Planning a Hair Transplant for Future Hair Loss

Category Archives: Male Hair Restoration

Planning a Hair Transplant for Future Hair Loss

One common misconception about a hair transplant is that it’s a one-and-done procedure. However, the need for additional procedures is very possible as time and hair loss progresses. A conscientious, ethical hair restoration surgeon – such as Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – will discuss long-term as well as immediate plans for follow-up surgeries during the initial patient consultation.

“When I counsel my patients, I always discuss the possibility or the likelihood of more transplants in the future because hair loss is progressive,” says Dr. Barusco. “What you see today on your scalp is not going to be the same in 10, 20 or 30 years. It’s safe to assume that if you are experiencing hair loss and facing a transplant, you’re probably going to be needing more as you get older.”

Why You May Need a Second Hair Transplant

For a variety of reasons, patients often have more than one hair transplantation procedure over their lifetime. Hair loss is dynamic, and an individual’s trajectory continues to evolve over time based on numerous environmental factors, genetics, overall health and age. Age-related changes include decrease in hair density, pigmentation and mass.

However, the most common cause of hair loss is androgenetic alopecia (male and female pattern hair loss). This is an inherited, progressive condition. As the International Society of Hair Restoration Surgery (ISHRS) reports, it is also an unpredictably progressive condition. Early hair loss due to androgenetic alopecia can be an indication that hair loss will progress rapidly and will continue until most hair is lost. A hair restoration surgeon may recommend a program that conserves existing hair with a hair restoration drug approved by the FDA, such as minoxidil (brand name Rogaine) or finasteride (brand name Propecia – which is recommended for men only).

While a hair restoration surgeon assesses a patient’s donor area to determine the number of hair grafts available for the transplant procedure being planned, the surgeon should also be calculating how many can be harvested for a subsequent surgery. The donor area is the region at the back of the head where hair grafts are harvested for transplantation into areas experiencing hair loss. This area serves as the primary source of healthy hair follicles for the transplant procedure.

Predicting the progression of androgenetic alopecia is not easy. According to the ISHRS, “An experienced hair restoration doctor is able to anticipate future hair loss, and place transplanted hair into those areas to create a reserve against future hair loss. On the other hand, surgical hair restoration procedures may be required after the original procedure due to progressive and unpredictable hair loss. A potential problem over the years of treatment is the possibility that androgenetic alopecia will outpace efforts to restore hair, and at some point there might not be enough donor hair available for transplantation. The surgeon will be able to anticipate the patients’ need for subsequent procedures, and custom design the long-term treatment plan accordingly.

This is a critical issue that should be discussed by the patient with the physician hair restoration specialist in planning a comprehensive approach to long-term hair restoration.”

The Difference That a Skilled Hair Transplant Surgeon Makes

The key to planning hair restoration surgery to address future hair loss depends upon the surgeon’s skill, experience and eye for achieving the best aesthetic outcome in planning the initial surgery. This includes educating patients and ensuring they have realistic expectations of what can be achieved.

For example, men who start losing hair in their 20s may want a hair transplant – which is understandable, as hair loss has an aging effect. However, Dr. Barusco advises against hair transplant surgery for those under the age of 25. The reason is – as mentioned earlier – a hair transplant relies on using donor hair from the back of the head. If performed too early, the donor hair may be distributed too heavily in one area, leaving too little to be transplanted later, when needed on another area of the scalp as hair loss progresses.

Moreover, as our blog post – “When Should You Have a Hair Transplant Procedure?” – covers, the male hairline continues to form up to approximately age 29. Younger men may believe their hairline is receding, when in fact it’s evolving into what is known as a mature hairline. This occurs when the hairline moves back about a half inch to one inch from where it used to be. A mature hairline forms the “M” shape that distinguishes the male hairline from the female oval hairline shape.

For this and other reasons, Dr. Barusco advises his potential patients to wait until their hair loss has stabilized. Doing so not only allows him an accurate determination of the best procedure to perform to address current hair loss, but predict how the pattern will progress over time and plan accordingly for the second procedure.

One sign of a botched hair transplant is one in which the surgeon – or unlicensed technician who actually performed the procedure – created an aggressive, forward hairline and/or placed too many grafts to fill in bald or balding areas – thus overharvesting grafts from the donor area, not leaving enough for a future procedure. Our blog post – “Don’t Let a Technician Perform Your Hair Transplant Surgery” – covers this important topic in detail. We strongly recommend you take the time to read it.

Will Your Second Hair Transplant Procedure be the Same as Your First?

This depends upon the experience and skill of your surgeon. Each patient’s situation is unique, requiring the ability to accurately forecast the pattern of progressive hair loss and accessing the amount of grafts that will remain in the donor area. The main procedures are as follows.

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.

No-Shave FUE – Developed by Dr. Barusco, the no-shave FUE completely conceals harvested donor sites immediately, allowing you to resume your regular activities with virtually no evidence of the procedure.

Follicular Unit Transplantation (FUT) – Also known as the “strip” method, the FUT procedure 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. Although many hair transplant practices encourage patients toward the FUE, there are circumstances in which the FUT will produce the more successful outcome.

Combination FUE and FUT – 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.

This decision should be based on a thorough consultation with a qualified surgeon. Each patient’s individual circumstances, preferences and long-term hair restoration goals must be carefully considered. Engaging in open and honest discussions with your surgeon is crucial to plan for the future. Understanding how many grafts you might need over time can help you decide whether FUT, FUE or a combination of both techniques aligns with your hair restoration journey while maximizing the potential of your donor area.

Plan Wisely for the Future by Choosing Your Surgeon Wisely

Being aware of the possibility that you will need more than one hair transplant procedure in your lifetime gives you all the more reason to make sure you choose your surgeon wisely. 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.

We understand that the main concern you may have is cost, which is why we offer financing options that can place this goal within reach.

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 Current State of Hair Transplant Surgery

Not so long ago, there was a certain degree of secrecy and shame involved with undergoing a hair transplant. Men who had a procedure didn’t want anyone to know – although the outcome tended to be obvious, as early techniques were crude by today’s standards. Now, hair transplants have gone mainstream, with men from all walks of life open about having had a hair restoration procedure, or actively seeking one. Improvements in technology allow results to have the appearance of natural growth, encouraging more men than ever to pursue their goal of a fuller head of hair – and the accompanying boost in self-confidence they expect.

