The older, traditional form of hair transplantation is called Follicular Unit Transplantation (FUT), or more commonly, “strip” surgery. In a “strip” surgery, the surgeon uses a scalpel to remove a large piece of scalp from the back of the head. This process requires stitches or staples to close the wound. The strip of scalp is given to a group of technicians who then manually dissect each individual follicular unit. These dissected follicular units are transplanted into the scalp by the surgical team. The recovery period for this procedure is significant, typically several weeks. In addition, patients may experience numbness, scalp tightness or lingering pain. More importantly, the risk of leaving a noticeable linear scar on the back of the head is unacceptable to many patients.

Donor Area Comparison

The “Strip” method:  a strip of scalp from your donor area is cut out with a scalpel, and the strip is completely removed from the head.  The donor area is pulled together and stitched close to the wound.  This method leaves a visible scar.
ARTAS Robotic method: the hair is removed individually by the robot and no cutting or stitches are needed.  The scalp retains the natural appearance with no linear scar.
Strip Method Post Procedure:                     ARTAS Method- 1 Week Post Procedure:

For the very latest technology in hair restoration, Dr. Bishara uses the ARTAS System. This interactive, computer assisted equipment employs image guidance to enhance the quality of hair follicle harvesting. ARTAS is the first hair transplant robot to improve the most challenging aspects of Follicular Unit Extraction (FUE). It received clearance from the Food & Drug Administration (FDA) for use in April 2011.  Please contact our office for more information at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.
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Plastic surgeons are seeing more patients who wish to undergo facial surgery, suggesting social media-posted selfies may be inspiring more Americans to consider plastic surgery.
The growing trend of taking selfies – a type of self-portrait photograph, typically taken at arm’s length with a hand-held digital camera or camera phone – and posting them on Facebook, Twitter,  Snapchat, and Instagram, has been attributed to the increase in nose jobs and other reconstructive facial procedures.
Dr. Edward Farrior, President of the AAFPRS who conducted the research that posed these assertions, states in CBS News:

“Social platforms like Instagram, Snapchat and the iPhone app Selfie.im, which are solely image based, force patients to hold a microscope up to their own image and often look at it with more self-critical eye than ever before. These images are often the first impressions young people put out there to prospective friends, romantic interests and employers, and our patients want to put their best face forward.”

According to an annual survey conducted by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) of a select group of the organization’s 2,700 members revealed one in three plastic surgeons reported seeing an increase in requests for facial procedures by patients who wanted to look better online.

Between 2012 and 2013 they saw a 10 percent rise in nose jobs, a seven percent rise in hair transplants and a six percent rise in eyelid surgery, says the NY Daily News. In addition, 58 percent of the doctors surveyed noted having a growing number of patients under 30 seeking out services – in part because of social media images like selfies.
Nose jobs (rhinoplasty) are the most popular elective surgical procedure conducted among those in the under 35 crowd – accounting for 90 percent of women, and 86 percent of men respectfully. And while women account for nearly 80 percent of plastic surgeries for face and eye lifts, men are becoming more determined to keep their hair and combat wrinkles.
This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX
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In consultations, women ask dozens of questions about the safety, durability and longevity of saline and silicone gel implants – the two types that are approved for sale by the U.S. Food and Drug Administration. Here’s a sampling:
Is it normal to have different-sized breasts?
Breasts are sisters, not twins. There’s no such thing as perfectly identical breasts. Most women have breasts that are slightly different sizes. In consultations, when women look at dozens of before-and-after photos, they are surprised and relieved to see that they are not the only ones with different-sized breasts.
The asymmetry can be addressed during surgery, by enlarging breasts with implants of different sizes, augmenting the smaller breast or reducing the larger breast. While surgery cannot transform those sisters into twins, it can make them look like sisters from the same family.
Will I be able to breastfeed if I get implants?
In most cases, breast augmentation surgery does not interfere with breastfeeding, because milk ducts are generally not disturbed during the procedure. When implants are placed through an incision made around the areola, milk ducts are sometimes disrupted, which may affect breastfeeding. However, not all women are naturally able to breastfeed, whether or not they have cosmetic breast surgery.
Do implants get in the way of reading a mammogram?
They can. That’s why technicians routinely ask women if they have breast implants. If so, they will gently displace (push up) the implants and take extra views of each breast. Because of the number of women who have had breast augmentation, radiologists are likely to have experience evaluating breasts with implants.
Can you make me a full C cup?
Women commonly think that being in proportion means wearing a C cup bra. Because there is no standard bra cup-sizing system, and because breast implants are measured in cubic centimeters not cup size, it’s better to refer to proportional as a “C look.” To achieve that, a 5-foot-tall woman with a small frame might end up wearing a B cup bra and a 5’ 8” woman might wear a D.
How soon can I get back to work and to working out?
The former depends on what your job entails. Generally, women who work in an office setting can go back to work on the fifth day after surgery. Those whose jobs entail lifting, pushing or pulling normally return to work at the end of the second week.
Three weeks after surgery is a milestone: That’s when women can run, ride a stationary bike and do lower-body weight training.  It’s also when policewomen or soldiers can put their bulletproof vest back. Women are usually comfortable doing arm exercises (upper-body weights) starting about six weeks after surgery.
Do breast implants have to be replaced every 10 years?
Breast implants don’t have an expiration date. They can handle hundreds of pounds of pressure, which is why a mammogram – which can apply up to 50 pounds – doesn’t harm them.
Through the years, manufacturers have increased the strength of the implant shell. On average, less than 3 percent of implants rupture or deflate.
Will my breast implants melt in a sauna?
Both silicone gel and saline implants have an outer silicone shell, which can melt at temperatures greater than 392 degrees Fahrenheit. A conventional sauna is typically between 150 and 190 degrees. If you were in an environment where your implants would melt, you’d melt too.
Women come in for a consultation to get their questions answered and to make an informed choice. While breast augmentation is not right for everyone, for those who choose it, it can make a life-altering difference.

