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Hair Transplant Scars- Scar Revision by Dr. Mark Bishara, MD in Mansfield & Southlake

Fixing and Repairing Hair Transplant Scars

Hair transplant procedures that use follicular units exclusively leave no visible scarring in the recipient area. In Follicular Unit Transplantation (FUT), there is a single thin line in the donor area where the strip was removed. In Follicular Unit Extraction (FUE) there are multiple tiny round, white scars in the donor area, one for each extracted follicular unit. Generallythese scars are undetectable and are of no cosmetic consequence to the patient.
When older methods of hair restoration surgery are used, current techniques are performed improperly or, less commonly, when a patient is a poor healer, scarring may be excessive and may present a cosmetic problem. The scarring may be due to the plug itself (which invariably leaves a round white scar), it may be caused by the elevation or depression of grafts (seen with some slit and minigrafting techniques), or it may be due to a stretched or thickened donor scar.
Scarring in the recipient area can be eliminated by keeping recipient sites very small. Sites such as those used in FUT and FUE, will not leave any visible marks. Scarring in the donor area can be minimized by meticulous closures, where the wound edges are perfectly approximated and are under little or no tension. Using an inert material to close the wound, such as stainless steel staples, also helps to minimize the destruction of hair follicles and the incidence of hair transplant scarring.
When significant scarring does result, a number of techniques are available to reduce it. The two most effective methods are scar revision (excising or changing the direction of a hair transplant scar) and camouflage (a technique where hair is transplanted directly into the scar). In addition, thickened scars may be flattened with cortisone injections, depressed scars may be raised with dermal fillers and an irregular surface may be made smoother with dermabrasion or laser treatments.
The method for fixing hair transplant scars must be tailored to the specific situation, since each hair transplant repair patient has unique problems which influence the approach. Perhaps the most significant issue is the amount of remaining donor hair reserves. The following examples illustrate a number of common techniques used to improve scarring.
For some instead of just covering it up their scar, they just want to get rid of the problem entirely, that is why they opt for scar revision surgery. In this procedure, the scar is removed and the scalp is pulled back together. There will still be some scarring but it will be much smaller than the original.
Follicular Unit Extraction (FUE) is a great method of concealing hair transplant scars. This time, the donor grafts are taken from the beard or chest hair and then implanted on the scar and given time to grow. Those with a high hair density in other areas of the body are considered to be the best candidates for this treatment. Usually 50% to 90% of the grafts grow in scars, making the scarred areas of the scalp much less visible.

Before your hair transplant surgery, discuss hair transplant scar treatments available to your surgeon. Your hair transplant surgeon can help minimize scarring by using a certain closure technique.  If you have more questions about fixing hair transplant scars or to find out more about what can be done for thinning hair, please don’s hesitate to contact us at (817) 473-2120 or visit our website at www.markbisharamd.com.

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Men's and Women's Hair Loss- by Dr. Mark Bishara, MD

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Male Hair Loss
Androgenetic alopecia or common male pattern baldness (MPB) accounts for more than 95% of hair loss in men. By the age of thirty-five two-thirds of American men will experience some degree of appreciable hair loss, and by the age of fifty approximately 85% of men have significantly thinning hair. Approximately twenty five percent of men who suffer with male pattern baldness begin the painful process before they reach the age of twenty-one.
Contrary to societal belief, most men who suffer from male pattern baldness are extremely unhappy with their situation and would do anything to change it. Hair loss affects every aspect of the hair loss sufferer’s life. It affects interpersonal relationships as well as the professional lives of those suffering. It is not uncommon for men to change their career paths because of their hair loss.
Diagnosis of Men’s Hair Loss
Typical male pattern baldness is usually diagnosed based on the appearance and pattern of the hair loss, along with a detailed medical history, including questions about the prevalence of hair loss in your family.
 
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Women’s Hair Loss
Mistakenly thought to be a strictly male disease, women actually make up forty percent of American hair loss sufferers. Hair loss in women can be absolutely devastating for the sufferer’s self image and emotional well being.
Unfortunately, society has forced women to suffer in silence. It is considered far more acceptable for men to go through the same hair loss process. Even more unfortunately, the medical community also treats the issue of women’s hair loss as if it were nonexistent. Since hair loss doesn’t appear to be life threatening, most physicians pay little attention to women’s complaints about hair loss and essentially tell their patients that “it’s no big deal”, and that “you’ll just have to live with it.”
Of course what these physicians don’t seem to realize is that the psychological damage caused by hair loss and feeling unattractive can be just as devastating as any serious disease, and in fact, can take an emotional toll that directly affects physical health.
We recognize that hair loss is women is a serious life altering condition that can no longer be ignored by the medical community and society as a whole.
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Diagnosis of Female Hair Loss
Hair loss in women isn’t always as straightforward as it is in most men. In men about 90 percent of all cases are caused by hereditary male pattern baldness. In women, however, hair loss can be triggered by a multitude of conditions and circumstances.
The below battery of diagnostic tests should be performed when attempting to pinpoint the hair loss trigger, as well as a scalp biopsy. These tests can at the very least eliminate the possibility of certain disorders causing your hair loss and perhaps aid in finding the actual cause. The truth of the matter is that for many patients these test usually come back with a reading of “within the normal range,” but it’s important to remember that the proper diagnosis of female hair loss usually starts of with the process of elimination.
Hair loss affects both men and women of all ages. 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.
 