However, the advanced state of hair transplant surgery has inadvertently led to abuse by those looking for a quick profit. Considering that hair transplants constitute a $53 billion dollar market worldwide, the incentive to do so is great. Black market Turkish hair transplant clinics and cosmetic surgery practices that utilize a robotic device operated by non-medical technicians are among the foremost bad actors. In a highly publicized case, the owner of a surgical center in Virginia Beach, VA, was arrested in 2023 for performing hair transplants without a license.

Dr. Marco Barusco Advocates for Hair Transplant Patients

Because such unethical clinics and practices continue to thrive, often causing irreparable harm to patients, Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – has become a tireless advocate for educating consumers about their risks. In his three-part YouTube podcast series – “The Current State of Hair Transplant Surgery” – Dr. Barusco provides his unique perspective as a leading hair restoration surgeon on why the situation has become so hazardous, why consumers need to take it seriously, and how they can protect themselves.

“One positive factor is that hair transplants are now mainstream,” says Dr. Barusco. “On the negative side, a lot of surgeries are being performed incorrectly. Right now, we’re seeing challenges in patients that have been really hurt by inexperienced people – unlicensed people. It’s been a dangerous thing.”

 

Part two of the series – “Pictures and Explanations: When Hair Transplants are Not Done Well” – features Dr. Barusco discussing photos of botched transplants with podcast host Peter Roman. Patient photos were provided by the International Society of Hair Restoration Surgery (ISHRS) from its ongoing consumer education campaign, Fight the FIGHT (Fraudulent, Illicit and Global Hair Transplants). The graphic photos of disfiguring results are of black market Turkish clinic patients. Dr. Barusco is a Fellow of the ISHRS – a distinction held by fewer than 10% of ISHRS members – and is highly involved in its Fight the FIGHT effort.

 

In part three of the series – “Do It Right or Don’t Do It At All” – Dr. Barusco talks with Roman about how cosmetic surgery practices add hair transplantation with robotic devices operated by unlicensed technicians. Says Dr. Barusco:

“What they [the robotic device manufacturer] do is go to a plastic surgery conference and buy an exhibitor’s space and set up with the machines and some sales people. They tell the surgeons, ‘Look, you can add hair transplant surgery to your practice. It’s a 50 billion dollar industry you can get a piece of. Just buy my machine. You don’t have to do anything. I will send the staff to do the procedure for you, and do the advertising.’ So it became very popular.”

However, Florida and other states in the U.S. have passed legislation which deems that harvesting hair and making incisions on a patient are functions that only a physician, a Physician’s Assistant (not the same as a technician or nurse) or a Nurse Practitioner are allowed to perform.

“If you don’t see any of them in the room, the surgery is being done illegally,” says Dr. Barusco. “Technicians and any other such individuals are practicing medicine without a license, and the doctor who allows them to do it in their practice is also aiding and abetting the illegal practice of medicine and may lose his or her medical license and/or face felony charges.”

Of course, the patients receiving bad outcomes may have to live with the result – and Dr. Barusco has consulted with far too many such people.

“I meet with patients almost every day who have trusted doctors and practices because they had these devices, only to find out later that they would need me to fix what’s been done to them. And what is even worse, is that these patients are coming to me not only with poor results on their hairline, but also scarring and thinning of their donor hair [the limited supply of permanent hair used for transplants] caused by taking too many hairs with incisions that are too close together and/or larger than they should be.”

How the FUE Helped Pave the Way for Bad Hair Transplant Practices

The vast majority of abuses in hair transplant procedures involve the popular follicular unit excision (FUE). Why? Because of the manner in which the procedure is performed. 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. When performed properly by an experienced, licensed hair transplant surgeon, the resulting scars are not readily visible and are easily concealed even by very short hair.

In the follicular unit transplantation (FUT), a very small strip of hair and skin is harvested from the donor area, then placed under a microscope to be prepared for implantation as hair grafts. The donor area is then closed with sutures. 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. As the FUT can only be performed by a surgeon’s hands, this procedure cannot be performed by a robotic device or unlicensed staff member operating a punch. The deceptive ease with which the FUE can be performed has, unfortunately, opened this procedure to widespread abuse.

How to Make Sure You Choose the Right Hair Transplant Surgeon

As we hope you’ve learned, today’s state of hair transplant surgery allows those who are an appropriate candidate for a procedure to achieve outstanding results – but only if you choose a licensed surgeon who specializes in hair restoration procedures. Looking for a hair transplant at a bargain can lead to disaster, as Chris, a victim of a Turkish black market hair transplant clinic, relates:

“Before choosing a hair transplant clinic in Turkey, carefully consider the consequences of making a poor decision. The repercussions can haunt you for the rest of your life, with little opportunity for correction or repair … Believe me when I say that the losses incurred from choosing the wrong place extend far beyond hair and money.”

In beginning your search, the ISHRS website is an ideal place to start. It provides consumers with unbiased information on a wide range of issues – including how to be sure that a properly trained and licensed physician performs your hair transplant procedure, questions to ask during your consultation and many others.

We also invite you to visit Dr. Barusco’s YouTube channel, Hair Loss Medical Advice, where you can learn as he discusses such issues as the types and causes of hair loss, hair transplant procedures, and much more. And of course, our blog features informative posts, updated every month.

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. We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach.

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!

New Year, New You: Transform Your Confidence with a Hair Transplant

Every year starts with TV commercials for fitness centers and weight loss products. The timing for such marketing is obvious. The new year symbolizes fresh beginnings – the promise you make to yourself that this will be the year you make improvements in your lifestyle, health and appearance.

Of course, these initial good intentions sometimes aren’t carried out into actions, set aside during the following months until next January delivers another guilt-inducing reminder of how last year’s resolutions went by the wayside. But if you need inspiration to kick-start a more vital-looking, self-confident you, a hair transplant can be the first step you take toward a new you in the new year!

Why New Year Resolutions are Hard to Keep

Let’s be honest. Getting in shape requires a lot of hard work and commitment to hitting the gym every other day. It’s a worthwhile goal, but your daily schedule might not be conducive to driving to a fitness center, and you may not have room in your home to accommodate equipment. Losing weight requires a commitment to changing the types of food you eat, and/or frequency of meals. Considering that eating is required to live, making this kind of modification in behavior is challenging on many levels.