This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX


In 2012, more than 330,000 women in the United States elected to have breast augmentation surgery; worldwide, that number exceeded 1.5 million. Although media coverage suggests otherwise, only a minute percentage of the women who get breast implants are actresses and models. They come from all walks of life; they include policewomen and CEOs, teachers and soldiers, young mothers and nurses.
About 30 percent of the women who get breast implants are in their 20s. They often report being self-conscious about their lack of development or embarrassed about their breasts being asymmetrical or uneven. About 35 percent are women in their thirties, many of whom lost breast volume after childbirth. Some want to recapture their pre-pregnancy breast size, while others liked the breast fullness they had during pregnancy and want to recreate it with implants.
Whether women are having cosmetic breast surgery (augmentation, lift or reduction) or reconstructive surgery after a mastectomy, their goals are similar: They want to look feminine, natural and proportional. They want their clothes to fit better.
In consultation, women ask dozens of questions about the safety, durability and longevity of saline and silicone gel implants – the two types that are approved for sale by the U.S. Food and Drug Administration.

This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX


NEW YORK (Reuters Health) – People who had rhinoplasty sounded a bit more nasal five months after the surgery, according to a new study from Iran.
The results from 27 surgeries showed that “the voices changed in statistically significant ways, but the changes were subtle,” Dr. Kamran Khazaeni told Reuters Health.
Khazaeni, a surgeon who specializes in ear, nose and throat procedures, worked on the study at Mashhad University of Medical Sciences in Iran.
The 22 female and five male patients “noticed changes, but overall, they were satisfied,” Khazaeni said. Patients ranged in age from 18 to 45 years old.
A team of linguists and speech pathologists detected more pronounced nasal sounds in test words like “man” and “namak” post-surgery after listening to voice recordings of the patients. Persian, the official language of Iran, has no nasal vowels, but does have nasal consonants – like the “m” in “man” and the “n” in “namak” – said Khazaeni, explaining why the group focused on those two words.
The results were confirmed with patient self-assessments and a computer program that analyzes acoustic sounds.
About one in 560 Iranians had cosmetic nose surgery in 2011. By comparison, about one in 1,250 U.S. men and women had the same procedure in 2012, according to national surveys from both countries.
Writing online January 28 in Plastic and Reconstructive Surgery, Khazaeni and his team say that if rhinoplasties can change vocal sounds by narrowing a person’s nasal cavity, people who rely on their voice for professional reasons should be made aware of this possible risk.
But Dr. Steven Pearlman, a facial plastic surgeon based in New York City who was not part of the current research, disagreed, at least in cases where patients are singers.
“The better trained the singer is, the less the nose has to do with it,” Pearlman said.
“I’ve operated on patients who are rock stars, Broadway stars and opera singers,” Pearlman told Reuters Health. “And in the classically trained American style of singing, you sing from the chest and the throat, not the nose,” he said, adding that speaking is different from singing and perhaps Middle Eastern methods of singing rely more on the nasal cavity for sound.
Regarding the study, the idea and goal were good, “but the execution was limited,” Pearlman said.
An important missing element is nasal airflow measurements taken on each patient before and after the surgery in order to detect changes in how air passes through the nose.
“Without this measurement, you may have airflow changes, but you don’t know,” he said.
The study raises interesting questions, such as why these results are being seen in Iran and not in North America, said Dr. Minas Constantinides. Anecdotally, of the more than 2,000 rhinoplasties he has performed, Constantinides said only one patient expressed concerns about more voice nasality after surgery.
Constantinides practices facial plastic surgery in New York City and is secretary of the American Academy of Facial Plastic and Reconstructive Surgery. He was not involved in the new research.
“I don’t think these results can be broadly applied to rhinoplasty,” he said. But, the current study “raises enough questions to bear being repeated” with larger groups of patients at a medical center in the U.S., he said.
“Rhinoplasty is one of the hardest procedures to do in facial plastic surgery,” Constantinides said.
“Patients understand that surgery always has some risk attached to it,” he said. “However, voice change is not something that patients need worry about in competent hands.”

This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX