Background

Although men do not face the same hormonal changes with aging that women do, the male biological clock still ticks, and over time changes in a man’s appearance can lead to a negative self-image, which can take a toll on mental and physical health. Today, men are turning to cosmetic surgery in an effort to help break the cycle of interaction between appearance and negative self-image. Because of this emerging trend, more male patients will be asking their trusted primary care providers for advice in navigating the potentially treacherous world of cosmetic surgery.
Whether in the public eye or leading a more private life, many men put forth energy, effort, and income to maintain a healthy, youthful appearance. Increasing access to more affordable, innovative, and less invasive forms of cosmetic surgery has resulted in more men turning to cosmetic procedures in an effort to look and feel younger. In fact, the American Society of Plastic Surgeons 2010 Report of Plastic Surgery Statistics indicates that of the 12.6 million plastic surgery procedures conducted annually, over 1.1 million were performed on men — a dramatic increase from the 225,009 procedures performed on men in 2000. Demonstrating their cost-effectiveness in these challenging economic times, minimally invasive procedures, such as botulinum toxin injections (Botox) and fillers, were up more than 9% from the prior year in 2010-2011. The more costly operative procedures that men undergo in large numbers include robotic hair transplants, nose reshaping (rhinoplasty), liposuction, cosmetic eyelid surgery (blepharoplasty), and facelifts, as well as surgery to correct male breast enlargement (mastopexy).
The ideal cosmetic plan maintains a life-stage balance of facial and body appearance that allows one to look their best throughout adult life. At earlier stages in life, avoiding excessive sun exposure, toxins from smoking, and recreational drug use will help to stall the progression of environmentally related aging changes. Later, avoiding significant weight fluctuation minimizes the development of loose or flabby skin. Body issues unrelated to such lifestyle factors as diet and exercise are best addressed once bone and soft tissues have reached maturity. For some, a time may come when surgery is considered for body issues unrelated to lifestyle, and plastic surgery may be the best option to help maintain a healthy self-image.
When selecting a plastic surgeon, patients should be sure to consider expertise and board certification. It is important to do the research and be patient with the selection process, because it can take some time. Patients should consider the procedure carefully and discuss with the surgeon whether a procedure is the right step to help meet their goals; this is an important part of the process because cosmetic surgery is not the answer for everyone. Patients should consult with their physician so that they can ask the correct questions in order to move forward appropriately.
A plastic surgeon will help identify patients whose body image goals and objectives may not be met with an operation alone. Postponing surgery with referral to a nutritionist, exercise trainer, or internist may be the appropriate outcome of the initial consultation. For surgery that is entirely elective, all patients should be close to their ideal health before having an operative procedure. If lifestyle choices and habits are not addressed preoperatively, the results of most cosmetic surgeries will be transient and therefore ultimately not worthwhile.
The following is a guide to help men look and feel their best throughout the lifespan.

Men in Their 30s

A man’s circulating testosterone level begins to decrease after age 30 years, with loss of lean muscle mass averaging 1% a year. Because of this, the most important thing a man can do to keep himself looking youthful is to continue building and maintaining his muscle mass. A regular program of cardiovascular fitness paired with weight training is essential to mitigate the natural aging process of decreased muscle mass. Proper hydration and attention to rest and diet are reflected in a healthier, more youthful appearance.
At this stage, age-maintenance procedures that are less invasive and are cost-effective can deliver results that look far more natural than other, more radical surgical choices. Skin care, sun avoidance, and proper use of sunblock are also crucial at this and every life stage.

Men in Their 40s

The use of botulinum toxin injection (Botox) and fillers has become much more common among men in their 40s and 50s, who are beginning to deal with the loss of facial skin elasticity. Because a man’s face has a more robust blood supply than a woman’s face, surgeons performing any personal enhancement treatments on the face must consider such factors as the depth of skin peeling, energy levels for light base treatments, and frequency of past use of topical medications.
The most common aesthetic procedure for men in this age group involves rejuvenation around the eyes. Blepharoplasty (eyelid surgery), when done well, can help revitalize a man’s face in a discreet manner, without announcing to the world that a cosmetic procedure was performed.

