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Is the Combined FUE and FUT Right for You?

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Is the Combined FUE and FUT Right for You?

Male Hair Restoration, ,

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

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

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

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

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

What is the Combined FUE and FUT Hair Transplant Procedure?

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

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

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

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

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

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

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

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

Choose Your Surgeon Wisely for Your Hair Restoration Journey

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

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

Principles of Male Hairline Design

Male Hair Restoration,

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

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

Why is the Male Hairline So Important?

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

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

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

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

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

The Art of Designing the Ideal Male Hairline

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Can Body Hair Be Used For Hair Transplants?

Male Hair Restoration,

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

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

The Limitations of Scalp Donor Areas

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

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

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

Where is Body Hair Harvested for a Hair Transplant?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Male Hair Restoration,

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

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

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

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

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

The Story Behind the Fight the FIGHT Campaign

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Male Hair Restoration

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How Important is the Crown Area to Your Appearance?

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

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

Considerations for a Crown Restoration Procedure

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

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

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

Poor candidates for crown restoration surgery:

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

Ideal candidates:

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

Cardinal rules for crown restoration:

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

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

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

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

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

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

Male Hair Restoration,

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

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

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

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

The Difference Between FUT and FUE Procedures

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

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

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

How Did the FUT Come to be Considered Outdated?

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

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

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

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

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

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

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

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

Make an Informed Decision and Choose Your Surgeon Wisely

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

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

The Big Picture: Hair Replacement and Self-Confidence

Male Hair Restoration, ,

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

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

Does Hair Loss Really Affect Self-Esteem?

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

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

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

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

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

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

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

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

Video Conferencing – Nowhere for Balding Men to Hide

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

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

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

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

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

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

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

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

Choose Your Surgeon Wisely and Reclaim Your Self-Confidence

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

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

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

Was 2021 a Very Good Year? Plan on Making 2022 Even Better by Getting Your Hair Back!

Male Hair Restoration,

As the world began to reopen in 2021, the plans that had to be postponed during the height of the COVID-19 pandemic were resumed. Yet even if 2021 was a good year for you, perhaps some goals still had to be put off – for example, a hair restoration procedure. If this was the case, 2022 can be the year you get your hair back!

Should a hair transplant be on your new year’s resolutions list, you need to be up-to-date on the significant advancements that have been made in the hair restoration field. As you begin researching your options, be aware that not all hair transplant surgeons or clinics offer every procedure – especially those requiring significant experience and top-level skill. Also keep in mind that even such popular procedures as the Follicular Unit Transplantation (FUT) and Follicular Unit Excision (FUE) demand an experienced surgeon to achieve the desired aesthetic result. Avoid the pitfall of assuming that because the FUT and FUE are well-established procedures, all surgeons perform them equally well.

Advancements in FUE

Hair transplantation is constantly evolving. Improvements in techniques and technology make possible outcomes that not only look like natural hair growth, but involve less patient downtime. Developments in FUE provide an excellent example.

To start at the beginning, FUE is a surgical hair transplant technique in which follicular units 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.

One aspect of the procedure that can be a downside is that it requires the donor area be shaved in order to harvest each graft. For many, this can be a difficult, embarrassing process because of appearing in public with a half-shaved head. Some patients may have to take time off work in order to allow their hair to grow back.

For this reason, Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – developed the innovative No-Shave FUE, which completely conceals harvested donor sites immediately, allowing patients to resume their regular activities with very little downtime. Dr. Barusco has produced an informative video for his YouTube channel, “Hair Loss Medical Advice,” that describes the procedure in detail.

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

Dr. Barusco explains the procedure in his Hair Loss Medical Advice video, Long-Hair FUE.

“It started with my good friend, Dr. Marcelo Pitchon from Brazil. I’m from Brazil originally. He popularized the method of the long-hair transplant with the strip method a few years ago. Nowadays, with the advantage of certain types of equipment that we have, they allow us to harvest hairs via FUE and still maintain the hair shaft at the same length that it was – one or two inches in length sometimes – and then we can use that length inside, keeping the hair instead of clipping it short. And then when we transplant, the patient has a preview of their result. Obviously, this only lasts for a few days, since most of the hairs that we transplant fall out during the healing phase – but it allows the patient to have an idea of what the result is going to be like.

“It also allows me, as a surgeon, to see that I’m not missing anything. Maybe I need to add a bit more density in a little area that I’m working on. The surgery is very laborious and time-consuming to perform because the longer hair gets in the way, so it requires a lot of patience and skill.”

How Can You Know if an FUE Procedure is Right for You?