When it’s hard to comply during the initial stages of any self-improvement program, motivation tends to suffer. If you’re not seeing results as soon as you’d like in proportion to the amount of effort or willpower you’re exerting, discouragement sets in. After all, why bother?

Unfortunately, this type of attitude leads to giving up and settling back into old, comfortable behaviors. Until next January, when you again feel the need to take control and make those positive changes. But maybe this year will be different!

How a Hair Transplant Can Make a Big Difference

If you are among the approximately 35 million men in the United States experiencing hair loss, a hair transplant can be a life-changing procedure. While well-meaning family members and friends may tell you that your self-esteem shouldn’t depend upon your physical appearance, it is human nature to feel better about yourself when you’re satisfied with the way you present yourself to the world. And that feeling can have a powerful effect.

As cited in our blog post – “The Big Picture: Hair Replacement and Self-Confidence” – 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.

Starting your self-improvement program with a hair transplant has one big advantage in that it requires no effort on your part – unlike exercise or following a weight loss plan. Although it generally takes 12 months for a hair transplant to fully grow out, you will begin seeing new growth and thickening from four to six months post-op. Our blog post – “What to Expect After Your Hair Transplant” – covers this topic in greater detail.

A Patient’s Testimonial Says It All

Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – has been honored to receive five-star reviews and testimonials from patients on a regular basis. But one heartfelt testimonial sent to Dr. Barusco from “Joe” several years ago continues to stand out:

“After my divorce I was feeling really low. I had gained weight and lost all desire to start over. My hair was receding which made everything else worse. Each day that passed it was harder and harder to look in the mirror and gain the motivation to get my life together. Finally I figured I’d go talk to someone to see what can be done about my hair. I did a quick Google search and came across Dr. Barusco’s website. I was impressed with the vast amount of information … and before and after pictures. I thought I’d give it a shot as there was a consult office in my area and there was no charge … I moved forward with the procedure and was impressed with the professionalism … My confidence definitely increased as the compliments came rolling in. I joined a gym and felt determined again. I just got home from my final follow up. I looked in the mirror and finally feel happy with who is looking back.”

In Joe’s case, undergoing a hair transplant gave him the psychological boost he needed to make other major personal improvements. In a follow-up, Joe reported that he had some cosmetic procedures performed, and is now living his best life!

Which Hair Transplant Procedure Is Right for You?

Dr. Barusco is an award-winning board-certified hair transplant surgeon with more than 25 years dedicated exclusively to hair restoration. He has long 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 this procedure 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 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 instead of many.

However, it’s important to understand that choosing a hair transplant procedure isn’t the same as ordering from a menu. An experienced, ethical surgeon will examine your scalp, diagnose the cause of your hair loss, then discuss your hair restoration goals and expectations – followed by a treatment plan that is right for your individual situation. Areas to be covered should include the type of surgery, why this type of surgery is recommended, which areas of the scalp will be involved, how the surgery will be performed and the results you can expect. Our blog post, “The Importance of Consultation Before Hair Restoration Treatment” – covers this topic in greater detail.

Make This the Year You Get your Hair and Self-confidence Back

Make this the year you transform your appearance and regain your confidence! Don’t let hair loss hold you back any longer – take the first step toward a new you in the new year! We understand that the main concern you may have is cost, which is why we offer financing options that can place this goal within reach.

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!

What to Do if You’re Unhappy with Your Hair Transplant

Getting a hair transplant represents a substantial financial and emotional investment. At the risk of perpetuating stereotypes, men don’t like talking about their emotions, yet hair loss has an effect that’s more demoralizing than most care to admit. The desire to project an image of vitality and the increase in self-confidence that results is a strong motivation in undergoing hair restoration surgery.

But what if you took the big step, and the outcome has fallen far short of your expectations? Should you resign yourself to dissatisfaction and regret? The hopeful news is that this may not be the end of your hair restoration journey. We’ll cover three common reasons why a hair transplant sometimes doesn’t achieve the patient’s aesthetic goal.

You’re Expecting to See Full Growth Too Soon

Of all the reasons we’ll discuss, this could very well correct itself. Hair transplant surgery isn’t magic. The surgeon wields a scalpel, not a wand. The “after” of the before-and-after patient photos that impressed you about the surgeon you chose most likely were taken one year post-op. During this time, your newly transplanted hair goes through various stages of shedding and growth.

Moreover, individual hairs don’t grow at the same rate. As our blog post – “What to Expect After Your Hair Transplant” – covers, while you might assume all of your hair will come in at the same time, don’t be alarmed if it’s somewhat patchy and grows out at different rates. Actually, this is typical of normal growth, but you don’t notice it with a full head of hair. About six months after your hair transplant, you may see that the new growth is not necessarily full or consistent around your head, but be patient. Despite the different growth rates, it usually looks natural throughout this time.

Backing up somewhat, the first stage of growth is the hair from the newly implanted grafts falling out. This indicates that the grafts are establishing themselves in their new location, and will start producing hair again – typically in about two months.

A good hair transplant surgeon will be sure to tell you what to expect during each phase of growth, so you shouldn’t experience anxiety about how your new hair is coming in. A good surgeon also will keep the lines of communication open to answer any questions you may have during this time. If your surgeon has addressed your expectations, all has gone well and there are no complications, you’ll see the desired result. However, this is assuming your surgeon has the skill to deliver the desired result – which leads to our next reason.

You’re Unhappy with Your Hairline and/or Scalp Coverage

Once your hair has grown out, your hairline or scalp coverage may not be as you had envisioned. Common reasons for dissatisfaction with a hairline are that it’s too far forward, or just looks “off.” You may not be able to put your finger on it, so to speak, but there is an explanation as to why your new hairline doesn’t have the appearance of natural growth.

While you may have an idea of where your restored hairline should be, a hair transplant surgeon’s technical skill should be informed by a strong aesthetic sensibility. Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration follows the classic “rule of thirds” as put forth by Leonardo da Vinci in determining each patient’s ideal hairline position.

