50cm) I placed 1,250 grafts giving a density of 25 follicular units/cm2. The other 1,086 grafts were placed in the remaining 100cm2. Another trick that I use to give the appearance of more fullness is to place the larger follicular units (those containing 3- and 4- hairs) in the central-forelock area. I first described these techniques over a decade ago in my paper “The Aesthetics of Follicular Transplantation” (pdf).
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Detail of Hairline
Left: Before Hair Transplant
Center: Position of Hairline
Right: After 1st Hair Transplant Session
Top View
Left: Before Hair Transplant
Center: Position of Hairline
Right: After 1st Hair Transplant Session
View this patient's pictures and rate his hair transplant surgery results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient VQC is a Norwood Class 5 with a high donor density (2.9) and wavy, dark hair. Results after two hair transplant sessions totaling 3,518 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Detail of Hairline
Because the hair is planted in a forward direction, the hair rests on the forehead below the marked hairline. This is accentuated by the wave. If the hairline were placed any lower, the overall look would not be as natural.
Left: Position of Hairline
Right: After 2nd Hair Transplant Session
Top View
Detail showing great coverage, but some thinness in the mid scalp. Density was added to this area on a subsequent hair restoration session.
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
View this patient's pictures and rate his hair restoration results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient EIQ has a Norwood Class 3 hair loss pattern with early diffuse thinning across the top of his scalp called Diffuse Patterned Alopecia (DPA). He has fine, blond hair with above average density. Results after three Follicular Unit Hair Transplants totaling 3,773 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 3rd Hair Transplant Session
Detail of Hairline
Note how a small session of 820 grafts adds enough density so that EIQ can comb his hair back and have the same appearance of fullness as when he combed it to the side (and took advantage of layering).
Left: Position of Hairline
Center: After 2nd Hair Transplant Session
Right: After 3rd Hair Transplant Session
Top View
Distribution of recipient sites in the first session and the final appearance.
Left: Recipient Sites
Right: After 3nd Hair Transplant Session
View this patient's before and after hair transplant pictures and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos Hairlines section:
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Bernstein Medical - Center for Hair Restoration patient GJK is a Norwood Class 5A with light brown, very fine hair and an above average donor density. Results after two hair restoration sessions totaling 2,433 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Top View
View showing the integration of follicular unit grafts into surrounding hair.
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
View this patient's Hair Restoration Surgery Pictures and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
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Bernstein Medical - Center for Hair Restoration patient BGD is a Norwood Class 6 with medium weight, slightly wavy hair of average density. Results after two hair transplant sessions totaling 3,005 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Detail of Hairline
Position of hair line and results after each session. Note how the hair is still a little wooly after the first session, but regains the original texture after the second session.
Left: Before Hair Transplant
Center: After 1st Hair Transplant Session
Right: After 2nd Hair Transplant Session
Top View
Note the slightly thin but totally natural look. An additional session can be used to add density.
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
View this patient's hair transplantation pictures and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos Hairlines section:
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Bernstein Medical - Center for Hair Restoration Patient QJS has hair loss limited to the front part of his scalp (Norwood Class 4a) and has medium to coarse black hair. Results after two hair transplant procedures totaling 3,523 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 2nd Hair Transplant Session
Detail of Hairline
Because of the patient's excellent donor density and limited hair loss, 2,085 grafts were placed into the frontal area in the first session.
Left: Before Hair Transplant
Center-Left: Position of Hairline
Center-Right: Recipient Sites
Right: After 1st Hair Transplant Session
Change In Appearance Over Two Hair Restoration Sessions
Multiple views after a second hair transplant session of 1,438 grafts.
Left: Before Hair Transplant
Center-Left: After 2nd Hair Transplant Session, Front
Center-Right: After 2nd Hair Transplant Session, Side
Right: After 2nd Hair Transplant Session, Top
View this patient's profile and rate his results in the Bernstein Medical - Center for Hair Restoration Hair Transplantation Photos section:
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Bernstein Medical - Center for Hair Restoration patient BES is an early Norwood class 6 with light brown, straight, medium fine hair with a donor density of 2.5. Results after one hair transplant session of 2,320 follicular unit grafts.
Click the thumbnails below for a larger view.
Before / After:
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
Detail of Hairline
Although the hairline is placed 1.5 cm above the patient’s upper brow crease, the weight of the hair causes it to lie down on the patient's forehead.
Left: Position of Hairline
Right: After 1st Hair Transplant Session
Top View
Although the patient has great results, the part-side could use a little more fullness. This will be accomplished in the second session.
Left: Before Hair Transplant
Right: After 1st Hair Transplant Session
View this patient's profile and rate his results in the Bernstein Medical - Center for Hair Restoration Patient Photos section:
Bernstein Medical (Dr. Robert M. Bernstein) / Norwood 6 / 4,433 grafts
in Results Posted by Leading Hair Restoration Clinics
Posted
Yes, I am involved in all of the procedures.