Because the traditional shaved FUE and no-shave FUE are well-known procedures, those interested in a hair transplant often request them. However, the type of hair transplant procedure that’s best for your particular situation may be different. Only a consultation with an ethical, conscientious surgeon who asks the right questions can help you determine the procedure that will provide the optimum immediate and long-term outcome. Our blog post – “Is the FUE Procedure Right for You?” – covers facts and possible risks (mainly from non-medical personnel performing the procedure) so that you can have a more productive consultation and be confident in your decision.

For even more in-depth information, watch Dr. Barusco’s videos – “Formal Indications for Hair Transplantation via FUE” – and “Contra-Indications for Hair Transplantation via FUE” – which covers the situations in which FUE is not (or should not be) recommended.

Choose Your Surgeon Wisely, and Get 2022 Off to a Great Start

If you’re determined to no longer delay restoring your hair, you deserve to know all of your options – and have an internationally recognized surgeon providing the right, and the best procedure for your individual situation.

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!

An Up-close Look at Hair Grafts

Male Hair Restoration,

If you are just beginning to explore your hair restoration options, you’ve doubtlessly encountered the term “hair graft.” But what exactly is a hair graft? The sources you may turn to for information could assume that you possess more background knowledge than you actually have. There is nothing wrong with that. As we at Tempus Hair Restoration always say, knowledge is power. The more you know about what a hair transplant involves, the better able you’ll be to find an ethical practice dedicated to providing the best possible result for your individual situation.

Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – answers this fundamental question in an episode of his YouTube channel series, Hair Loss Medical Advice. 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.

How Are Hair Grafts Harvested?

The type of hair transplant procedure you have will determine how the grafts are harvested. For the Follicular Unit Transplantation (FUT) method, hair follicles are harvested from the donor area of the scalp as strips. After harvesting, each strip is divided into smaller sections until ready for transplantation. For the Follicular Unit Excision (FUE) method, follicular units are extracted individually from the scalp.

As you now know, each hair graft is a complex structure that must be harvested carefully so that it remains intact. And this is the point at which Dr. Barusco cautions against the increasingly popular use of robotic devices in hair transplantation. Many hair clinics that utilize such robots promote this as a selling point. The website for one such practice proudly states that “The physician does not actually harvest the donor grafts; the harvesting step is completed by the [brand name redacted] robot.”

We invite you to read Dr. Barusco’s insightful article on this topic, in which he shares his experience in treating patients whose original hair transplant procedure was botched by robots operated by non-licensed, non-medical personnel. Although the subject has been covered in some of our previous blog posts, unfortunately, it still bears repeating.

The Issues With Robotic Devices

The following excerpt from Dr. Barusco’s article explains the situation from his insider’s perspective.

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

“Many doctors have also bought a robotic device that assists in FUE procedures. A robotic arm makes incisions in the skin to remove follicles from the donor area. The new version also makes recipient incisions and places the removed hair grafts. But robots are machines, and if the person behind the controls does not know basic rules of hair transplantation, the results may be bad. Sometimes, the robot can’t see the hair very well (the best case for the robot is dark, straight hair against light skin) and the surgeon has to switch mid-procedure to a manual extraction. Well, what if the surgeon does not know how to do this?

“In non-ideal patients, hair follicle damage (transection) rates can be higher than manual extraction done by an experienced surgeon. Also, manual extraction and an experienced surgeon allow the use of very small diameter punches (0.8mm or smaller), which creates very small incisions. The robotic device uses a two-step punch (a sharp punch scores the skin, and a slightly larger, dull punch dissects the hairs). This limits how small the punches can be. Bigger punches create larger incisions, which in turn create larger scars. Finally, a robot is a machine, and cannot provide the constant small adjustments needed to create a natural-looking transplant, which is the outcome you’re looking for.”

An Important Fact About Hair Grafts

Once a graft is taken from the donor site, hair will never grow there again. This is yet another important reason to research the credentials of any hair transplant surgeon and/or practice that you consider to perform your procedure. Only an experienced, skilled surgeon can harvest grafts without creating “patchy” areas that are missing hair, or leaving scars that cannot be concealed by new hair growth. And, only such a surgeon knows the proper alignment when implanting the grafts to the receptor site to achieve the effect of natural growth for an aesthetically pleasing result.

Keeping Hair Grafts Viable

Taking the proper steps to keep hair grafts viable after harvesting is just as essential as the harvesting procedure itself. 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.

During your consultation with your (potential) hair transplant surgeon, ask how hair grafts are treated and prepared for transplantation after harvesting. An ethical surgeon will readily answer this – and any other – question you may have. If the surgeon wants to know why you want to know, or hesitates or offers a general “answer” – such as the practice follows industry standards (without explaining what those standards are) – continue your search.

By the way, the person who performs the actual consultation should be the surgeon him/herself – not a technician, nurse, associate or salesperson. Our blog post – “The Importance of Consultation Before Hair Restoration Treatment” – covers the process step-by-step, including questions a good hair restoration surgeon will ask each patient, and the examination of hair and scalp to make an accurate diagnosis in order to determine the appropriate treatment. It also contains a link to Dr. Barusco’s video on this topic. As most people have no experience in how to evaluate the practices and clinics with which they’re about to schedule a consultation, this is critical information for protecting yourself and achieving your hair restoration goals.

Now That You Know, Choose Your Surgeon Wisely

The hair graft is the foundation of every hair transplant procedure. From how it is harvested, prepared before transplantation and finally implanted to achieve the effect of natural hair growth, the graft must be in the hands of an experienced, skilled surgeon at each step. 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!

Deciding Between Hair Restoration and a Hair System

Male Hair Restoration,

Those looking into hair restoration options may be considering a hair system as a possibility that offers the instant gratification of immediate concealment of their balding scalp. In spite of the dramatic before-and-after photographs on the websites of establishments specializing in hair systems, however, there are a good number of factors to weigh in your decision.

Assuming you’re doing your homework – which is presumably why you’re on our website’s blog page – you probably are already familiar with the basics of today’s hair systems. A hair system is designed to provide complete or partial coverage of the scalp. Unlike the toupee of days past, a hair system is applied semi-permanently, and is only removed for replacement or replenishing at the provider’s salon or facility. One reason a hair system may be attractive is its ability to provide a wide range of options in fullness, length and style – whereas the results of a hair transplant depend upon the amount of donor hair you have available, as well as the potential for future hair loss.

Having said that, not every hair system is the same, yet has the same potential drawbacks. Here are the questions and factors to consider.

Does the Hair System Use Human or Synthetic Hair?

Human hair, as can be expected, provides a more natural look than synthetic. Most human hair comes from China and India, and is stripped of its cuticle and dyed to match client specifications (in the case of a custom-made system). A colorfast garment dye is used, rather than salon hair color. Additional processing may be done to alter hair texture.

What is the Foundation of the Hair System?

Another factor that affects quality and price is the foundation, or base, to which the hair is attached. The base is typically lace or polyurethane. The higher the quality, the more refined the foundation – and the higher the cost. At the upper price range, the foundation will be carefully shaped to mimic a natural male hairline.

However, here is something for Floridians to consider. No matter how lightweight the hair system’s foundation, it – and the attached hair – will cover the entire scalp, or most of its surface. Given the Sunshine State’s intense summer heat, wearing a hair system attached to the top of your head by adhesive will be hot and uncomfortable if you spend any amount of time outdoors. Add the inevitable sweat that stays trapped underneath the foundation to the equation. Now, keep in mind that the hair system cannot be removed except by the provider of the service.

Is the Hair System Custom-Made or Mass-Produced?

Again, a bespoke hair system will provide a more natural appearance than a mass-produced or “stock” system that’s only adjusted for fit and trimmed for style.

What is the Cost of a Quality System, and How Long Does It Last?

Prices vary among providers for both custom and stock systems. If you’ve already conducted basic research online, you’ve probably seen that even general, “ballpark” figures are difficult to find and not particularly useful. Providers want prospective customers to schedule an appointment rather than lead you to expect a set price, which is understandable. For reasons that we hope are obvious, you should not order a hair system online.

The lifespan of a hair system is easy to determine, however. A system can last for two to six months, but most providers recommend replacing it after two to four months, before signs of wear-and-tear become obvious. For this reason, providers recommend purchasing at least two systems. In addition to needing to be replaced frequently, other regular costs include monthly maintenance and/or retightening charges.

The Advantages of a Hair Transplant Procedure

For the advantages that hair system providers claim, this solution entails ongoing expense, high maintenance and – for those living in hot climates – some amount of discomfort, especially during triple-digit summer temperatures. With a hair transplant – no matter which of several procedures is determined best for your particular case during a consultation with a hair restoration surgeon – you have your own hair, growing from your own scalp.

Unlike the extensive maintenance that a hair system involves, transplanted hair requires no special care. Our blog post – “Busting Common Hair Transplant Myths” – dispels the notion that you’ll have to “baby” your transplanted hair indefinitely. Aside from following initial post-surgical care instructions, you can shampoo, dry and style your hair as usual – as well as enjoy your favorite outdoor activities.