As our blog post – “Principles of Male Hairline Design” – covers, in addition to properly positioning the hairline restoration to your facial features, implanting each follicular unit (hair graft) to create the appearance of natural growth is essential to preventing the result from looking like a hairpiece.

“There are no straight lines on the human body,” says Dr. Barusco. “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.”

During the transplant procedure, 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 effect.

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.”

As for scalp coverage, a common reason for dissatisfaction is that there isn’t as much hair covering bald areas as you’d expected. So we pause at this point to emphasize the importance of consulting with your prospective surgeon before the procedure. When discussing your goals for your outcome, you should have a candid discussion with the surgeon about your expectations for your hairline and overall scalp coverage.

For example, Dr. Barusco has had patients who wanted hair on areas of the scalp that he considered secondary – that is, not as obvious as the hairline – yet that was the area on which the patient wanted to see hair growth. Learning what the patient wants is an important part of the consultation.

“However, patients need to be realistic. If you say you want the hair you had when you were 18, that will not be possible with a hair transplant. No one will be able to give you that unless you get a hair piece. But if I don’t tell you that – or worse, I lead you to believe that can happen – that’s wrong. If I don’t know what your goals are, I may make a recommendation that’s not appropriate.”

Your Hair Transplant Failed

Unfortunately, this is becoming an increasingly common situation as more clinics utilize robotic devices illegally operated by unlicensed technicians, or follow other unethical practices. Hair transplants performed by black market clinics outside of the United States – most commonly Turkey – are notorious for hiring unqualified, unlicensed individuals to harvest hair follicles and implant them into the recipient area. Our blog has several posts on this topic, which we encourage you to read.

The reasons a transplant can fail are numerous, including the following:

  • Poor diagnosis of the reason for hair loss – there may be a medical reason that a transplant can’t address.
  • Poor understanding of hair and scalp anatomy.
  • Poor understanding of hair physiology.
  • Poor planning of the transplant procedure.
  • Poor preparation of hair grafts, resulting in fewer viable grafts.
  • Poor technical execution of the transplant procedure – placing hairs at the incorrect angle or direction; placing transplanted hairs too close together, etc.
  • Poor management of the limited number of donor hair follicles – overharvesting the donor area.
  • Damage to existing hair follicles by overly aggressive surgery.

Can an Aesthetically Unpleasing or Failed Hair Transplant be Corrected?

This can only be determined by a consultation with a hair restoration surgeon who has extensive experience in corrective procedures. Depending upon the amount of healthy follicles remaining in the donor area and other factors, it is possible, in many cases, to mitigate the damage of bad hair transplants and achieve the look the patient had originally anticipated. Unfortunately, there are situations in which the damage is too extensive to be corrected. Again, only a consultation with a highly experienced, ethical hair restoration surgeon can provide an assessment of the degree to which a bad outcome can be repaired.

But how do you find one? You don’t want to repeat the circumstances that led you to misplace your trust in your original surgeon, but as we often warn, there is much misleading “information” regarding hair transplant surgery that works against consumers educating themselves about how to choose a qualified surgeon.

The website of the International Society of Hair Restoration Surgeons (ISHRS) is an excellent place to start. It provides consumers with unbiased information on a wide range of issues – including how to be sure that a properly trained and licensed physician performs your hair transplant procedure, questions to ask during your consultation and many others.

We also invite you to visit Dr. Barusco’s YouTube channel, Hair Loss Medical Advice, where you can learn as he discusses such issues as the types and causes of hair loss, hair transplant procedures, and much more. And of course, our blog features informative posts, updated every month.

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. We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach.

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!

What to Expect After Your Hair Transplant

If you’ve made the decision to have a hair transplant, you’re most likely focusing on the ultimate outcome. Imagining how you’ll look with a restored hairline and more overall fullness is the psychological light at the end of the tunnel. But between surgery day and the day your mirror reflects the image you want to show the world, there are many days that are critical in achieving the desired result. It is during these days that you should know what to expect in terms of post-surgical care, healing time and milestones in the growth process.

Your surgeon will provide this important information, but if you have just started researching hair transplant surgeons, it’s helpful to have a good idea of what lies ahead. It’s also helpful to have this knowledge beforehand when you consult with a surgeon so you can ask well-informed questions and therefore have a better overall understanding of the process.

The Basics of Post-Operative Hair Transplant Care

As we at Tempus Hair Restoration always emphasize, hair restoration surgery is surgery. As with any other outpatient surgical procedure, following the surgeon’s post-operative instructions is essential to both your safety and the success of the procedure’s objective. Although specific instructions may vary depending upon the individual patient, general instructions you can expect to receive are as follows:

  • Your newly transplanted hair grafts are especially sensitive during the first seven days after surgery. Any rubbing, bumping, or scratching may cause them to be damaged and lost.
  • Stay hydrated – drink plenty of fluids.
  • Avoid any strenuous physical activity during the first seven days. Walking is okay, but not power walking. You may resume cardio exercises – such as running, cycling, etc. You may resume regular exercise (and weightlifting) after 14 days.
  • Do not swim in chlorinated pools during the first seven days after surgery, as chlorine (and other pool chemicals) may damage the grafts. Do not dive. 

Again, this is just a brief snapshot of general post-op instructions. Your surgeon will give you detailed printed instructions for you to take home and follow. But you now know that you need to plan for some amount of time to recover before resuming your regular schedule and activities. Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – covers the instructions he gives his patients in his video – “Post-Operative Instructions Following Your Hair Transplant Procedure” – on his YouTube channel, Hair Loss Medical Advice.

Is What You’re Seeing Normal or Cause for Concern After Your Hair Transplant?

During this time and soon after, you could wonder if what you experience is normal or cause for concern. According to Dr. Barusco, about 50 percent of patients will have some degree of edema (swelling caused by fluid trapped in the body’s tissues) in their forehead. To prevent swelling, sleep at a 45-degree angle by using two or three pillows for the first three or four nights post-surgery, and avoid bending over.

As for the scalp itself, expect the graft sites to form scabs in 24 to 72 hours after surgery, and for the scabs to fall off in three to 10 days. As the scabs fall off, you may notice that hair is shed with them. This is to be expected. Do not pick or scratch the scabs, as doing so can cause infection and endanger the grafts.

Several weeks after your hair transplant or anytime thereafter, an ingrown hair(s) may appear. This will look like a small pimple or painless bump in the donor or recipient area. Applying a warm washcloth or compress to the area for 10 minutes three times a day is typically recommended for relief, but contact your surgeon before taking any action.

While we’re on the subject, contact your surgeon if you experience unusual swelling, inflammation or discomfort – or have questions about shampooing techniques or any other matter regarding how you should care for your hair and scalp during this initial time. Following advice you find online – regardless how reputable the source seems – can lead to complications or a poor outcome. When in doubt, call your surgeon and follow his/her instructions! Dr. Barusco gives every patient his cell phone number so he is always available to answer questions and address concerns.

What Should Your Hair Look Like as It’s Growing In?

A common question is if there is a difference between how hair grows in from a Follicular Unit Excision (FUE) or Follicular Unit Transplantation (FUT). The answer is no. Healing, growth velocity and the presence of aesthetically visible results are all independent from the surgical technique used.

The first stage of growth, ironically, is the hair from the newly implanted grafts falling out. This indicates that the graft is establishing itself in its new location, and will start producing hair again – typically in about two months. This should be followed by visible growth and thickening from four to six months.

While you might expect your hair to grow in at the same time, don’t be alarmed if it’s somewhat patchy and grows at different rates during this stage. All hair doesn’t grow at the same rate, but you just don’t notice it with a full head of hair. About six months after your hair transplant, you may see that the new growth is not necessarily full or consistent around your head, but be patient. Despite the different growth rates, it usually looks natural throughout this time. In fact, such gradual growth creates the impression that you haven’t had a hair transplant. Strangers and casual acquaintances aren’t likely to notice. Your hair transplant should be fully grown in by 12 months, barring any health issues during that time.

As you see, hair restoration is a journey that can’t be rushed. Doing your due diligence in choosing your surgeon wisely, following the post-op care plan that he/she gives you and taking care of yourself throughout the first year (and hopefully every year thereafter) will position you for success in achieving the result you had anticipated.

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.

We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach. Putting yourself at risk of the consequences of a hair transplant procedure at an overseas black market clinic – or even an unscrupulous domestic clinic where unlicensed non-medical personnel harvest and implant hair grafts – isn’t worth the perceived savings.

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 Dangers of Black Market Hair Transplants in Turkey

If you’re considering hair restoration surgery, you’ve doubtlessly read about the advantages of traveling to Turkey for the procedure. Surgery at a bargain price combined with an exotic vacation are strong lures for many men eager to restore their youthful hairline. However, much of what you read about Turkish hair transplant clinics are a combination of deliberate disinformation produced by the clinics themselves, social media hype and publicity provided by mainstream publications more eager for readers’ eyeballs than presenting the facts.

Yes, facts can be boring. But there are far worse things than being bored – for example, being permanently disfigured by a botched hair transplant procedure performed by non-medical clinic employees who go to their other jobs, like waiting tables or driving taxis, after their shift at the clinic. Unfortunately, since the publication of our blog post – “Consumer Beware – The Risks of Medical Tourism for Hair Transplants” – this dangerous trend is still on the rise.

In 2019, the International Society of Hair Restoration Surgery (ISHRS) – the world’s leading medical authority on hair loss treatment and restoration – launched a worldwide campaign designed to raise awareness of the risks of medical tourism for hair transplants. Its Fight the FIGHT (Fraudulent, Illicit and Global Hair Transplants) campaign targets the hair transplant black market, which is built upon fraudulent hair restoration clinics and misleading advertising claims.

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 who achieve certain landmarks on teaching and leadership. Currently, fewer than 10% of the ISHRS members are Fellows. As such, Dr. Barusco and the Tempus Hair Restoration team are proud to help the ISHRS in this important mission.

We want to make it clear that many members and Fellows of the ISHRS are Turkish citizens, and uphold the organization’s code of ethics. They are as concerned as all other members regarding the alarming proliferation of black market clinics, and are doing their part to educate consumers about how to identify and avoid them.

Yet despite the ongoing work of the ISHRS on a global level, black market clinics continue to thrive. There are two big reasons for this: social media and mainstream media – especially men’s lifestyle and fashion magazines.

One such magazine featured an article by a reporter who traveled to Istanbul for hair transplant surgery, and referenced (as well as quoted) the ISHRS website’s FightTheFIGHT page about the risks of black market clinics. The reporter also interviewed Dr. Ricardo Mejia, who sits on the ISHRS Board of Governors. Dr. Mejia advised him to conduct thorough research to ensure that any doctor he was considering is registered with the ISHRS. Despite Dr. Mejia’s caution and the warnings on Fight the FIGHT, the reporter was still more influenced by posts on Reddit and before-and-after photos showing apparently impressive results.

In a follow-up article written 10 months post-surgery, the reporter related a satisfactory outcome. Still, such articles do a disservice to readers, as they give the impression that the risks are exaggerated, and your experience may also be positive. The reporter provided no information as to how he determined the clinic he chose was legitimate. Instead, he seemed to take a leap of faith that his surgery wouldn’t be botched. He was lucky. You may not be.

Risks of Having Hair Transplant Surgery at a Turkish Black Market Clinic

At a legitimate hair restoration practice, you’ll have a consultation with the surgeon, who will diagnose the cause of your hair loss and recommend the best transplant procedure for your individual situation. A black market clinic only wants your money. The person you meet may wear a white lab jacket or surgical scrubs, but may or may not be a surgeon – or any licensed medical professional at all. You aren’t likely to receive an accurate diagnosis or solid treatment plan.

And you definitely won’t be told if you’re not a good candidate for the surgery. Reasons a legitimate hair transplant surgeon will turn away a patient include serious health conditions (such as uncontrolled type 2 diabetes), and not enough availability of donor hair. As long as you can pay, a black market clinic will take your money – and, of course, not produce the result you had expected while quite possibly endangering your life.

But that’s just the starting point. Other risks include the following:

An unnatural-looking hairline – Achieving a male hairline that looks natural is harder to do than you might think. An experienced hair transplant surgeon with knowledge of how the male hairline changes over time can implant hair grafts to get the right amount of coverage while looking age-appropriate. A hairline that’s too aggressively forward, goes straight across the forehead with no variations, etc., will look “off” at best, bizarre, at worst. Our blog post – “Principles of Male Hairline Design” – covers this topic in detail.

