All posts by Tempus Hair Restoration

Is the Combined FUE and FUT Right for You?

Male Hair Restoration, ,

Men experiencing advanced hair loss may feel that they are beyond the help that hair restoration surgery can provide – or feel discouraged over the length of time and number of surgeries required to achieve results. With the breakthrough combined FUE and FUT procedure gaining prominence, however, those who believed that they had to resign themselves to baldness are wondering if this is the ideal solution for their situation.

For those just learning about hair transplant procedures, Tempus Hair Restoration provides the following definitions:

Follicular Unit Excision (FUE) – In this procedure, follicular units (hair grafts) in groupings of one, two or three hairs are individually extracted from the back of the head (donor area) using small circular punch blades instead of a scalpel. The grafts are then transplanted to the thinning or balding areas of the scalp. Once the desired number of grafts are obtained, the donor sites are left to heal without suturing. The resulting scars are not readily visible and are easily concealed even by very short hair.

Follicular Unit Transplantation (FUT) – Also known as the “strip” method, the FUT procedure involves harvesting a very small strip of hair and skin from the donor area, then placing it under a microscope to be prepared for implantation as hair grafts. The FUT has undergone refinements over the years so that the only evidence is a pencil-line linear scar easily concealed by hair – even at a shorter length.

Our blog post – “An Up-close Look at Hair Grafts” – covers the anatomy, harvesting, treatment, preparation and implantation of grafts in greater detail.

What is the Combined FUE and FUT Hair Transplant Procedure?

Although the FUE and FUT are different procedures, they can be used in tandem. Among his many contributions to the hair transplantation field, Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – is known for pioneering the combined FUE and FUT technique, which covers large areas of baldness in a single surgery. Patients with advanced hair loss are typically required to undergo multiple hair transplant procedures to obtain coverage of their entire bald scalp – having to wait one year or more between procedures. The reason is that most practices – particularly those solely offering FUE treatments – can move only a certain amount of grafts in one procedure, due to limitations of the surgeon’s experience and/or surgical staff. The combined FUE and FUT allows patients to reach their ultimate goal sooner, with one procedure versus many.

Performed during the same surgery, each type of procedure makes it possible to harvest grafts from different donor areas in order to attain the optimum number for transplantation – without the risk of overharvesting. This is important, as once a graft is harvested from a donor site, hair will never grow there again. An inexperienced surgeon – such as one who specializes in another area, such as cosmetic surgery – or allows non-medical personnel to harvest grafts using a robotic device – can deplete the donor area and/or leave visible scars.

Dr. Barusco has found that a common misconception he encounters among his patients is that the FUE procedure is “non-invasive.” In fact, all surgical procedures are invasive, as they involve making an incision in the skin. When performed correctly, an FUE will appear to leave no scars. As mentioned earlier, the tiny dot-like scars are hidden by the hair – thereby seeming to be invisible to the patient and casual observers.

Who is a Good Candidate for a Combined FUE and FUT Procedure?

While only a hair restoration surgeon with extensive experience in this procedure can determine if your type of hair loss positions you as an appropriate candidate based upon an in-depth consultation, there are two main parameters:

  • Men diagnosed with genetic hair loss (androgenetic alopecia) whose hair loss has stabilized, and have a stable hair loss pattern.
  • Men who have a reduced amount of donor hair available because of previous hair restoration surgery or an overall sparse donor area.

As exciting as the combined FUE and FUT procedure is, be aware that this is an advanced procedure and should be performed only by surgeons and teams with a large amount of experience. To determine if the surgeon you’re consulting is qualified to perform the combined FUE and FUT, ask the following questions – which we highly recommend you ask during a consultation for any type of hair restoration procedure:

  • How often have you performed this procedure?
  • Who will evaluate my hair loss and recommend a course of treatment? What is their education, training, licensure, and experience in treating hair loss? Only physicians, Physician’s Assistants and Nurse Practitioners are legally allowed to diagnose a patient and to recommend medical treatments. Otherwise, the person recommending procedures and/or treatments is practicing medicine without a license, a Felony crime in Florida and many other states.
  • Who will be involved in performing my surgery, what role will they play, and what is their education, training, licensure, and experience performing hair restoration surgery?
  • Will anyone not allowed by the State Medical Board be making incisions or harvesting grafts during my surgery? If so, please identify this person, explain their specific role and why they are legally permitted to perform it.
  • Is everyone involved in my surgery covered by malpractice insurance?

Choose Your Surgeon Wisely for Your Hair Restoration Journey

Keep in mind that the success of any hair transplant procedure ultimately depends upon the experience, skill and integrity of the surgeon. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

How Lifestyle Affects Hair Loss

General,

Although many people assume that the cause of male hair loss is entirely genetic, lifestyle and health play an important role. No element of the human body exists or functions independently of the others – including hair follicles. Whether you’re making choices that are good for your health or undermine it, the results will be evident in the quality and quantity of your hair. This is not to claim that clean, healthy living will prevent hair loss if, indeed, androgenetic alopecia (AGA) – otherwise known as male or female pattern hair loss – is in the genetic hand you’ve been dealt. But it will make conditions more favorable for successful growth should you decide to get a hair restoration procedure, as well as possibly prevent other types of hair loss.

Conversely, certain choices can accelerate the progression of AGA, and make restoration challenging, if not impossible in some cases. We’ll look at the lifestyle choices that impact hair loss, and why they have an effect.

How Smoking Affects Hair Loss

The devastating effects that smoking has on health are well-known. Nicotine is a vasoconstrictor – which makes blood vessels contract. This restricts the delivery of oxygen to every cell of the body, including the skin and hair follicles. Over time, this makes hair regrowth harder, so when strands fall out, they aren’t replaced as readily – or at all.

As published in the Journal of Cosmetic Dermatology (JCD), a research study was conducted on 1,000 healthy males ages 20 to 35 to assess the demographic and clinical features of early-onset AGA among smokers and nonsmokers and to evaluate whether prevalence of AGA was affected by smoking. The study found that the prevalence of AGA among smokers was statistically higher than among nonsmokers, while severity of AGA was not associated with the intensity of smoking. The study concluded that nicotine and its derivative cotinine might be responsible for accelerating AGA progress.

In addition to nicotine starving cells of oxygen, the numerous toxic substances in cigarettes have been implicated in causing damage to the DNA of hair follicles. 

It is typical practice for surgeons to tell their patients who smoke to abstain for at least two days prior to surgery. Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – is no exception.

“Smoking makes the blood vessels in your scalp and all over your body contract. And that can actually impair your healing and impair the growth of the transplant.”

How Diet Can Affect Hair Loss

The old adage, “You are what you eat” is true. Unfortunately, many people lack the information they need to achieve a balanced diet, or go to extremes – either making high-fat, high-calorie fast food the mainstay of their diet, or following every quick weight loss fad that comes along. Neither are good for your long-term general health, or the health of your hair.

Hair is sensitive to nutritional imbalances. An inadequate intake of essential vitamins or minerals can impact the hair growth (anagen phase)/rest cycle (telogen phase). For this reason, a junk food diet high in saturated fat, salt and sugar – and low in essential vitamins and nutrients –not only leads to hair follicles being poorly nourished, but increases the risk for type 2 diabetes.

For those with type 2 diabetes, persistently high uncontrolled blood sugar levels can lead to damage in various tissues, organs and blood vessels. Damage to blood vessels can restrict blood flow, resulting in certain cells receiving less oxygen and nutrients than they need. This deficiency can negatively impact the normal growth cycle of hair follicles, which can lead to hair loss.

In addition, according to a study published in the Texas Heart Journal Institute, obesity is the leading risk factor for type 2 diabetes. However, any weight loss program needs to be based on the fundamentals of healthy nutrition and physical activity. So called “crash” diets are harmful, as well – to both hair and overall health.

A WebMD article points out the following: “Dramatically restricting your calorie intake means that you likely are not ingesting enough essential nutrients, like protein, fatty acids and zinc. These deficiencies, especially if maintained over a period of time, can lead to a type of hair loss called telogen effluvium. The good news is that this condition is generally reversible, so adopting healthier, less restrictive eating habits will allow your hair to grow back.”