If the non-surgical aspect of a hair system appeals to you, a hair transplant procedure involves minimal discomfort. Local anesthesia is administered by injection, numbing the scalp. You remain awake and comfortable during the procedure. Post-surgical discomfort is readily treated by short-term prescription or over-the-counter pain relievers. Depending upon the type of procedure, down-time is also minimal. While you don’t get the immediate effect of a full head of hair, once your newly transplanted hair starts to grow, it’s all yours!

One exception to the need for patience is the breakthrough No-Shave FUE. Developed by Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – this procedure immediately conceals donor areas of the scalp, allowing patients to quickly resume regular activities. The No-Shave FUE is of particular benefit for those whose job puts them in the public eye, although anyone who is a good candidate will appreciate the instantaneous aesthetic result.

For others considering a hair system, not having a complete understanding of state-of-the-art hair restoration techniques could be weighing the decision more toward this end. One common misconception is that hair restoration only involves hair transplantation. Depending upon your individual case, hair transplant surgery may be followed up with such non-surgical treatments as Finasteride (Propecia) and minoxidil (Rogaine) to prevent or slow further loss and promote growth.

More recently, the introduction of adipose tissue and growth factor treatment has proven to be effective when administered as part of a course of treatment that includes surgery, or as a stand-alone treatment. It promotes stronger hair growth in thinning areas, improving volume and scalp coverage. Adipose (fat) tissue is a biologically active tissue that can stimulate the growth cycle of scalp hair. This therapy utilizes the stromal vascular fraction of subcutaneous adipose tissue, and the growth factors they secrete.

In other words, the treatment uses the patient’s own fat, harvested from just under the skin through a very thin liposuction cannula, with no stitches necessary. The fat is concentrated and purified in a centrifuge. It is then combined with plasma obtained from the patient’s blood, and injected into the scalp. This therapy helps repair damaged hair follicles, stimulating stronger, thicker growth. Results may be seen in three to four months, with 12 months typical to achieve the full benefit.

Our blog post – “Adipose Tissue and Growth Factors – Expanding Hair Restoration Horizons and Telling the Truth” – describes this treatment in detail, as well as Dr. Barusco’s role in its ongoing research through the STRAAND clinical trials.

Another concern may be the possibility that subsequent hair transplant surgeries will be necessary as hair loss continues. While the non-surgical treatments just mentioned are prescribed and administered to prevent or slow the progress of further hair loss, an additional transplant may be needed. However, this is a situation to be discussed with and monitored by your hair restoration surgeon.

Why You Should Consult a Hair Restoration Surgeon Before Making a Decision

Before choosing a hair restoration system over a hair transplant, schedule a consultation with a hair restoration surgeon. An ethical surgeon will conduct a thorough consultation and recommend the course of treatment appropriate for your individual situation. In fact, you may even be told that you are not a good candidate for a hair transplant. If so, this would not necessarily be a green light to get a hair system. Any recommended non-surgical treatment would require a non-covered scalp.

Dr. Barusco covers what prospective patients can expect during a consultation with him in our blog post – “The Importance of Consultation Before Hair Restoration Treatment” – as well as in his informative YouTube video – “The Importance of Consultation” – both of which explain the role of consultation in making an accurate diagnosis of the cause of hair loss and mapping a treatment plan that will achieve the optimal outcome.

Weighing the Cost of a Hair Transplant Procedure

Finally, we understand that a good deal of one’s decision may be influenced by price. As previously covered, the true cost of a hair system over the years adds up considerably – and in the end, you have nothing to show for all of the money spent.

Should you reach a point where a hair system is no longer desirable, practical or affordable, consider whether your self-image and self-confidence will be removed as the last system is peeled from your scalp. A hair transplant is permanent, even if an additional procedure may eventually be needed. Again, supplemental non-surgical treatments can help prevent or slow the progress of further hair loss. A hair transplant is an investment in yourself that can ultimately pay big dividends!

Unlike many other hair restoration practices and clinics, Tempus Hair Restoration does not have set-fee procedures or pricing per number of hair grafts. Our approach is to treat each client as an individual, taking into account such factors as the following:

  • Your specific type of hair loss
  • Amount of current and projected hair loss
  • Complexity of procedure
  • Ethnic background (which affects hair texture and growth patterns)
  • Medical history/pre-existing conditions
  • Desired aesthetic result
  • Additional relevant circumstances, depending upon your individual situation

Once Dr. Barusco has made a diagnosis and treatment plan, our patient educator discusses next steps, including pricing and financing options. We offer qualified clients third-party 12-month interest-free financing — as well as low-interest 60-month financing. A hair restoration procedure by world-renowned surgeon Dr. Barusco can be within reach.

Learn the Facts, and 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. 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!