Hair growing in the wrong directions – A knowledge of the directions of hair growth is essential in placing grafts. Personnel at black market clinics lack this knowledge, which means hair grafts are implanted incorrectly – resulting in a strange, unnatural growth pattern.

Improper graft preparation – When hair grafts are harvested from the donor site, time is of the essence in preparing them for implantation. Improperly treated grafts quickly die, and will not grow in the recipient area – resulting in a failed transplant. Poor quality control conditions include dehydration, warming and oxygen deprivation. A photo taken at one Turkish clinic shows hair grafts on strips of cotton gauze laid out in bloody rows in what appear to be baking pans, evidently drying into non-viability as they wait to be transplanted.

Overharvesting of grafts from the donor area – The donor area is where grafts are harvested for implantation into bald areas of the scalp. Once a graft is taken from this area, no hair will grow there again. Black market clinics tend to offer a large number of grafts – usually between 2,000 – 4,000 graft extractions per session – but with no consideration for the patient’s degree of hair loss. A licensed, ethical hair transplant surgeon takes into consideration the amount of donor hair each patient has available, and plans the surgery according to anticipated – as well as current – hair loss. This helps ensure that enough donor hair will be available for future hair transplants. There are numerous accounts of black market clinics decimating donor areas, leaving disfiguring permanent scars – and no way to correct the often-botched transplant.

Infection from Unsanitary Operating Room Conditions – When you think of an operating room, you assume the surgical theater will be sterile. In black market clinics, it’s common for several patients to undergo transplant surgery simultaneously in one large room, much like a warehouse. Under such conditions, maintaining a safe, sanitary environment is impossible – putting patients at risk for hepatitis, HIV or other infections. This is because the emphasis for the clinic is volume – performing as many hair transplants as possible each day for maximum profit. Patient safety is not a priority.

Don’t be a Victim of a Turkish Black Market Clinic! Choose Your Surgeon Wisely!

We hope we have provided information that will prevent you from making a serious mistake that can negatively impact the quality of your life and general health. To further educate yourself, we recommend visiting the links we’ve provided in this blog post to the ISHRS website. This organization is an unbiased source of information, and holds its members to the highest ethical standards – as well as establishing and enforcing industry standards.

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.

We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach. Putting yourself at risk of the consequences of a hair transplant procedure at an overseas black market clinic – or even an unscrupulous domestic clinic where unlicensed non-medical personnel harvest and implant hair grafts – isn’t worth the perceived savings.

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!

What You Need to Know About Bodybuilding and Hair Loss

Competitive bodybuilders have a laser-like focus and fierce determination to achieve their goals. If you are among those dedicated to chiseling yourself to perfection, that moment on the competition stage in front of the judges is the most important. During this critical time, showing your confidence is the direct result of your success in all aspects of your training – as well as your attitude about yourself during your daily life.

If you’ve been experiencing hair loss, your self-image could be negatively impacted. Let’s face the truth – in our society, the progression of hair loss signals the loss of youth and vitality, no matter how sculpted you are. Some men embrace their baldness, but not everyone has the shape of head that looks good completely bereft of hair. Although judges don’t award points for hair, they do take into account the amount of self-confidence you project.

You also might be wondering if all that’s involved in striving to be the best in this demanding sport that’s actually a way of life is causing your hairline to recede. It’s time to learn what you need to know about this complex issue so you can make informed decisions.

Does Bodybuilding Cause Hair Loss?

Hair loss is a common issue among bodybuilders, but is the process itself the cause? As you probably already know, androgenetic alopecia (AGA) – otherwise known as male pattern hair loss (although it also occurs in women) – is in the genetic hand you’ve been dealt. However, as our blog post – “How Lifestyle Affects Hair Loss” – covers, lifestyle can trigger hair loss, or accelerate it in those genetically predisposed.

But first, let’s acknowledge the elephant in the room. Those looking to increase muscle mass and athletic performance have long turned to anabolic steroids, despite their dangerous side effects. Add hair loss to the list. Although not life-threatening, it’s indicative of the other negative conditions steroid use triggers. Those who are genetically predisposed to AGA can quickly accelerate its progression. This is 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.

Assuming you avoid anabolic steroids use, other factors can account for hair loss. Look at it this way. As a competitive bodybuilder, you push your body to the extreme for prolonged periods – far beyond what most others are willing or able to do. According to a study published in the Journal of the International Society of Sports Nutrition, intense resistance exercise itself can cause increases in androgenic hormones (testosterone for males). Our next section will cover the findings of this important study in further detail.

How Diet and Nutrition Can Affect Hair Loss for Bodybuilders – Facts and Myths

You may have read some conflicting reports on the effects of workout supplements and hair loss. Here is what we know for certain. Following a strict diet to maintain your physique may mean you’re not getting enough nutrients – such as vitamins and minerals – which are essential for healthy hair growth. 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), leading to hair loss. However, such hair loss is temporary, and (in healthy individuals) hair resumes normal growth when nutritional balance is restored.

Creatine supplements have gained popularity as a means of enhancing stamina, developing strength and increasing muscle mass. However, creatine has a reputation for hair loss as a side effect. Although creatine may indirectly increase the level of DHT, no definitive link between creatine and balding has been established. According to the Journal of the International Society of Sports Nutrition study cited earlier, this belief is based upon a single study in which college-aged male rugby players who supplemented with creatine experienced an increase in DHT concentrations over time.

“Given that changes in these hormones, particularly DHT, have been linked to some (but not all) occurrences of hair loss/baldness, the theory that creatine supplementation leads to hair loss / baldness gained some momentum and this potential link continues to be a common question / myth today. It is important to note that the results of [the study] have not been replicated, and that intense resistance exercise itself can cause increases in these androgenic hormones.”

So while creatine may not cause hair loss, keep in mind that maintaining a balance of nutrients is imperative in giving your body what it needs to be healthy, as well as to achieve optimum performance.

Making the Decision to Get a Hair Transplant

As a competitive bodybuilder, you know that appearances count! While most say they believe that people shouldn’t be judged on the basis of their appearance, you actually are, in every competition! For whatever reason you’re experiencing hair loss, a hair transplant procedure can help you get the psychological boost that gives you that all-important competitive edge. When you take the stage looking and feeling your very best, the judges will take notice!

Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – counts many competitive bodybuilders among his patients, achieving the desirable look of healthy natural growth. He understands their concerns and recommends the most appropriate procedure for each individual’s situation.

In addition to the popular Follicular Unit Excision (FUE) and Follicular Unit Transplantation (FUT) procedures, Dr. Barusco offers two advanced – yet proven – procedures that can help those who are in the public eye and need to present a particular image to their audience. He developed the groundbreaking No-Shave FUE, which completely conceals harvested donor sites of the scalp immediately, allowing the patient to resume regular activities with virtually no evidence of the procedure.

The Combination FUE and FUT 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.

While each procedure provides an advantage to bodybuilders in regard to a reduction in aesthetic downtime that could affect your ability to compete, Dr. Barusco will base his recommendation on his determination as to whether you’re an appropriate candidate.

Regardless of which procedure is right for you, post-surgery care is crucial. You may have had a procedure that doesn’t look as if you’ve just received a hair transplant, but the surgical site needs sufficient time to heal. To give your hair grafts the best possible opportunity to heal and establish themselves, you should wait at least one month after a hair transplant before going to the gym, lifting weights or doing other strenuous exercise. This also will decrease the possibility of bleeding or trauma, which could affect the grafts. Your surgeon should take your lifestyle into account when giving post-op care instructions.

Choose Your Surgeon Wisely to Be Your Best

The path you’ve chosen as a competitive bodybuilder is demanding. As high as your standards of physical excellence are, you’re always striving to meet those of the judges. Your standards of a hair restoration surgeon should be just as high.

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!

Questions to Ask a Hair Transplant Surgeon

Have you made the big decision to undergo a hair transplant procedure? If so, you’ve most likely been paying attention to advertising by national brand clinics and other practices that position hair restoration somewhat as a consumer purchase. However, no matter what the procedure, hair transplant surgery is surgery. This takes it from the realm of a consumer purchase to a medical procedure. Once you see it from this lens, you understand how important it is to not only ask questions of the hair restoration surgeon who may be performing your procedure, but to ask the right questions. 

Heavily advertised clinics and practices depend upon consumers’ familiarity with their brand name, expecting you to assume that you’ll be treated well and get the outcome you want. However, as our blog post – “What to Look for in a Hair Transplant Surgeon” – states, choosing a hair transplant surgeon based solely upon the amount of advertising the doctor or practice does is no guarantee of good results. 

There are also those who “shop” by price only, looking for the practice offering the lowest cost and assuming that all hair restoration surgeons are equally skilled. This assumption is greatly mistaken. As our blog post – “Is Your Hair Transplant Surgeon Qualified? What You Need to Know!” – covers, 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 prior surgical training or accreditation of any kind. And as we frequently note, some clinics assign the harvesting and implantation of hair grafts to non-medical technicians, which has resulted in serious complications and outcomes ranging from poor to irreversible due to overharvesting of the donor site.

How to Find a Reputable Hair Restoration Practice

Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – believes that knowledge is power – and therefore consumers need a base knowledge about the hair restoration field in order to make an informed decision. For this reason, we’ll start with how to find a reputable practice, which isn’t as easy as you may think. Advertising can be misleading, and websites that seem to be of an informative nature can have affiliate links, which means that the owner of the website is paid a percentage of the revenue of products sold on the site.

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. The ISHRS offers objective, unbiased information, and does not accept advertising or affiliate links. Its 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. 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.

Questions to Ask the Surgeon During Your Consultation

Whether your consultation will be virtual or in-person, first make sure that you will be talking to the surgeon who will be performing your procedure – not a salesperson or medical technician. As our blog post – “The Importance of Consultation Before Hair Restoration Treatment” – cautions, if you’re told the doctor cannot or will not meet with you, leave – or don’t schedule the consultation in the first place. This is a red flag that should not be ignored!

For additional information on this topic, Dr. Barusco’s informative YouTube video – “The Importance of Consultation” – is a comprehensive discussion of what you should expect during your hair loss consultation. Running at just over 24 minutes, this video covers every aspect in detail – including Dr. Barusco’s observations about how less-than-conscientious practitioners fail their patients.

The following questions are courtesy of the ISHRS so that you can make an informed decision about the surgeon who will perform your hair restoration procedure.

The Physician’s Training and Credentials

Questions about the physician’s training include:

  • 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/province or the state/province 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.

The Physician’s Experience

If you are considering surgical hair restoration (hair transplantation, scalp reduction, flap grafting) you should want to know:

  • 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?

Other Relevant Questions 

  • 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?

What is the Most Important Aspect of Choosing a Hair Restoration Surgeon?

As you’ve learned, a well-known brand name or cost should not be the basis of choosing a hair restoration surgeon. Being an informed patient and asking the right questions will help you achieve the outcome that allows you to face the world and live your best life with renewed self-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!

Hair Transplantation to Conceal Scars

Whether caused by injury or surgery, scars on the head leave a constant reminder of either a trauma that the individual is trying to emotionally move on from, or a procedure intended to improve one’s appearance – but left unwanted evidence. In both cases, a hair transplant designed to conceal such scars can provide a major step to restoring the self-confidence needed to make the recipient feel like a whole, healthy person again, or the last mile to complete the aesthetic goal of a brow lift or facelift.

Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – has extensive experience in performing hair transplants to cover scalp scars of every type. Although each patient has their own story about the journey that led them to his practice, the particular problem that scars on the scalp pose is fundamental.

Why Doesn’t Hair Grow on Scars?

Hair typically doesn’t grow on its own in scar tissue because it lacks the dermal structures to support hair growth, as exist in normal skin. Regular readers of our blog may be familiar with our blog post – “An Up-close Look at Hair Grafts” – which describes a hair follicle and its related structure.

A follicular unit 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.

In undamaged skin, blood vessels under the follicles help them grow and regenerate. But when skin is damaged, a scar consisting of thick fibrous tissue forms, which doesn’t allow hair follicles to grow back. Because scar tissue tends to be thicker than undamaged skin, scars on and around the scalp are conspicuous. Scars caused by injury are also irregularly shaped, while those from surgical procedures show the path of the sutures.