Fad diets likewise tend to be imbalanced in food varieties and essential nutrients, and therefore also should be avoided. Any healthy weight loss program will be based upon gradual results – rather than a dramatic drop – and not be considered a “diet,” but a true long-term modification that becomes a way of life.

As for the question as to whether alcohol use causes hair loss, the answer is yes in the case of excessive alcohol use and alcohol addiction. Two of the main reasons are:

  • Poor nutrition, or not eating the right nutrients.
  • Inability to absorb the proper nutrients because of alcohol consumption.

How Steroid Use Affects Hair Loss

Bodybuilders and others looking to increase muscle mass and athletic performance have long turned to anabolic steroids, despite their dangerous side effects and risk of addiction being widely known. Add hair loss to the list. Although not life-threatening in and of itself, it’s an indication of the other negative conditions steroid use triggers. Those who are genetically predisposed to AGA can quickly accelerate its progression. Why? Because the Type II 5-alpha reductase enzyme transforms testosterone into DHT (dihydrotestosterone). DHT clings to receptors on hair follicles and causes them to weaken. Hair loss accelerated by steroid use is permanent.

Good Health is the Foundation for Healthy Hair – and a Successful Hair Transplant Procedure

No matter how much of your hair you keep by living a healthy lifestyle, good health and the ability to enjoy life to its fullest are their own rewards! As mentioned earlier, being in good overall health will help set the stage for success should you decide to have a hair restoration procedure. Your scalp and hair follicles will receive an optimum supply of blood and oxygen so that the implanted grafts can take hold and thrive. Our blog post – “An Up-close Look at Hair Grafts” – explains the anatomy of a hair graft, as well as how grafts are harvested and implanted.

Of course, in order to achieve the best result possible from your hair transplant, choose your surgeon wisely – based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Principles of Male Hairline Design

Male Hair Restoration,

Every man experiencing hair loss wants to restore his hairline to its youthful fullness. However, turning back the clock through hair transplant surgery involves much more than replacing what’s been receding. Designing a hairline with the look of natural growth isn’t as easy as you may think. It requires a hair restoration surgeon with the experience, technical skill, artistry – and the ability to visualize how your hair loss will progress over time – to achieve a hairline that appears as natural 20 years from now as it does today.

Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – is dedicated to educating all who are considering hair transplant surgery about the fundamentals of the process – including how he approaches hairline design. This blog post is based on his video – “Principles of Male Hairline Design” – which is on his YouTube channel, Hair Loss Medical Advice.

Why is the Male Hairline So Important?

“Hairlines are extremely important,” says Dr. Barusco. “When you see yourself in the mirror and your hairline is receding, you look a little older, and it’s bothering you. But imagine if you go in for a transplant and the hairline isn’t done correctly. It’s very hard to conceal. If you have liposuction and it doesn’t turn out great, you can at least hide it under clothes. You don’t have that option with a bad hairline.”

For this reason, understanding the aesthetics of a natural male hairline is essential in understanding why a good hair restoration surgeon will plan your hairline in a certain way. The male hairline is characterized by a lower overall position on the forehead, an “M” shape, and a forward flow pattern of the frontal hairs. This differs from the female hairline, which sits higher on the forehead, has an inverted “U” shape, and frontal hairs in a backward-facing whorl flow pattern.

In the case of teenagers and young men, the hairline is in a more forward position and has slightly rounded edges. This “juvenile” hairline gradually becomes a mature hairline – which many men initially mistake for hair loss. This is a natural process – mainly among Caucasian males – and does not necessarily indicate the beginning of androgenic alopecia, also known as male pattern baldness.

However, men who are experiencing genetic hair loss may want to recreate their youthful hairline through a hair transplant procedure. Dr. Barusco educates his potential patients who express this goal as to why this will not create a good result over the long term.

“If you’re in your 30s or 40s right now, the hairline that appeals to you may be a little too aggressive. It may look good for maybe the next 10 years or so, but when you’re getting into your 50s and beyond, that hairline may look pretty weird. Because when we age, our hair ages, and if the hairline is too aggressive, it will not age with you – meaning it won’t change. Our hairline aging process normally involves a little bit of recession, a little bit of moving back on the forehead. Once you do a transplant, that will no longer happen – so you have to make sure that what you do today is going to look natural when you’re older. Otherwise, who wants that?”

The Art of Designing the Ideal Male Hairline

In your mind’s eye, you may have an idea of where your restored hairline should be. But a hair transplant surgeon’s technical skill should be informed by a strong aesthetic sensibility. Dr. Barusco follows the classic “rule of thirds” as put forth by Leonardo da Vinci in determining each patient’s ideal hairline position.

“When I look at a hairline, the first thing I look for is where I should put it in relation to the eyebrows, and how high or how low on the forehead. That’s what we call height – the main parameters as far as the position of the hairline that should be considered. When you look at Leonardo da Vinci’s works, you will see that he divided the face of the subject he was trying to sculpt or draw into thirds, so that the distance between the chin and the tip of the nose, the tip of the nose to the eyebrows and the eyebrows to the hairline were all in proportion. The tip of your nose should be about the same distance as your eyebrows to your hairline. If you do it on yourself, you’ll see that it’s pretty close. Some people have naturally low hairlines, and they are the exceptions. But most of us follow that proportion.”

According to the International Society of Hair Restoration (ISHRS), a good hair restoration surgeon will make recommendations based upon your individual situation.

“The surgical placement of a hairline by transplantation or other technique is an esthetic decision that you must make in consultation with your physician hair restoration specialist. The physician can be of great assistance in this decision because the physician’s perspective is professional and three-dimensional. The physician sees you, and assesses your hair restoration need, in global perspective. Your view is primarily what you see in the mirror. While you may wish to recreate the hairline you are accustomed to seeing in the mirror, the physician may have other recommendations based upon such considerations as the likelihood of need for future procedures as your hair loss continues. It may be necessary to consider the need for future revisions in the hairline to accommodate progressive hair loss.”

Dr. Barusco is a Fellow of the ISHRS. This is a distinction that is only given to those who achieve certain landmarks on teaching and leadership. Currently, fewer than 10% of the ISHRS members are Fellows.

In addition to properly positioning the hairline restoration to your facial features, implanting each follicular unit to create the look of natural growth is essential to preventing the result from looking like a hairpiece. Our blog post – “An Up-close Look at Hair Grafts” – describes hair grafts (also known as follicular units) in detail.

“There are no straight lines on the human body. You don’t want to put anything in a straight line because it doesn’t look natural. It will catch peoples’ eyes for the wrong reason. You want to create variability.”

Throughout the process, Dr. Barusco implants hair grafts to build macro and micro irregularities into the hairline. Each follicular unit graft can contain one to three (or even four) hair follicles, which Dr. Barusco varies to further create a natural appearance.

Dr. Barusco also takes great care in creating a frontal temporal transition to achieve this visual variability. “If I just design a hairline and go straight into the hair without creating that soft transition to the temples, it’s going to look artificial. The effect will be so obvious that people will either know you’ve had a transplant, or think you’re wearing a hairpiece. Neither is a desirable outcome.”

The Importance of Having Realistic Expectations for Your New Hairline – and What You Should Look Out For

Dr. Barusco reports patients of other hair transplant surgeons coming to him seeking help for a botched hairline. Such results as a blunt hairline angle, a perfectly straight hairline and a heart-shaped hairline are among the examples of poor hairline design that he has remedied through corrective surgery. Photographs of each patient (with their identity concealed) can be seen on Dr. Barusco’s video referenced earlier in this blog post.

As we always emphasize, knowledge is power. Knowing the principles of good male hairline design will help you have an informed consultation with a hair restoration surgeon – as well as recognize red flags that may be raised. For example, be wary of a surgeon who recommends an aggressively low hairline, as it will not age well over the years. Also, as Dr. Barusco observes, the customer – or the patient – isn’t always right. If such a hairline is your idea, setting realistic expectations instead will make you happier in the long run than if the surgeon you choose agrees to do what you want rather than make their case as to why it’s ultimately not in your best interest.