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Are Men Giving Up On Hair Loss Treatments And Heading Straight For Transplants?

Men suffering from hair loss may be getting fed up with all the miracle pills and potions being touted on the internet.
According to an opinion poll of hair experts conducted by WhatClinic.com, there has been a 260% increase in men enquiring about hair transplants, and a staggering 180% increase in men actually traveling abroad for cheaper hair transplant procedures.
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HuffPost UK LIfestyle spoke to Dr Maurice Collins, medical director of Hair Restoration Blackrock, to find out why there is a surge of interest.
He said: “Two factors, the technology of hair transplantation has improved dramatically over the last 10 years. A good hair transplant carried out by a trained team of technicians and a specialist hair transplant surgeon should not be noticeable, not even to ones barber.
“The old toilet brush style transplants of the 70s are definitely a thing of the past. Secondly, the likes of James Nesbitt and Wayne Rooney going public has helped remove the stigma of having a hair transplant. Men in their 40s, 50s and 60s are still unlikely to talk openly about their hair loss concerns, but men in their 20s and 30s are much more open.”
Follicular unit transplantation (FUT) is where a strip of the scalp, including the hair follicles, is removed and replanted at the front of the head. Follicular unit extraction (FUE), sometimes called FUE Harvesting, takes individual hair clusters (of between one and four hairs) and replants them one by one, which although more time-consuming, gives better results and less chance of scarring.
In a recent poll of cosmetic surgeons, 78% confirmed that interest from men in cosmetic surgery was definitely growing. Of those asked, almost nine out of 10 (89%) said they believe men are now far more conscious of their appearance than ever before.
The bottom line, says Dr Collins, is that there is no cure for hair loss. “The drugs that are currently available (Minoxidil and Finasteride) can arrest hair loss for a limited number of years but do not reverse hair loss. Hair transplantation takes existing hair from the back of the head and plants it on top and at the front. It restores a hair line and fills in the gaps, but it is not a cure. It is likely that if a cure is found it will come from stem cell research. ”
As for men travelling overseas for the procedure, Turkey has proven to be the destination of choice for UK men, aided by the considerably lower costs, and affordable flights. India boasts the most competitive average prices, however it may well be the cost of flights that has deterred patients.
So are transplants the only option if you’re worried about your hair? No, says Dr Collins.
“Only one in four men who visit proceed to have a transplant. For those who choose not to have a transplant, the first option is to accept your hair loss and shave your head. Many men are not too worried about their hair loss and look great with a shaved head – think Andre Agassi or Bruce Willis. Others are not suitable candidates. For example they may not have enough donor hair for transplantation. The donor hair comes from the back of the head, which is immune to hair loss. Budget and age are also factors.
“Many men benefit greatly from taking Minoxidil and Finasteride. The synergistic effect of taking both drugs can arrest hair loss and strengthen the existing hairs for a number of years, which has the effect of more hair, as if the patient has new hair. Young men will often opt for this option for a number of years before considering a hair transplant. Lastly, a patient may not be suitable if their hair loss pattern is not yet established, meaning it would be too soon for a transplant. Men in their mid-thirties and older, where their hair loss pattern is established are more suitable than those in their 20s.”
For men who are considering transplants however, Dr Collins advises doing your research.
“Shop around, compare a few clinics,” he says. “Don’t got for the cheapest. You get what you pay for. Look for a clinic that is run by trained surgeons. Look for experience and qualifications. The industry is currently unregulated, meaning anyone can set up a clinic, a GP, a nurse, a salesman. Make sure your consultation is with the surgeon who will carry out your transplant, not a salesperson. If the consultation is free then it’s a sales pitch not a consultation. Look for patient testimonials on the clinic website.”
This news is brought to you courtsey of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa, with offices in Mansfield and Southlake, TX
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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). We do this procedure on both men and women. Please conact out office for more information at (817) 473-2120 or click below.
 

