The Dangers of Black Market Hair Transplants in Turkey

Category Archives: Male Hair Restoration

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!

Principles of Male Hairline Design

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?

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

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

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

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!