Men in Their 50s and Beyond

Men in this age group will typically experience increasing skin accumulation along the jawline and the neck; this is often referred to as “jowls.” Traditional approaches for face and neck lifts do not work particularly well on men because the scars cannot be hidden under the hairline, as with women. To avoid the problems caused by hairline alteration, an alternative operation to a traditional face and neck lift is performed: Using a geometric incision pattern to remove the excess neck skin hides the scar in the area between the bottom of the chin and the Adam’s apple. The presence of hair follicles in the beard also helps camouflage the scar.

Regardless of age, encourage your patients to take a planned, realistic, and conservative approach to achieving their ideal body image. Less favorable cosmetic surgery outcomes among men, such as those seen in Bruce Jenner, Mickey Rourke, and Burt Reynolds, can and should be avoided with the guidance and support of surgeons who demonstrate a clear understanding of what cosmetic surgery options are available, along with knowledge of overarching health concerns.
At the office of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa, we provide a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance.  Please call our office to find out more about us at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.

Background

From the 1960s into the mid 1990s, transplanted hair appeared unnatural because surgeons used unnaturally large-appearing hair grafts consisting of 10-25 hairs each. That era is over. Hair naturally grows in 1-4 hair follicular groupings. In the early 1990s, surgeons began switching from using unnatural-appearing hair “plugs” (10-25 hairs) to using consistently natural-appearing hair follicular groupings (1-4 hairs). In current practice, all women and men should expect consistently natural-appearing transplanted hair.
Follicular unit transplantation is the standard surgical technique to treat male- and female-pattern hair loss. Follicular unit transplantation is also used to correct unnatural-appearing plug-like transplants, repair eyebrows, and redistribute hair in persons with inactive scarring alopecias.

The ARTAS System

The ARTAS System
For the very latest technology in hair restoration, Dr. Mark Bishara is now using the FDA approved 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).

Frequency

Male-pattern hair loss affects approximately 50% of all men, and female-pattern hair loss affects approximately 30-40% of all women. The rate of loss and extent of loss vary from patient to patient.
Follicular Unit Transplants (FUT) is designed to produce effective results with minimal downtime and no damage to surrounding hair follicles. Dr. Bishara is highly experienced in performing all of these procedures, and will help you determine which one is right for you in order to achieve the best possible results.  Please call our office to schedule a consultation appointment with Dr. Bishara at (817) 473-2120 or visit our website to learn more at www.MarkBisharaMD.com.

 

What is Hair Restoration?

Hair restoration includes the surgical and non-surgical methods used to counteract or slow symptoms of hair loss in men and women. Methods may be used individually or in combination to produce the desired results depending on a person’s needs. Finding the right hair restoration solution can be difficult. It’s an important decision that can improve your life in unimaginable ways. But one size does not fit all types of hair loss.

For Men

Getting straight answers about hair loss treatments for men can be almost as frustrating as losing your hair.
Some guys are great candidates for hair transplant surgery, others prefer the lifestyle advantages of the hair replacement process, and some simply want to prevent their existing hair from thinning any further. No matter what kind of hair loss you have, it’s an ongoing process that changes over time.
Dr. Mark Bishara’s office offers a variety of treatment options, including non-surgical and surgical.

For Women

Millions of women suffer from hair loss, more than 30 million in the U.S. alone. And while most treatments available today seem to be designed with men in mind, the good news is that there are safe, proven treatments designed especially for women.
Women’s hair–and women’s experiences with hair loss–are very different. That’s why Dr. Bishara will first assess why you are having hair loss and what option we can do to help you.

Hair Restoration Options:

PROPECIA®

PROPECIA® is available by prescription from Dr. Mark Bishara and is a once-a-day pill developed to treat mild to moderate male pattern hair loss, a hereditary condition that causes receding hairlines, thinning and/or balding on the top and front of the scalp. This product is proven effective for treating hair loss in MEN ONLY.

Low Level Laser Technology (LLLT)

The low- level laser therapy treatment is also known as “The Cold Laser”. The laser light generated by low-powered (cold) lasers has recently come into use as a non-surgical hair restoration treatment for patten hair loss.
The LaserCap® using Low Level Laser Technology (LLLT) can help men and women of all ages who suffer from hair loss by emitting pulses of laser light energy to the scalp to stimulate the hair follicles and improve blood circulation in the area, encouraging hair growth once again.