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'Globalization' of Cosmetic Surgery- by Dr. Mark Bishara, MD

Would you consider traveling to Mexico or India for a less-expensive rhinoplasty or breast augmentation procedure? Would you consider traveling to Texas for a Robotic Hair Transplant procedure?  Many Americans are doing just that-and the trend is having an impact on the market for cosmetic plastic surgery.
The paper, by ASPS Member Surgeon Dr. Kevin C. Chung and Lauren E. Franzblau of the University of Michigan, discusses “the rise and transformation of the medical tourism industry, foreign and domestic forces that influence cosmetic surgical tourism, and the pros and cons for all involved parties.” Chung and Franzblau write, “The rapid globalization of the industry also marks a fundamental shift in the world’s perception of elective procedures: patients are becoming consumers and these medical services are being viewed as commodities.”
At the office of Dr. Mark Bishara, with offices in Mansfield and Southlake, TX- we have patients traveling from all over the world for Robotic Hair Transplants.  We perform the surgery in both of our locations, making it even easier for patients to access the closest office for them.
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More ‘Medical Tourists’ Are Traveling for Cosmetic Surgery
Traveling for medical care is nothing new-but in the past, people were more likely to travel from poor countries to obtain higher-quality care in wealthier countries. Today, prompted by the ease and relatively low costs of travel, more patients from the United States and other western countries are traveling to the developing world to access less-costly medical and surgical procedures. Because cosmetic plastic surgery procedures aren’t covered by insurance, they make up a major part of the burgeoning medical tourism market.
Figures vary, but there’s a consensus that medical tourism is growing rapidly: India alone may have more than one million medical tourists per year. Other countries with growing medical tourism industries include Mexico, Dubai, South Africa, Thailand and Singapore.
In many countries, governments are working actively to foster their medical tourism industry. Some destinations even market procedures performed in resort-like settings, encouraging patients to combine a vacation with cosmetic surgery. Traveling abroad also lets patients recuperate privately, without anyone at home knowing that they’ve had plastic surgery.
Raising Potential Concerns Over Safety and Quality
The growth of medical tourism may have a significant impact on the cosmetic surgery market in the U.S., but also raises concerns over physical safety and legal protection. Although destination countries promote the quality and safety of their procedures and facilities, there is often little evidence to support these claims.
“Because the practice of medical travel does not appear to be going away in the foreseeable future, plastic surgeons must understand the international market and learn to compete in it,” Chung and Franzblau write. Since U.S. surgeons may find it hard to compete on price, effective strategies may include emphasizing superior quality and safety of care, or developing “niche markets” of procedures that can be profitably performed at home.
The authors emphasize that medical tourism “is not purely good or bad”-neither for patients nor the countries involved. Patients may be drawn by lower costs, but must consider the potential risks of undergoing surgery in a foreign country, as well as traveling after surgery. ASPS provides information for patients considering travel abroad for cosmetic surgery, including risks and follow-up care.
For the U.S. and other developed countries, medical tourism means fewer patients and less revenue-but may also bring increased opportunities for collaboration with rapidly modernizing countries in other parts of the world. Chung and Franzblau conclude, “To retain patients and be competitive in a global market, U.S. plastic surgery must be vigilant of the changes in medical tourism and must adapt accordingly.”
This news is brought to you courtesy of Dr. Mark Bishara and
The Paragon Surgery & Med Spa
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Lady Gaga & Her Battle With Hair Loss- by Dr. Mark Bishara, MD

Lady Gaga 300x232 resized 600For many people, Lady Gaga is seen as a music icon, an individual, a very creative person and yes, a woman who struggles with hair loss. The 25-year-old has been open about her hair loss and has said that her hair has started to fall out because of the constant hair dyeing. The natural brunette is known for platinum blonde hair and because of it, she’s been open about her hair loss.
So what’s a woman to do about hair loss? Rumors have been swirling that Lady Gaga is using Minoxidil (Rogaine®) to combat her hair loss.
What is Rogaine? It is the only FDA-approved topical solution to regrow your hair. For women, it enables them to take control of hair loss and start regrowing healthy hair. It is a very good treatment for hereditary hair loss. Initially sold as a prescription product, Rogaine is now sold over the counter and for women, the 2% solution is recommended.
One thing to keep in mind, use of minoxidil to abate hair loss or re-grow hair should be viewed as a lifetime commitment if the re-growth is to be maintained.
More density to the hair is achieved with continuous use, which allows for easier styling, but bear in mind that it does not replace all of the missing hair and that the response to treatment is individual.
Side effects may include an itchy scalp and other minor skin irritations, which occurs in approximately 6% of females, according to Leavitt.
There are additional treatments availbalbe to women with hair loss, both non-surgical and surgical.  In addition to Minoxidil, there is the Laser Cap (LLLT) as well as Robotic Hair Transplants.
Laser Cap- 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. Dr. Mark Bishara fully endorses the results of this advanced technology and is proud to offer LLLT in his office through treatment with the LaserCap.
During the LLLT procedure, beams of light are absorbed by the scalp to stimulate blood flow and allow more nutrients to flow to the hair follicles. As a result, hair begins to grow again. Many patients experience significant improvement to the amount and quality of their hair after this procedure, and report benefits such as:

  • Reduction of excessive hair loss
  • Improvement of hair shaft quality
  • Repair of damaged hair follicles
  • Thicker, easier-to-manage hair
  • Reduction of excess oil production in the scalp
  • Relief from itchy scalp symptoms
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Robotic Hair Transplants
FUT performed by Dr. 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, an area of 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.
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Please contact our office for more information on female hair loss options at (817) 473-2120 for more information.
 

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