Category Archives: General Hair Transplant Thoughts & Ideas

I am proud to announce that my 9th hair transplant textbook, Hair Transplant 101, was just released at the end of July 2023 by the amazing publisher Quality Medical Publishing (QMP). This new book follows on the heels of my last textbook that came out April 2022, which is the world’s largest and most encyclopedic […]

One of my greatest passions in hair restoration is designing recipient sites. These sites dictate the pattern, direction, and density of transplanted and grafted hairs – something I feature throughout this website. At my annual hair transplant course that I direct and have done so now for 9 years, I always incorporate a lecture that […]

Gradual Transitions Shown in Recipient Sites for the Crown When I design recipient sites for hair restoration I am always cognizant that each site must blend naturally to the adjacent sites for several reasons.  First, hair naturally slowly transitions in angle from one area to another.  In a natural untransplanted scalp no hair angles abruptly […]

Artistically designed hair transplant to create optimal visual hair density The goal of hair restoration is to build up enough hair density that one does not have much see-through effect.  Put another way, rows upon rows of hair grafts must be placed so that each row adds to the visual effect of blocking one’s view […]

By Emina Karamanovski The only predictable thing about the human body is that it is unpredictable.  Scarring and the way we heal is one of those unpredictable human behaviors.  I have been observing variations in scar healing of hair-transplant patients for over 20 years. Medical procedures like other things in life, improve through trials and […]

By Emina Karamanovski It is not a first time that an old technique finds a new application. In the last few years, the ancient art of skin pigmentation (tattooing) found its place in the medical community, specifically in hair restoration. I was sincerely impressed with the results of micropigmentation and its versatility. Men and women […]

By Emina Karamanovski Often times I get asked what is the newest thing in hair restoration. There are two major progresses made in the last ten years. One helped improve the density and naturalness of the transplanted hair, and the other improved scarring in the donor area. Progressively, we started trimming extra tissue off of […]

By Emina Karamanovski The other day an older gentlemen came for a consultation. He wanted to restore hair not because he wanted to look younger nor because he needed to boost his self-esteem but he was simply tired of having to protect his head from sun. He was tired of having to wear a cap […]

In a previous video featured on YouTube and on this Web site, I discussed the dangers of performing hair transplants in men who are too young. Age is a relative thing and it depends on how much baldness one has, how fast that hair loss is, what kind of hair quality (density, thickness, color, curliness, […]

There is perhaps not a day or maybe week that goes by without my thinking of how to perform more beautiful artwork for the head. Is it all just the same thing? I certainly do not think so. I have worked on constantly refining my thinking of how to create better results. Recipient sites, the […]

Pain control is so very important for every patient. I take that concern to an extreme level. As many of you know for my conventional linear harvesting (standard hair transplant) where discomfort can be greater, we have every patient under what is known as Level 2 conscious sedation, meaning patients do not feel anything. If […]

Hair loss that affects men can be devastating. Hair loss in men who believe that they are truly women can be exponentially worse. They do not have the option of shaving their head and their gender identity can be worsened because of it. By being sensitive to this kind of plight is the first step. […]

I have heard these words many times throughout my hair-transplant consultations, usually leading to the next sentence, “Please make my result as conservative as possible.” That sounds intuitively appealing but it is really not the right answer. I totally understand the issue with one’s fear that a result will be spotted out, especially since hair […]

When trying to create a natural result in a hair transplant, there are so many factors to consider in getting a result that looks amazing. One factor that is little talked about is how to transition from one part of the scalp to another, e.g., the hairline to the midscalp, from the vertex to the […]

Robots are meant to perform repeated, technically precise work that a human hand cannot perform reliably. In this case the ARTAS Robotic FUE (Follicular Unit Excision) technology does an incredible job at harvesting hairs with utmost precision in a distribution pattern that affords maximal camouflage in an individual who wants to keep his hair short. […]

I love to tell the story of when I was sitting in the audience of a facial plastic surgery conference in San Diego with an esteemed colleague of mine who did not do hair transplants. My colleague said in a haughty way that he could easily tell a hair transplant since they all looked rather […]