Robotic Hair Transplants- The ARTAS System

Dr. Bishara uses the ARTAS System, which is an interactive, computer assisted equipment employs image guidance to enhance the quality of hair follicle harvesting. Performed in both of Dr. Bishara’s offices (Mansfield & Southlake), FUE robotic hair transplant moves healthy, functioning follicles to the areas of the patient’s scalp most impacted by baldness. The implanted hairs develop their own blood supply, begin to grow and new hairs are seen a few months after the procedure has taken place. New hair continues to grow over the course of a full year, making the change in the patient’s appearance gradually noticeable to others. Healing time is short, and there is no resultant linear scar as happens with other methods of hair restoration, because there is no incision.   This procedure is done on men and women.

Hair loss is a condition that occurs as a result of a side-effect of medication, aging, genetics, and traumatic injury to the scalp with scarring. Hair loss affects both men and women of all ages. This condition may cause pattern baldness, patchy spots or thinned hair.
Dr. Mark Bishara is proud to offer a wide range of comprehensive hair restoration procedures. Combined with his extensive experience and advanced skills, these procedures are often highly effective. The best treatment option for each patient depends on the location, cause, and extent of hair loss. Dr. Bishara will take the time to evaluate each patient, discuss his/her individual goals and together develop a personalized treatment plan using one of his many successful hair loss treatment options.  Please contact our office at (817) 473-2120 for further information or visit our website at www.MarkBisharaMD.com.
 

The ARTAS® System enhances manual surgical performance in three key areas where robotics are proven to extend human capability. For the very latest technology in hair restoration, Dr. Bishara is now using 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.

About the ARTAS® Robotic Procedure:

  • Skin tensioner is placed on the trimmed donor area to keep the area taut
  • High resolution visualization identifies follicular units on the surface of the patient’s skin and targets them for harvesting
  • Image-guided robotic arm maneuvers and deploys the two-needle system, compensating for patient movement
  • Inner needle scores the skin, then the dissecting punch separates the follicular unit from the remaining tissue
  • Gentle suction lifts the dissected graft partially out of the scalp, so technicians can remove using forceps
  • Grafts are manually transplanted in the desired scalp areas

A Better Patient Experience

Nearly 35 million American men are candidates for hair restoration, but only a small fraction choose the procedure. Uncertainty about the procedure results and the long recovery times may be too high a hurdle for many patients. Candidates are demanding a minimally invasive technique that provides consistent, safe results.
With the minimally invasive ARTAS® Robotic System, Dr. Bishara can build patient confidence with reproducible, natural-looking outcomes with fast recovery times. There are many patient benefits including:

  • Robotically precise and consistent
  • Reduced treatment times
  • Less discomfort
  • Faster healing and return to normal activities
  • Nearly undetectable donor area with no linear scar
Before and after pictures of some of our patients:




A Commitment to Clinical Excellence
The ARTAS® Robotic System is the product of nearly a decade of research and development by Restoration Robotics in collaboration with some of the most respected leaders in hair restoration medicine. After rigorous testing in clinical trials, the ARTAS Robotic System received clearance from the Food and Drug Administration in 2011.  Restoration Robotics continues to partner with a growing number of hair restoration physicians, such as Dr. Bishara, to apply robotic technology to improve patient outcomes.
Please call our office for more information on this unique and effective robotic hair restoration procedure at (817) 473-2120 or click on one of the buttons below:  Please also visit our website at www.MarkBisharaMD.com for more information on ARTAS.

 

 


While many men are fine with hair loss, for others baldness demands a remedy, which they seek in a variety of ways.
Over the years, the number of treatments that have been claimed to cure baldness has been exceeded, perhaps, only by the number of jokes about the condition. But since baldness — as unappealing a prospect as it may be for many men — is not an illness, procedures and drugs to treat it may not get the scrutiny given those for genuine medical conditions.
Things have gotten better, so there’s some of the older techniques and older treatments … and there are newer ones, so it’s a work in progress.  But while treatments have come along that have not worked well, there are things available for men who are losing or have lost their hair and would like to cover their pates. There are a variety of medical and surgical options, as well as things that are completely noninvasive.
Male pattern baldness is typically associated with the conversion of testosterone to dihydrotestosterone (DHT). Over time, the presence of this hormone has been linked to the thinning or “miniaturization” of hairs. The new hair that grows grows thinner and less pigmented.
For most men, noticeable hair loss begins in their 20s or 30s, but some see it even younger. Male pattern baldness tends to start later, affecting, to some degree, 20 percent of men by the time they reach the age of 20. But for most of these men, there are a lot of options to stop, reverse or delay hair loss. Here are a number of treatment options that have been tried and the pros and cons of trying them out.