“Some people may want some modification here and there when we discuss their hairline. As long as I think it’s safe and it’s going to look great, I may agree. But I will give you my advice if I don’t think you should have that done. I have had many patients walk out on me and say that if you can’t do that, I’ll find someone who will. I may not be able to change their mind, but I tell them to be careful, because it isn’t a matter of if it can be done, but if it should be done. My goal is for you to have a natural result so you don’t have to fix it later.”

As we also always emphasize, be sure to choose your surgeon wisely – based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Can Body Hair Be Used For Hair Transplants?

Male Hair Restoration,

Do you think nature has played a cruel trick on you because you have plenty of hair everywhere on your body except your scalp? Why can’t some of that hair grow on your head? Perhaps it can! Transplanting hair from the chest, abdomen or beard to the scalp may be an option under certain circumstances to address hair loss when there is not enough hair in the donor areas of the scalp to be harvested for a hair restoration procedure.

Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – is a pioneer in utilizing hair grafts from other areas of the body to fill in thinning areas of scalp in order to achieve an aesthetically pleasing look of full growth. As can be expected, the technique for harvesting body hair is more time consuming than harvesting follicles from the scalp, and requires a high degree of skill. Dr. Barusco discusses the details of this approach, which is based on the video – “Transplanting Body Hair to the Scalp” – on his YouTube channel, Hair Loss Medical Advice.

The Limitations of Scalp Donor Areas

Traditionally, hair transplant surgery relies on the supply of scalp donor hairs. These are permanent hairs that are not susceptible to the action of the dihydrotestosterone (DHT) hormone, which – in very fundamental terms – is a factor in male pattern hair loss (androgenic alopecia). Temporal areas (sides of the scalp) and the occipital area (back of the scalp) are typically those from which hair grafts are harvested for transplantation into bald or balding areas of the scalp.

However, the amount of available hair in donor areas is finite. As our blog post – “An Up-close Look at Hair Grafts” – states, “Once a graft is taken from the donor site, hair will never grow there again.” Hair restoration surgeons who are experienced, skilled and conscientious avoid overharvesting, which depletes donor sites, leaving the patient with patchy growth and/or visible scarring.

“Sometimes, we see patients who don’t have enough donor hair, or have already had multiple hair transplants, and the supply has been depleted,” says Dr. Barusco. “So what do we do then? We can use other areas as donor zones.”

Where is Body Hair Harvested for a Hair Transplant?

Body hair can be harvested from several locations. Dr. Barusco considers the chest and abdomen to be the optimum areas because the amount of hair tends to be abundant, and the quality of hair is good. Although people typically think about hair only in terms of what is visible above the skin, Dr. Barusco considers the entire anatomy of the hair graft. Also known as a hair implant or follicular unit, a hair graft is a cylinder of skin and hair that encompasses the hair follicle, the sebaceous gland (which secretes sebum – a lubricating oily matter – into the hair follicles to lubricate the skin and hair), the arrector pili muscle (a microscopic band of muscle tissue which connects a hair follicle to the dermis), and the papilla – or bulb – of the hair, which is an important stem cell reservoir. A hair graft includes all of these structures. Each follicular unit graft can contain one to three (or even four) hair follicles.

“In harvesting chest or abdominal hair for transplantation, we sometimes can get grafts with two follicles, although the majority will be singles. If you have enough hair, we can harvest enough for a few thousand grafts.”

Chest hair is short, making it suitable for filling in certain areas of the scalp. But Dr. Barusco has noticed an interesting phenomenon about post-transplant chest hair.

“The chest hair only grows about an inch or two, but over time, we noticed that once the hair is implanted in the scalp, it starts to grow longer and longer. For some reason, the location changes the hair growth cycle phases so the growth phase starts to increase – so sometimes, a patient can get long hair.”

The submental (under chin) area of the face is another suitable location for harvesting. While many people seek Dr. Barusco’s services for a beard transplant, those who already enjoy healthy beard growth may be an appropriate candidate for harvesting these hairs for transplantation to the scalp.

“The nice thing about beard hair is that it’s usually a little coarser, and it tends to grow long. If you have a beard, you know that if you don’t shave or trim it, it will keep growing long. So when you transfer it to the scalp, the hair will continue to grow, which can allow you more flexibility in styling.”

In harvesting beard hair – as well as hair from the chest and abdomen – Dr. Barusco takes great care to select grafts so as not to be noticeable. For both body hair and beard hair harvesting, Dr. Barusco uses the Follicular Unit Excision (FUE) method, which involves harvesting follicular units from the scalp individually with a small diameter round punch. This results in tiny circular dot-like scars that are easily concealed by surrounding hair and for all practical circumstances are not visible. In addition, the under chin area itself is inconspicuous when one is facing forward.

Areas of the beard that Dr. Barusco will not harvest from include the neck, cheeks and goatee. “Sometimes, patients who have hair all the way into the neck ask me if I can harvest follicles from that area. I don’t, because the skin is different. Scarring will be more visible, and if you shave there, it’s going to show. The same is true of the cheeks and goatee. But as long as we stay in the safe zone under the chin, you should heal very well.”

As for the surgery itself, local anesthesia is used to numb the areas of the scalp involved in the procedure. For harvesting of body hair, Dr. Barusco administers a special anesthetic technique he developed to numb the appropriate surface area, ensuring a safe, comfortable experience for the patient.

Are You a Good Candidate for a Body Hair to Scalp Transplant?

Regardless of the procedure, a one-on-one consultation with a hair transplant surgeon is necessary to ensure that you are an appropriate candidate.

“During the consultation, I will tell you what I can do safely and realistically. Everybody’s hair is different. There are different types of hair loss, and different hair loss possibilities in the future. But if you’ve had a few transplant surgeries, or you have had a couple of big ones and there’s not enough hair in the traditional donor areas anymore to remove without overharvesting, hair from the body can be a good option for filling in some areas. In the consultation, I will discuss all of these factors and circumstances with you so you will have realistic expectations of the outcome.”

If you are wondering if a body hair transplant can help address your hair loss, be sure that the surgeons you consider have extensive experience, rather than having performed it sporadically. Also, ask to see before-and-after photographs. The results should look like healthy, natural growth, with no detectable difference between body and scalp hair.

Ultimately, choose your best hair transplant surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Fighting the FIGHT Against Illicit Hair Transplants: Dr. Barusco Participates in World Hair Transplant Repair Day

Male Hair Restoration,

Are you the victim of a hair transplant performed at a clinic you thought was a legitimate facility, but actually wasn’t – and are now living with the results of a seriously botched procedure? Or do you know of someone who is? You have the opportunity to be selected for pro bono (free) corrective surgery by Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – on November 11, 2022.

On that date, Dr. Barusco will be among 65 hair transplant surgeons worldwide participating in World Hair Transplant Repair Day. This is the second year that the International Society of Hair Restoration (ISHRS) is holding this event as part of its Fight the FIGHT (Fraudulent, Illicit and Global Hair Transplants) global consumer awareness campaign.

With more than 1,000 members throughout 70 countries, the ISHRS is dedicated to achieving excellence in patient outcomes by promoting the highest standards of medical practice, medical ethics and research in the medical hair restoration industry. Dr. Barusco is a Fellow of the ISHRS. This is a distinction that is only given to those who achieve certain landmarks on teaching and leadership. Currently, fewer than 10% of the ISHRS members are Fellows.

Toward increasing consumer awareness of this problem and his involvement with World Hair Transplant Repair Day, Dr. Barusco has produced this video for his YouTube channel, Hair Loss Medical Advice. The video – “The Dark Side of the Hair Restoration Industry” – provides an overview of the prevalence of black market clinics, substandard operating room conditions, disastrous results and how to recognize and avoid such clinics.

Learn about this important campaign and how you can submit yourself as a candidate for a pro bono corrective procedure performed by Dr. Barusco on November 11. If you know someone who is the victim of an illicit black market hair transplant, share this information and encourage them to register. Dr. Barusco will select the recipient in October, so please act now to be sure that you – or a friend or family member – will be considered.