Surgical scars on most locations of the body can be concealed under clothing, but scalp scarring has nowhere to hide. Depending upon the location and/or size of the scar – as well as the amount of hair one has – it typically isn’t possible to grow hair long enough to comb or style over the scar. Even so, no matter how carefully styled one’s hair may be, wind and the numerous movements you make throughout the day are likely to shift its position, falling away from the scar to leave it visible.

What are the Challenges of Hair Transplants to Conceal Scalp Scars?

This type of hair restoration surgery involves implanting hair grafts into the scar tissue itself. Because the original hair follicles are gone, the surgeon must determine the correct angle and direction in which to place the individual grafts to fill in the areas of lost hair. Also, the thick, stiff nature of scar tissue makes precise placement of hair grafts more challenging.

Another major challenge is ensuring the hair grafts have an adequate blood supply. They must take root, so to speak, and connect with surrounding capillaries before hair can start to grow. Scar tissue is prone to poor blood supply, so it’s more difficult for transplanted follicles to get the nutrients necessary for healthy hair growth. If the blood supply is inadequate, the transplanted hair follicles will die or be unable to function adequately.

Hair Transplants to Conceal Scars from Trauma and Neurosurgery

As the International Society of Hair Restoration Surgery (ISHRS) notes, the head is particularly vulnerable to injury. Major causes of head/scalp trauma are motor vehicle accidents, childhood accidents, sports injuries, industrial accidents and physical violence. Neurosurgery performed to treat brain injury will result in additional scaring.

Regardless of the severity of such injuries, performing restorative surgery requires the highest level of experience, medical knowledge, strategic planning, skill and sense of aesthetics. In this field, Dr. Barusco is renowned for the complex procedure he performed for “K.J.” – a man whose near-fatal motorcycle accident resulted in multiple skull surgeries. A few years after making a remarkable recovery, K.J. decided he was ready to make the most of his second chance at life, without the scars that he felt self-conscious about. His inspiring story is the subject of our blog post – “See Me, Not My Scar – Restoring Hair to a Head Trauma Patient Other Doctors Turned Away” – which we invite you to read in its entirety. K.J. also provided this testimonial video, which can be seen on Dr. Barusco’s YouTube channel, Hair Loss Medical Advice.

“(The patient’s) case was difficult, and posed a higher risk of serious complications due to the surgeries he had for his head trauma,” said Dr. Barusco. “Particularly the reconstruction of his skull with a synthetic material, which was placed under the area to be transplanted. This made the procedure of transplanting hair more challenging and risky. Most other doctors don’t have the experience or the facilities to perform this procedure under sterile conditions, and with the pre- and post-operative preparations that were needed to do it safely.”

Dr. Barusco chose the Follicular Unit Transplantation (FUT) procedure on K.J., which he determined would achieve the best result. “Due to his various scalp scars, the safe area for donor hair harvesting was limited to the back and right areas of his scalp. An FUT was recommended in order to move more hair in one procedure.”

Although Dr. Barusco decided that the FUT was the appropriate procedure for K.J., the Follicular Unit Excision (FUE) may also be used. Typically done as a shaved procedure (where the donor area is shaven), Dr. Barusco created an improved technique known as the “no-shave” procedure. This technique allows clients to have the benefits of an FUE procedure without having the downtime of waiting for the hairs of the donor site to grow in. Advantages include complete concealment of harvested donor sites immediately, and a quicker return to normal activities, as no suture removal is required.

In addition, Dr. Barusco created a pre- and post-operative protocol designed to increase safety in these types of procedures. This protocol was published in a scientific journal and in a medical textbook, and today is used by many doctors in the field.

Hair Transplants to Conceal Cosmetic Surgery Scars

Ironically, the surgical procedures that many seek to achieve a more youthful appearance – such as facelifts and brow (forehead) lifts – result in scarring along the hairline, and sometimes complete loss of hair in some areas, such as the sideburns. Depending upon the experience and skill of the surgeon, cosmetic surgery scars may be discrete and not readily visible, or more obvious.

In his YouTube video – “Hair Transplants Into Scars from Plastic Surgery” – Dr. Barusco makes the following observations:

“Many patients come to me because they’ve had a cosmetic procedure – like a facelift or forehead lift – or skin cancer or an accident or burns, and now the scars are hard to hide. So a lot of times the incisions from a facelift are going to go either in front of the hairline. They start around the temples, depending if you have a lower lift, they’re going to be tucked in usually behind the ear. So this can affect your hairline around the ears – sometimes behind the ears … It depends on what you need and what your doctor is going to do for you. Sometimes, the doctor will make an incision in front of the hairline – sometimes behind the hairline – and it wraps around the ears. So when you go for your consultation for your facelift, ask your physician to tell you which technique he or she is going to use, because that can affect your hair in different ways.”

Visible scarring, hairline distortion and sideburn distortion are complications that occasionally follow facelift and brow lift surgery. Camouflage is possible whether these facelift and brow lift scars are located around the ears, in front of the hairline or within the hairline. Grafts are implanted directly into and around the scar so as to create a seamless transition between the facial skin and the scarred area. Our blog post – “Hair Transplants to Conceal Facelift Scars – What You May Not Know” – explains this topic in greater detail.

A hairline that is higher or farther back than desirable – as well as the loss of sideburns – can also be repaired. Again, meticulous care is taken to match the angle and direction of the hair in the reconstruction zones so as to produce a completely natural-appearing result. Dr. Barusco’s YouTube video – “Hair Transplantation to Cover Facelift and Eyebrow Lift Scars” – provides case studies and before-and-after photos of patients for whom he performed such restorations.

While we always emphasize the importance of making sure the surgeon you choose for your hair restoration has the experience, qualifications and skill to provide the best possible result, it is even more essential to do so when your goal is to conceal scalp scarring. This is not a procedure to be performed by a surgeon whose practice depends upon one or two types of procedures performed in a rather standard manner for all patients. As with our determined patient K.J., those living with scars want their appearance restored to the point where they can feel comfortable and confident facing the world – either as a fully integrated healthy individual, or as a younger, more refreshed version of themselves!

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!

Is the Combined FUE and FUT Right for You?

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!