Follicular Unit Transplant


Performed in two different ways, follicular unit transplantation remains the best surgical option for men seeking to counter their hair loss.  Hair transplant is the gold standard. It’s 100 percent. The body doesn’t reject its own hair.
FUT performed by Dr. Mark Bishara is a method of hair restoration surgery in which hair is transplanted only as natural, individual follicular units. This ensures that patients will achieve the most natural results and also allows Dr. Bishara to transplant the maximum amount of hair into a small area. These follicular units consist of up to four individual hairs in each follicle.
During the FUT procedure, the hair is trimmed short and then the scalp is numbed with a local anesthetic before being removed through a vibration distraction technique. The removed follicles are then stripped to their most natural state and then placed in the recipient area. Sutures are placed in the donor area, which are usually hidden by the patient’s hair. The healing process begins immediately after the procedure, and patients are usually able to resume normal hair care after a week. Hair growth typically begins about three months after the FUT procedure.
Rogaine
Surgery may be fine for some, but others prefer pharmaceutical treatments to the knife. The decision to pursue actual surgery … is not something everyone wants to do.  Many patients begin with medications.

One of those pharmaceutical interventions is the topical application of minoxidil, a foam known to many by the brand name of Rogaine. It’s probably not going to work that well for people who have already lost a lot of their hair,  but for those early on in the process, minoxidil works great.

Hair Plugs

In this process, which is no longer widely used, a small, circular cone of scalp –was removed from the back of the head and placed in a hole put in the front. It’s really not done much anywhere anymore. While follicles are able to blend into the scalp and look natural, plugs never did because of their size — they were 30 times larger than the follicles transplanted now. The size made the plug look completely unnatural, something that can be gotten around — when done properly — with the modern follicle transplant.

Propecia


Propecia is a great medication [for hair loss]. It works about 85 percent of the time, at least to prevent further hair loss.
Originally designed to treat enlarged prostate, Propecia, known scientifically as finasteride, can be taken orally on a daily basis to counter hair loss. It has been shown to be highly effective, but it is not perfect. It works best when the patient is younger and the hair loss is early on. It doesn’t grow hair on a bald scalp; it only reverses the miniaturization process. Propecia has really remarkable results.

Flap Hair Restoration

The hair flap, also known as flap rotation, has not been done in a while. The hair flap involved isolating a flap of skin from the back of the head — where the hair was still growing — and rotating it to the front, maintaining the blood flow through the artery attached to the skin. The problem with the flap is it’s much too dense and you’re using up too much hair in a small area. The procedure had other drawbacks- It’s very unnatural looking and the hair is in the wrong direction.

Low Level Laser Technology (LLLT)

The low- level laser therapy treatment is also known as “The Cold Laser”. The laser light generated by low-powered (cold) lasers has recently come into use as a non-surgical hair restoration treatment for patten hair loss.
LaserCap | Low Level Laser Technology (LLLT)The LaserCap® using Low Level Laser Technology (LLLT) can help men and women of all ages who suffer from hair loss by emitting pulses of laser light energy to the scalp to stimulate the hair follicles and improve blood circulation in the area, encouraging hair growth once again. Recently, the FDA has announced its approval of Low Level Laser Technology for use in the promotion of hair growth for men, with approval for women anticipated soon as well. Dr. Bishara fully endorses the results of this advanced technology and is proud to offer LLLT in his office through treatment with the LaserCap.

Stem Cells

Needless to say, stem cells aren’t used as a hair loss treatment now, but hopes are high that we’ll have an endless supply of hair 20 years from now.  Doctors had differing opinions — ranging from five to 20 years — on how soon stem cells would be available. But the consensus was that hair treatments would change.
Fortunately, there are several treatments available to help promote hair growth or restore hair loss. These treatments are minimally invasive and affordable, and allow patients to enjoy a renewed confidence as thick, full and beautiful hair is restored. Hair loss treatment includes topical and/or oral medications, laser comb therapy, and transplantation.
Dr. Mark Bishara is proud to offer a wide range of comprehensive hair restoration procedures. Combined with his extensive experience and advanced skills, these procedures are often highly effective. The best treatment option for each patient depends on the location and extent of hair loss. Dr. Bishara will take the time to evaluate each patient, discuss his/her individual goals and together develop a personalized treatment plan using one of his many successful hair loss treatment options.  Please call us for more information at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.