The Story Behind the Fight the FIGHT Campaign

ISHRS launched Fight the FIGHT in 2019 in response to the ever-increasing incidents of disfiguring hair transplants performed by unlicensed, non-medical technicians in illicit clinics. The use of unlicensed technicians to perform aspects of hair restoration surgery – which should only be performed by a properly trained and licensed physician – places patients at the following risks, all of which jeopardize patient safety and outcomes:

  • Misdiagnosis of the cause of hair loss.
  • Failure to diagnose hair disorders and related systemic diseases.
  • Performance of unnecessary or ill-advised surgery.
  • Unlicensed technicians may not be covered by malpractice insurance.

As the ISHRS states, “Vulnerable patients are lured by cheap prices and false advertising presented with misleading information alongside attractive medical tourism packages to visit clinics that use non-medical persons with very little training in aesthetic hair transplantation. This type of surgery is unsafe. It is a serious health risk often leading to tragic side effects such as permanent scarring, infection that leads to disfiguring results with very little to no recourse for correction.”

The lure of foreign clinics to consumers unfamiliar with ethical standards and practices in the field of hair transplantation is understandable. As our blog post – “Consumer Beware – The Risks of Medical Tourism for Hair Transplants” – covers, such clinics offer transplants at bargain rates, included as a package deal with airfare, luxury hotel accommodations and transportation. Combining an exotic vacation with a hair transplant procedure at a total cost lower than a comparable procedure alone by a reputable surgeon in the U.S. seems like an attractive deal. Slick clinic websites look professional and position the facility as trustworthy. But it’s all a sophisticated deception. False claims about their legitimacy, staff experience and positive patient outcomes do effective groundwork in misleading potential patients.

What do patients actually get for their hair transplant package? Poor growth, improper graft preparation (which means a higher number of grafts become non-viable), misangled graft placement, unnatural hairlines, a pluggy doll’s hair appearance and complete donor decimation are often reported. Severe scarring and disfigurement are also common. Add to that the risk for such infections as hepatitis or HIV. This is because the emphasis for the clinic is volume – performing as many hair transplants as possible each day for maximum profit.

Hair Transplant Surgery Performed by Non-medical Technicians – an Ongoing Problem

However, this disturbing trend is not limited to foreign clinics. Over the past several years, Dr. Barusco has dedicated himself to educating consumers about the risks of hair transplant surgeries performed by non-medical technicians using robotic devices to harvest and implant hair follicles. Our blog post – “Don’t Let a Technician Perform Your Transplant Surgery” – covers this important topic in detail. We also frequently reference Dr. Barusco’s article – “The Truth Behind Advertising Devices Instead of Surgeons” – which provides his insights on the marketing of such devices to cosmetic surgeons, plastic surgeons, family practitioners and others who have no training or experience in hair restoration surgery. In the article, Dr. Barusco relates his own experience in correcting the damage done to patients who had placed their trust (and money) in doctors who depend on these machines to perform the delicate procedures that only a highly skilled surgeon can.

The practice is becoming so prevalent that consumers have come to accept this as a typical, legitimate situation – which it is definitely not. These clinics gear their marketing and advertising to mislead the public into believing that technicians have a high degree of training and are just as capable as a surgeon to perform most – if not all – of the procedure. And that doing so allows them to offer hair restoration surgeries at a discount.

As the ISHRS states, “In fact, this is a common occurrence in many cosmetic surgery offices in the United States, where a surgeon will buy a heavily marketed device to assist with donor harvesting, then advertise their own credentials to attract patients, and in a ‘bait and switch’ type operation, bring in technicians to perform most if not the entire procedure.”

According to ISHRS policy, hair restoration surgery should only be performed by qualified physicians who possess education, training, and current competency in the field of hair restoration surgery or other licensed health care professionals who are properly trained, performing the procedure within their scope of practice, and supervised by a qualified and experienced physician.

“The cons of some of the heavily advertised, new technology available for hair transplantation (suction-assisted, easy-profit devices and robotic technology) are rarely discussed,” says Dr. Barusco. “Marketing campaigns make the unaware consumer think that unless a doctor has one of these devices, he or she is not up to par with the science. Even worse, they lead the consumer to think that if a practice or doctor owns one or more of them, he or she automatically knows what they are doing and will provide good results. Neither could be farther from the truth.”

The truth is, hair transplant surgery is surgery – and as such, requires a surgeon to perform. The position of the ISHRS is that “ . . . any procedure involving a skin incision for the purpose of tissue removal from the scalp or body, or to prepare the scalp or body to receive tissue, (e.g., incising the FUE graft, excising the donor strip, creating recipient sites) by any means, including robotics, is a surgical procedure. Such procedures must be performed by a properly trained and licensed physician. All FUE harvesting tools, including robotic devices, are considered extensions of the hand of the operator, and as such, all operators of these devices must be physicians. Physicians who perform hair restoration surgery must possess the education, training, and current competency in the field of hair restoration surgery.”

To help ensure you have the information to make informed decisions about who performs your hair restoration surgery, the ISHRS urges you to ask the following questions – as well as questions regarding costs, risks, and short and long-term benefits and planning:

  • Who will evaluate my hair loss and recommend a course of treatment? What is their education, training, licensure, and experience in treating hair loss? (Otherwise, the person recommending procedures and/or treatments is practicing medicine without a license, a Felony crime in Florida and many other states.)
  • Who will be involved in performing my surgery, what role will they play, and what is their education, training, licensure, and experience performing hair restoration surgery?
  • Will anyone not licensed by the state be making incisions or harvesting grafts during my surgery? If so, please identify this person, explain their specific role and why they are legally permitted to perform it.
  • Is everyone involved in my surgery covered by malpractice insurance?

Has Your Hair Transplant Been Botched by a Non-medical Technician?

As much as Dr. Barusco and the ISHRS strive to educate consumers about the risks of illicit clinics and non-medical technicians performing hair restoration procedures, far too many people aren’t reached. If your hair transplant was botched under the circumstances this blog post covers, you have the opportunity for Dr. Barusco to perform corrective surgery free of charge if you are selected as his patient for World Hair Transplant Repair Day. To submit yourself as a candidate for surgery on World Hair Transplant Repair Day, please click here to access the contact form.

Note: According to the ISHRS rules for this event, contact with the physician does not guarantee participation and pro bono procedures are limited. Local laws and regulations may apply.

For those who are not selected, we invite you to schedule your free virtual consultation with Dr. Barusco to learn your options for a corrective procedure. Dr. Barusco has helped numerous patients achieve the look they had originally anticipated. Our blog post – “Undoing the Damage of a Bad Hair Transplant” – provides examples of how Dr. Barusco was able to mitigate the poor aesthetic effect of an ineptly performed procedure.

We understand that the main concern you may have is cost. Tempus Hair Restoration offers 12-month interest-free financing, or up to 60-month terms with low interest. Your hair restoration journey should take you where you want to be, with a result that improves your self-image and self-confidence. Dr. Barusco and our Tempus Hair Restoration team are here to help.

Crowning Glory – The Art of Hair Transplantation to the Crown Area

Male Hair Restoration

Catching that first glimpse of a bald spot comes as an unpleasant surprise for many men. Yet, the crown area of the scalp is a common area of hair loss caused by androgenic alopecia – better known as male pattern hair loss. Even though you can’t readily see it yourself, a balding crown can cause feelings of self-consciousness and the sense that you’re turning into your father or grandfather – in other words, aging.

Just as with a receding hairline, a thinning crown – also known as the vertex – typically requires a hair transplant to regain coverage. However, for several reasons, crown transplants involve certain challenges when planning and executing in order to achieve the desired aesthetic effect of natural growth. To do so successfully requires a high level of both technical skill and artistry on the part of the hair restoration surgeon.

Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – is a leader in performing crown restoration procedures. He has written about his techniques for several textbooks, as well as taught during medical conferences. The information featured here incorporates content from Dr. Barusco’s video – “Transplanting Hair to the Crown of the Scalp” – featured on his YouTube channel, Hair Loss Medical Advice.

Why is the Crown Area Especially Challenging for Hair Transplant Surgery?

To begin to answer this question, it’s helpful to identify the three main regions of the scalp:

Frontal – This is the section that you see when you look straight-on in the mirror (and, of course, that others see as they face you). It includes the hairline and hair around the temples. The frontal region is where the hairline starts to recede in male pattern baldness – and where men typically first notice hair loss.

Mid-scalp – As the name implies, this is the center region of the scalp. The mid-scalp usually maintains some hair growth until late-stage baldness.

Crown – This is the highest point of the scalp, situated toward the back of the head.

“One of the most challenging things about the crown is that geometrically speaking, it’s an ellipsoid – which means it’s curved in every direction – from front-to-back, and from side-to-side,” says Dr. Barusco. The rounded nature and changes in angle of this region necessitates considering how the implanted hairs will lay against the scalp. “It’s a dome-shaped area. The hairs are going in a centrifugal way from the center; they spread out to the side and they tend to open up – and so we have to account for that, too.”

In addition, the hair whorl throws another curve ball, so to speak. The whorl is the hair that grows in a circular pattern around a visible center point on the scalp. In more scientific terms, the hair whorl denotes the spiral disposition of hairs around an axis, which is determined by the follicle growing direction. Because there are many different whorl patterns, identifying and following the individual patient’s unique whorl in order to place the implanted hair follicles appropriately is essential to achieving the look of natural growth. Dr. Barusco’s YouTube video – “Understanding the Crown Area of the Scalp” – provides additional information about the growth of hair in this region. 

But there is one more challenge – one that requires astute forecasting on the surgeon’s part. As is the case with androgenic alopecia, hair loss is progressive.

“Hair loss in the crown can be subject to progression. It’s very important to contain this, otherwise you may end up with what we call the ‘halo effect.’ That’s when you’ve lost hair around the transplanted hairs, and have this doughnut shape where there’s hair loss with hair around it. This isn’t cosmetically pleasing, so we want to avoid that. The transplant must be approached carefully and methodically.”

The challenges of a crown transplant can be met to give the patient a good aesthetic effect, says Dr. Barusco. Looking at the radius and circumference of the crown, Dr. Barusco uses a mathematical equation to determine the amount of follicular units to transplant. Our blog post – “An Up-close Look at Hair Grafts” – covers the anatomy and harvesting of follicular units in detail.

To achieve a full look to the crown with a natural, soft result, Dr. Barusco uses the cross-hatching technique, which he has written about for medical textbooks and reference publications. He is the author of Chapter-13 Advanced Transplantation of the Crown: How to Increase Visual Perception of Coverage and Density with Cross-Hatching for the book, “Hair Transplant 360 (Advances, Techniques, Business Development & Global Perspectives), Volume 3” by Samuel M. Lam.

This technique involves placing hairs so that they grow toward each other – hence the term “cross-hatching.” It follows the patient’s whorl pattern to give the illusion of higher density using fewer hairs. “But I have to follow the pattern of your natural hair growth. If I go against your whorl pattern, or against the behavior of your hair, it will be very hard for you to style, because the hairs will be fighting with each other. The cross-hatching technique can be used, but it has to be performed carefully.”

How Important is the Crown Area to Your Appearance?

While a bald spot is one of those things that might bother you once you become aware of it – and you’d rather restore the lost hair as well as prevent or slow future progression – it may not be that apparent to others. Those in the teaching profession – whose work necessitates writing on a chalkboard or whiteboard, giving students a prolonged view of their back and bald spot – may be especially self-conscious. However, having a full hairline is more desirable to most men – especially to those who are frequently on Zoom conference calls or using dating apps.

This brings up a point about the goal of hair restoration surgery – as well as that of a good surgeon. The idea is to achieve a natural-looking result. A very full crown with a receded hairline is not a natural male (or human) hair growth pattern, while a fuller hairline with a thinning crown is commonplace and natural. The aesthetic effect in the first example is unsettling. Other people may not be able to articulate why it doesn’t quite look right, but they’ll sense that something is “off” about that person’s appearance – which is not the impression you want to create!

Considerations for a Crown Restoration Procedure

Dr. Barusco makes the following considerations when consulting with a potential patient for a crown hair transplant:

  • The potential for progression of hair loss.
  • The amount of hair grafts that will be required.

“It is necessary to set the patient’s expectations about the amount of coverage that it’s possible to achieve, depending upon the amount of current loss, potential future loss and available donor hairs.”

Poor candidates for crown restoration surgery:

  • Young patients – hair loss will progress even more over the years.
  • Patients with limited donor area.

Ideal candidates:

  • Those who have stable and limited hair loss – usually middle-age and not expected to lose much more hair.
  • Those who have abundant donor hair.

Cardinal rules for crown restoration:

  • Aim for coverage, not density – unless the patient has a very small area of hair loss and abundant donor hair.
  • Set realistic expectations, and be sure the patient understands and accepts them.

Do You Think a Crown Area Hair Transplant is Right for You?

Choosing to have a hair transplant procedure of any type is a decision you make to help improve your self-image and self-esteem. Our blog post – “The Big Picture: Hair Replacement and Self-Confidence” – is dedicated to validating the very real effect that hair loss has on one’s psychological well-being, and how you have the right to pursue an appearance that makes you feel better about yourself and your place in the world.

Once you decide to take this important step, be sure to choose your surgeon wisely – based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Not Your Father’s FUT – How Advancements Have Refined This Classic Procedure

Male Hair Restoration,

The follicular unit transplantation (FUT) or “strip” method of hair transplantation tends to be considered antiquated by many who are considering hair restoration surgery. Consumer preference for the follicular unit excision (FUE) procedure has increased over the years for a number of reasons – some of which are misconceptions based more upon marketing than fact. However, refinements in the procedure have greatly reduced the early drawbacks, and may be the better option, depending upon one’s circumstances.

The FUT was a breakthrough technique when developed and introduced in the mid-1990s, providing a significant aesthetic improvement over the “mini-grafting” and “micro-grafting” methods then prevalent. These tended to create the unnatural telltale corn row, doll hair, pluggy-looking results associated with hair transplants of yesteryear.

As Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – explains in his video – “Is FUT or Strip Surgery a Thing of the Past?” – on his YouTube channel, Hair Loss Medical Advice, the FUT is performed by removing a finger-width of scalp, with the lower and top edges of the incision brought together and stitched. This results in a pencil-line linear scar across the back of the head that is concealed by hair. A haircut with #3 or #4 clippers on the back and sides of the head usually completely conceals the donor scar.

“The suturing technique that we use is sort of like a baseball stitch,” says Dr. Barusco. “It’s called the running suture. Basically, there are knots on the ends and then just little loops bringing the tissue together. Almost immediately, the lines practically disappear. The stitches that we use now are dissolvable, so you don’t have to even come in to the office to have them removed. The hair will curtain over, completely concealing the stitches. The typical patient assumption about the FUT is that it will be aggressive and painful, and leave a huge scar that they will not be able to cover. This is not true.”

The Difference Between FUT and FUE Procedures

The FUT procedure involves harvesting a very small strip of hair and skin from the donor area, then placing it under a microscope to be prepared for implantation as hair grafts. Also known as a hair implant or follicular unit, a hair graft is a cylinder of skin and hair that encompasses the hair follicle, the sebaceous gland (which secretes sebum – a lubricating oily matter – into the hair follicles to lubricate the skin and hair), the arrector pili muscle (a microscopic band of muscle tissue which connects a hair follicle to the dermis), and the papilla – or bulb – of the hair. A hair graft includes all of these structures. Each follicular unit graft can contain one to three (or even four) hair follicles. Our blog post – “An Up-close Look at Hair Grafts” – covers this topic in greater detail.

The FUE involves harvesting follicular units from the scalp individually with a small diameter round punch. As Dr. Barusco explains in his YouTube video – “Are There Advantages of FUT Over FUE?” – “They need to be harvested with good quality and without trauma. These hairs – these groups of hairs – are harvested individually with a little punch, and the difference between that and the FUT is that you don’t have to take these grafts to the microscope to be dissected. We take them there just for quality control to see what they look like, but they are somewhat harvested ready to be implanted.”

Unlike the fine linear scar of the FUT, the FUE leaves circular dot-like scars, which are also easily concealed. Therefore, unscrupulous hair transplant clinics may claim that the FUE is “scarless,” which is false. Our blog post – “Is the FUE Procedure Right for You?” – covers this technique in greater detail. 

How Did the FUT Come to be Considered Outdated?

Advertising by some hair transplant clinics creates the misleading impression that the FUT leaves unsightly scars. These types of ads are intended to scare prospective patients away from FUT surgery so they only consider the FUE procedure – which perhaps is the only type the surgeon offers, or prefers performing. Such surgeons also may heavily promote FUE because they have a robotic device that harvests follicles. Dr. Barusco provides his insight as to the serious risks such devices create in hair transplantation surgery in an informative article we encourage you to read here. In addition, the media actively spreads the fallacy about FUT being an outdated technique, as most articles about hair transplant procedures are written by those who have no background in this area of medicine.

“Many times, it’s portrayed as if it’s the only – or the best – solution for a hair transplant procedure,” says Dr. Barusco. “I don’t agree with that. The FUE technique does not work for every single patient, for a variety of factors. Strip surgery is still a great technique. I perform both, and don’t have a preference, so I can tell you which one is better for your particular situation.”

In fact, the FUT was the better procedure for Dr. Barusco’s own hair transplant, having undergone four FUT surgeries himself. “I still have a lot of donor hair left. If I’d had an FUE, my donor area would probably be much weaker.” Why? Dr. Barusco compares the situation to that of resodding a bare area of lawn with patches of turf taken from other areas of the lawn. “If you do enough of that kind of harvesting, you end up having holes, and that’s what can happen with the donor area.”

The FUT may be the preferable option for the following types of patients:

  • Those who need a large number of grafts moved during a single surgery.
  • Those who will require multiple surgeries to reach their goal.
  • Those who will require additional hair transplant surgeries over time.
  • Women – However, not every woman experiencing hair loss is a good candidate for a hair transplant.

Combining the FUT and FUE Procedures to Achieve Maximum Coverage in One Surgery

Although the FUT and FUE are different procedures, they can be used in tandem. Among his many contributions to the hair transplantation field, Dr. Barusco is known for pioneering the combined FUE and FUT technique, which is designed to treat advanced hair loss during a single surgery as opposed to several with a one-year waiting period between – as is typical. This procedure allows patients to achieve their ultimate goal in less time, with one procedure versus many.

Be aware that this is an advanced procedure that should be performed only by surgeons and teams with a significant amount of experience in this specific technique. For this reason, selecting the right hair restoration practice is essential to achieving a good outcome.

Make an Informed Decision and Choose Your Surgeon Wisely

As we hope you’ve learned, the FUT is still a solid option that may be the appropriate procedure for your type of hair loss and/or hair restoration goal. But whether your hair restoration surgeon recommends a FUT or FUE as your better option for a successful result, keep in mind that the success of any hair transplant procedure ultimately depends upon the experience, skill and integrity of the surgeon. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

The Big Picture: Hair Replacement and Self-Confidence

Male Hair Restoration, ,

The topics of our Tempus Hair Restoration blog posts often cover specific hair transplant procedures or reasons why hair transplants are now increasingly popular. However, there is a fundamental reason that men have hair restoration surgery: to improve their self-confidence.

Society has always expected men to be emotionally strong and impervious to self-doubt, anxiety and insecurity about their ability to achieve their goals. But experiencing hair loss can have an effect that’s more demoralizing than most care to admit. Understanding that you have the right to pursue an appearance that makes you feel better about yourself and your place in the world is essential in taking the steps to improving your self-esteem and emotional health.

Does Hair Loss Really Affect Self-Esteem?

You’ve probably heard friends and family members say, “It’s only hair. It’s not that important.” Although they’re trying to be supportive, scientific data validates your feelings about your receding hairline or balding crown.

Multiple studies have linked male pattern hair loss to lowered self-esteem and decreased confidence. An article for WebMD written by journalist Marta Manning and medically reviewed by Jennifer T. Haley, MD, FAAD, cites a 2019 study published in the International Journal of Trichology. The study found that androgenic alopecia (genetic, a.k.a. male pattern baldness) lowered the quality of life for many men, with particular effects in the areas of self-perception and interpersonal relations. A 2018 research study published in the Journal of Cosmetic Dermatology identified low self-esteem in many patients with androgenic alopecia and found that confidence can improve after hair transplantation treatment.

“Hair loss in men can affect self-esteem to the extent that a man believes his appearance to be an important part of what makes him a worthwhile or valuable person,” psychologist Paul Greene, PhD, says. “For men who are very invested in their appearance and who identify as a younger-looking man, hair loss can significantly impact self-esteem.”

In the same WebMD article, general practitioner and medical advisor Nikola Djordjevic, MD, says, “Hair loss has been affecting men’s self-esteem for centuries, if not longer. Long thick hair during ancient times was a symbol of masculinity and vitality, so it makes sense that men are psychologically affected by hair loss nowadays as well. Hair loss symbolizes aging and debility, which is why I think that men start feeling more depressed as their hair starts falling out.“

Does a Negative Perception of Balding Men by Other People Affect Your Self-Confidence?

You may receive the well-intentioned pep talk that it doesn’t matter what others think about your hair loss, as long as you feel good about yourself. Yet that can be hard to do in a society that clearly favors men with a full head of hair in the job market, on the dating scene and in many other situations. Our blog post – “Does Hair Loss Hurt Your Career?” – covers the findings of formal studies and polls that confirm a societal bias against men experiencing hair loss. This blog post cites a survey by job search website Ladders, which was conducted by Dove Men+Care. The survey found that of the 2,000 men who participated, the majority tied their work identities to their hair. The article reports the following results and observations.

“In the hair census, 8 in 10 men said that their hair made them look professional, the look of it was important, and that their hair helps them feel confident. Perhaps the majority of these men are preoccupied with their hair because they recognize what science has found: that societies judge men on how much hair they have on their heads.”

In addition, a study in JAMA Facial Plastic Surgery found that a few more hair follicles can make all the difference between people seeing you as a success or a lost cause. Researchers at Johns Hopkins University recruited participants to compare photos of men before and after they received a hair transplant. Although they were looking at the same men, participants rated men after they got their hair transplants as more attractive, approachable and successful.

Video Conferencing – Nowhere for Balding Men to Hide

Even though the peak of the COVID-19 pandemic is over, the trend for job interviews and meetings to be held virtually through such videoconferencing apps as Zoom shows no signs of reversing. But whether you’re interviewing or videoconferencing with coworkers and clients, that flattened-out, washed-out on-screen image is unflattering to most people. Add hair loss to the equation, and the picture looking back at you in that little square can have a very unsettling effect on your self-image and self-confidence. An increasing number of prospective hair transplant patients specifically name Zoom as the motivation that brings them to the surgeon’s office.

From Ridicule to Approval – The Changing Attitude Toward Men Who Have a Hair Transplant

Not so long ago, society judged men who had a hair transplant harshly – considering them vain or trying desperately to hold on to youth. Fortunately, public opinion has changed to approval, with the recognition that the desire to enhance one’s appearance is based in the strive toward achieving greater self-confidence.

Unfortunately, early hair restoration procedures were crude by today’s standards, producing outcomes that were obviously not the result of natural growth. Instead of achieving the youthful look they had sought, hair transplant recipients often were subjects of ridicule. The International Society of Hair Restoration Surgery (ISHRS) made the following observation.

“In the old days (think 1980s), there was no mistaking who had a hair transplant. The telltale corn row, doll hair, pluggy-looking hair transplants of yesteryear were — believe it or not — once considered state-of-the-art. But that was well before the evolution of hair transplantation. Over the last 20 years, hair restoration techniques have evolved considerably. These techniques have become so refined and results so natural-looking that most people cannot tell if someone has even had a hair transplant.”

Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – has been at the forefront of advanced hair restoration procedures, having developed such techniques as the groundbreaking no-shave FUE. Short for follicular unit excision, the no-shave FUE completely conceals harvested donor sites immediately, allowing you to resume your regular activities with virtually no evidence of the procedure.

Going one step beyond the no-shave FUE is the long-hair FUE. It is also known as the “preview” long-hair FUE because it gives the patient a preview of what the ultimate result will be. As with any hair transplant, the hair in the newly implanted grafts soon falls out, to be replaced by new growth as the grafts establish themselves. Dr. Barusco is one of only a few doctors in the world with the experience and skill to perform this technique.

Another leading-edge, yet proven procedure is the combined FUE and FUT (follicular unit transplantation). This technique covers large areas of baldness in a single surgery. Patients with advanced hair loss are typically required to undergo multiple hair transplant procedures to obtain coverage of their entire bald scalp – having to wait one year or more between procedures. This allows patients to achieve their ultimate goal sooner, with one procedure versus many.

Choose Your Surgeon Wisely and Reclaim Your Self-Confidence

Despite today’s advancements in hair restoration procedures, bad hair transplants are still out there. Conduct your research into hair transplant surgeons carefully. Our blog post – “Is Your Hair Transplant Surgeon Qualified? What You Need to Know” – will help you make an informed decision. When the reflection in the mirror reflects you as you see yourself, you’re ready to face the world with renewed confidence!

Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Is Your Hair Transplant Surgeon Qualified? What You Need to Know!

Dr Marco Barusco,

You may consider yourself a savvy consumer who arms yourself with as much knowledge as possible before making a major purchase. Unfortunately, however, many people seeking a hair transplant choose a clinic or practice based on its advertising. But slick, expensive ads don’t guarantee that the doctor (or doctors) have the qualifications, education, experience and skill to achieve the desired result – or even follow safe practices.

Regular readers of our blog are familiar with our oft-repeated advice, “Choose your surgeon wisely.” Here, we’ll tell you what you need to know about researching doctors, and which questions to ask during the consultation – as well as red flags that warn you to keep searching!

Why You Need to be Careful When Choosing a Hair Transplant Surgeon

Although a hair transplant procedure is outpatient surgery performed under local anesthesia while the patient remains awake, it is still surgery. Complications and bad outcomes can occur. Given the nature of hair replacement surgery, a poor result may not be obvious until new growth occurs. Even more insidious are cases in which the procedure appears to be successful, but additional hair loss over time can’t be addressed because too many hair follicles were harvested from the donor area of the scalp, thereby depleting the supply of available hair when another transplant becomes necessary.

There is an increasing tendency for people to have too casual an attitude toward elective cosmetic surgery procedures of every type. Much of this attitude can be attributed to social media – which promotes images of physical perfection while delivering the message that cosmetic procedures are commonplace, and an easy way to achieve such an image for yourself.

Add to this situation the number of hair restoration clinics proliferating in every town. Some are heavily advertised national brands with clinics throughout the United States, while others are more regional. In addition, many plastic surgery practices have added hair restoration as a profitable revenue stream. Walking into such a clinic or practice (either actually or virtually) assuming that the surgeon you’ll consult with has the qualifications, experience and aesthetic ability to understand and achieve your goal may put you at risk. In effect, you are placing your trust in a brand name, rather than an individual surgeon.

Plastic surgeons also should not be assumed to be equally proficient in performing hair transplants. As our blog post – “Don’t Let a Technician Perform Your Hair Transplant Surgery” – states, “… a plastic surgeon may perform great liposuctions and facelifts and be an authority on these procedures, but have no experience in hair restoration surgery.”

In fact, you may be surprised to learn that the field of surgical hair restoration is not regulated by either the United States government or the medical community. According to the American Hair Loss Association, any licensed physician can legally perform hair transplant surgery without any prior surgical training or accreditation of any kind.

How to Find a Qualified Hair Transplant Surgeon

A valuable online resource for anyone considering a hair restoration procedure is the International Society of Hair Restoration Surgery (ISHRS). This is a global non-profit medical association, and the leading authority on hair loss treatment and restoration. With more than 1,000 members throughout 70 countries worldwide, the ISHRS is dedicated to achieving excellence in patient outcomes by promoting the highest standards of medical practice, medical ethics and research in the medical hair restoration industry. The ISHRS offers objective, unbiased information, and does not accept advertising or affiliate links.

The ISHRS website provides free resources for consumers – such as its Find a Doctor database. This is maintained and updated with the name, location, contact information and link to the ISHRS member page of each doctor.

Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – is a Fellow of the ISHRS. This is a distinction that is only given to those ISHRS members who achieve certain landmarks on teaching and leadership. Currently, fewer than 10% of the ISHRS members are Fellows.

In conducting research on individual surgeons, the ISHRS recommends learning about the surgeon’s training, credentials and experience in the field of hair restoration. Start this process by visiting the website of each surgeon you’re considering. Some of the following points should be in the physician’s biography or elsewhere on the website:

Training and Credentials

  • From what medical school did the physician receive his/her M.D. (Doctor of medicine, allopathic medical), D.O. (Doctor of osteopathic medicine) or M.B.B.S. (Bachelor of medicine, bachelor of surgery, also abbreviated as, M.B.Ch.B.) degree?
  • What year did he/she receive the medical degree?
  • When was the physician licensed to practice medicine? Is he/she licensed to practice medicine in your state in which the treatment will take place?
  • Where (hospital or medical center) did the physician complete his/her internship and residency training?
  • Did the physician have additional training in a medical or surgical specialty after completing residency?
  • Is the physician board certified or a diplomate of a legitimate certifying board? Learn more about what this means.
  • Does the physician hold membership in their related specialty professional society? For hair restoration surgery, this is the International Society of Hair Restoration Surgery. Do they attend scientific conferences and workshops? Membership and attendance in such societies is not essential, but it is an additional indication of commitment and advanced training.

Experience

  • How long has the physician been doing surgical hair restoration procedures?
  • How many hair restoration procedures has the physician done? How many of the specific type you may consider having done?
  • How many hair restoration procedures does the physician currently do per month? A busy practice can be one indication that a surgeon is skilled and well respected by patients.
  • Is hair restoration surgery the physician’s only practice, or does the physician perform other types of cosmetic surgery? This question may be important to ask for two reasons: (1) if hair restoration is only part of an overall treatment you think you may need-for example, hair restoration and treatment to remove facial wrinkles and sun-damaged skin-a dermatologic or plastic surgeon will be able to consult with you regarding the overall treatment, and (2) to determine whether the surgeon performs enough hair restoration surgery to maintain his/her skills.
  • Will the physician, on request, provide names of patients who are willing to be references for the physician?

It is also important to understand that unqualified, non-medical technicians and other staff are increasingly performing hair transplant surgery using robotic devices to harvest and implant hair follicles. The practice is becoming so prevalent, that consumers have come to accept this as a legitimate situation – which it is definitely not. This is a significant problem that the ISHRS – and Tempus Hair Restoration – works to educate consumers about. On its Consumer Advocacy page, the ISHRS urges potential patients to ask the following questions during consultation, as well as questions regarding costs, risks, and short and long-term benefits and planning:

  • Who will evaluate my hair loss and recommend a course of treatment? What is their education, training, licensure, and experience in treating hair loss? Only physicians, Physician’s Assistants and Nurse Practitioners are legally allowed to diagnose a patient and to recommend medical treatments. Otherwise, the person recommending procedures and/or treatments is practicing medicine without a license, a Felony crime in Florida and many other states.
  • Who will be involved in performing my surgery, what role will they play, and what is their education, training, licensure and experience performing hair restoration surgery?
  • Will anyone not allowed by the State Medical Board be making incisions or harvesting grafts during my surgery? If so, please identify this person, explain their specific role and why they are legally permitted to perform it.
  • Is everyone involved in my surgery covered by malpractice insurance?

Dr. Barusco’s informative article about the risks of hair restoration procedures performed by unqualified technicians using robotic devices covers this issue in greater detail – including his experiences in working to correct the results of transplants botched under these circumstances.

“My practice has always been very busy with patients coming in for repair of procedures performed by other doctors. But in the last few years, I have seen a sharp increase in patients coming in for me to repair or replace hair transplants that were not done by experienced hair transplant surgeons, but by robots and/or by unqualified people under poor or no supervision of a qualified physician. In some cases, patients did not even know the name of the doctor they chose, but they knew that they had a robotic “procedure” or the new FUE device ‘procedure.’ This is so wrong, it makes my skin crawl.”

Red Flags to Watch Out For

Unethical practices are out there. The ISHRS has issued an alert regarding misleading and improper messaging as marketed by hair restoration surgeons. We encourage you to read the entire alert for additional information. Pay close attention to claims on websites and advertisements. If you encounter any of the following, immediately look elsewhere!

  • Scarless surgery
  • No incision
  • No touch
  • No cutting
  • Cloning
  • Hair multiplication
  • Non-invasive
  • Eliminates the need for additional procedures
  • Pain free
  • Guaranteed results
  • Unlimited grafts
  • No risk

Now That You Have Knowledge, You Have the Power to Choose Your Surgeon Wisely!

While you may be getting subtle – and not-so-subtle – messages from social media and society in general that aesthetic surgical procedures are quick and easy with little to no risk, the surgeon you trust to restore your hair, self-image and self-confidence needs to be selected with great consideration. There is no shortcut to achieving a worthwhile goal.

Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Am I Losing My Hair? Warning Signs to Look For!

Hair Loss Procedures,

Questions about hair loss can start when you notice more hair than usual in your hair brush or shower drain trap – or the “shedding” you’ve been attributing to a change in seasons continues and/or increases. Is it just your imagination, or reason for concern? Dr. Marco Barusco – founder and Chief Medical Officer of Tempus Hair Restoration – notes that shedding 100 to 150 hairs per day is part of the normal hair cycling process. Losing a significant amount beyond that could indicate an issue that needs to be evaluated by a hair restoration surgeon before the condition progresses.

The most frequent concern that patients bring to Dr. Barusco is an increase in shedding hair, but without scalp symptoms, such as itching or burning.

“I see patients every day here at the office with different types of hair loss and some very common symptoms that happen to everyone,” says Dr. Barusco. “It may be happening to you or someone you know, and a lot of times they can be a little deceiving. You’re just dismissing it as, ‘Well, I know it’s going to get better,’ or ‘It’s just a simple hair loss issue.’ In reality, that could be the sign and symptom of something more serious that needs to be treated so you can preserve your hair.”

Healthy hair has growth and resting phases, which accounts for typical shedding. But there can be certain situations in which shedding occurs more rapidly. The medical term for this condition is telogen effluvium. Women are more susceptible after surgery, undergoing general anesthesia, or experiencing a stressful event or trauma – as well as the hormonal changes of menopause, or discontinuing birth control pills. Thyroid disease is another possible cause. Returning to hormone-induced causes, new mothers may experience hair loss two months after giving birth. This shedding usually peaks after four months, and is normal and temporary. Dr. Barusco’s video on the topic of pregnancy and hair loss for his YouTube channel, Hair Loss Medical Advice, provides additional helpful information.

How to Recognize Signs of Excessive Hair Shedding

Evaluating the rate of your own hair loss isn’t as easy as you may think. In his informative YouTube video, Dr. Barusco notes that the apparent amount of shedding can fool the eye. For example, a bundle of 50 hairs of thick, curly texture will look more voluminous than a bundle of 50 thin, straight texture hairs. The same holds true for long hairs versus shorter hairs. For this reason, Dr. Barusco often instructs his patients to save their shed hairs in self-sealing plastic bags.

“Sometimes, you just have to sit down and count the hairs of the patient. Many times, we are between the 100 to 150 hairs that they would shed every day. But it’s important for us to have that parameter.”  

From Hair Shedding to Noticeable Areas of Hair Loss on the Scalp

Even more alarming is when the situation shifts from excessive shedding to visible areas of hair loss on the scalp. “There are different stages of thinning,” says Dr. Barusco. “You can go very easily from a mild scalp see-through to a little bit more area, to then many areas.

“Another clinical presentation that I see many times is when the hairline and temples get thinner. This is much more common in African-American women. It’s called traction hair loss, or traction alopecia – and it happens because of tightly pulled hairstyles and weaves. This causes a good deal of trauma to the hair follicles – particularly around the frontal scalp at the temples and the hairline. Over time, these stressed-out follicles become weaker, and they’ll become thinner and thinner. Eventually, you may see balding spots. However, it is my job to evaluate each patient to rule out other causes, because there are other conditions that can mimic this.”

What You Need to Know About Alopecia

“Alopecia” is a general term for hair loss. There are many types of alopecia, each with its own pathology and set of symptoms. Androgenetic alopecia is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness.

Alopecia areata is an autoimmune disorder that causes hair loss on the scalp and elsewhere on the body. Males and females of every age and ethnic group can develop alopecia areata. It often first appears during childhood and can be different for everyone who has it. According to the American Academy of Dermatology (AAD), alopecia areata can cause different types of hair loss: alopecia areata (hair loss in patches), alopecia totalis (total hair loss on the scalp) and alopecia universalis (hair loss on the entire body).

Alopecia areata is characterized as a superficial inflammation. The hair follicles – the “bulbs” below the skin surface – remain protected, so hair loss typically isn’t permanent. Our blog post – “Advanced Treatments for Non-Pattern Hair Loss” – provides additional information.

“These types of lesions are very common, characterized by a pretty much completely bald spot that can start small and grow,” says Dr. Barusco. “It can also occur in the beard, eyebrows, eyelashes and armpits – any area of the body that has hair.”

Other types of alopecia include the following:

Central centrifugal cicatricial alopecia (CCCA) – This is a form of scarring alopecia that results in permanent hair loss in the crown region of the scalp. According to the Journal of the American Medical Association (JAMA) Network, it is the most common form of scarring hair loss in black women over age 30. However, it may be seen in men and among persons of all races and hair color – although rarely.

Frontal fibrosing alopecia (FFA) – This is a form of lichen planopilaris that is characterized primarily by slowly progressive hair loss and scarring on the scalp near the forehead. In some cases, the eyebrows, eyelashes and/or other parts of the body may be involved, as well.

Lichen planopilaris (LPP) – This affects the scalp and hair. It is a form of lichen planus, an inflammatory condition affecting the skin and mucous membranes. Symptoms may include scaly skin and redness around hair follicles, and bald patches – as well as pain, burning or itching on the scalp. Tiny, red bumps (papules) may appear around hair clusters. LLP can result in scarring that leads to permanent hair loss.

A fungal infection in the scalp can also cause hair loss. For example, in the case of ringworm – which is actually a fungus – the fungus targets the hair shaft, which causes the hair to shed. The outside ring is red and inflamed, and as it expands, the center will heal. “Sometimes, the hair can start going back to the center of the lesion – so that’s how we got the name of ringworm, because there’s a circle of red, then the central areas will start to heal and look less red,” says Dr. Barusco. “This can be treated with antifungals, and the hair can be grown back. But it needs to be addressed, so don’t just look at this and let it go.”

Don’t Take a Wait-and-See Attitude Toward Shedding Hair

If you’re concerned that you’re losing more hair than usual – yet hesitant to schedule a consultation with a hair replacement specialist – you also may be losing valuable time in getting a diagnosis that can treat the cause of your hair loss and prevent or delay future loss. As you’re familiar with your hair, any changes you notice are worth investigating. Just as you shouldn’t ignore troubling symptoms regarding your overall health, paying attention to warning signs about the health of your hair and scalp is also important. Consulting a hair restoration surgeon who – like Dr. Barusco – is also a physician will give you the best opportunity for an accurate diagnosis, appropriate treatment plan and good outcome.

Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!