It may have been a little while since I have likened my hair transplant team to a Formula One race team but I believe it is worth restating that here and elaborating on why I feel that way. Another example is the peloton in the bicycling world: without the team to help bring the team […]

One thing that I have been fascinated about and has been a technique that I have favored is the use of micropunch instruments. Rather than using a needle or chisel blade, I oftentimes prefer a very tiny punch instrument in which I can remove between 0.5 to 1 mm in size of bald tissue into […]

Every year and every day I am seeking to attain better hair transplant results and the way to accomplish that task is to enlist better instruments, techniques, and ancillary measures. One small but prominent addition to my practice over the past year has been the use of the Cole tumescent gun that allows me to […]

I was on the panel for the Basics course at the ISHRS annual meeting in the Bahamas and explained my algorithm for how I speak with patients in a constructive and efficient manner, and my colleague sitting next to me wrote down my algorithm saying it was a great idea. Accordingly, I thought I should […]

Unfortunately, I did not see much sun while I was in the Bahamas for the 2012 Fall ISHRS meeting. Partly because there was little sun to be had (it was raining most days) but also because I was simply enraptured by all the meetings that had a huge learning impact on me. I also was […]

I have attended the International Society of Hair Restoration Surgery (ISHRS) annual meeting almost every year for the past decade even when it has been in remote settings like Amsterdam, which it is in a foreign city about every third year to appeal to the foreign audience membership and to live up to the organization’s […]

My hair-transplant coordinator, Emina Karamanovski, was on an extended hiatus over the past year working as the national training director for ARTAS Robotic FUE System by Restoration Robotics. She did an amazing job during that time to train physicians across the United States and the world including me on the ARTAS system. Although she had […]

When I design recipient sites for hair restoration I am always cognizant that each site must blend naturally to the adjacent sites for several reasons. First, hair naturally slowly transitions in angle from one area to another. In a natural untransplanted scalp no hair angles abruptly change so for optimal naturalness these gradual transitions must […]

The goal of hair restoration is to build up enough hair density that one does not have much see-through effect. Put another way, rows upon rows of hair grafts must be placed so that each row adds to the visual effect of blocking one’s view of the bald scalp behind it. This brief article will […]

At times I get the question during a consultation, “What makes you better than [fill in the blank name]”? Even though I may spend 30 minutes detailing every little nuance of what makes us better: a more artistically designed and customized hairline, better donor harvesting and donor closure, better recipient site creation, more gentle graft […]

Many times hairs are just moved from the back of the head to the front of the head based on the number of hairs that are bundled in each follicular unit. For example, 1-hair grafts are placed into the front hairline and 2-hair grafts behind that and so on. However, little is paid to the […]

The principle of modern hair restoration is predicated on “donor dominance.” Donor dominance refers to the concept that hair transplanted from the donor area (back of the head) and placed into the front (recipient area) will never be lost despite ongoing hair loss due to the fact that the transplanted donor hair retains its native […]

One of the major topics that patients ask about hair transplant surgery is “What is the recovery process like?” or “When can I go back to work?” I try to frame the answer in such a way as to help that person understand the situation as well as possible so that he can make a […]

Many of the other blog articles have touched upon various elements of quality control that lead to excellent surgical outcomes. What I would like to do is to talk more globally about problems that I see that make a hair transplant result look fake when looking closely at the work. Unfortunately, the public thinks that […]

A graft must fit a recipient site like a hand fits a glove perfectly. Too tight and the graft becomes pinched inward leading to either hair death or a tufted fake appearance. Too loose or too deep and the hair can fall inward into the site and cause unnatural pitting. Too short a site will […]

After repeated hair transplants, the donor area can become tighter over time. Even some individuals who have never had a hair transplant may be born with relatively tight scalps. In these individuals when I feel the back of the scalp and it feels tighter than I would like, I prepare them for surgery with 2 […]

There are many types of scarring alopecias (scarring hair loss) like lichen planopilaris, discoid lupus erythematosis, etc. This article will not try to review all the many types of histologic (tissue) diagnoses but to explain what goes through my head as a hair-transplant surgeon when encountering various scarring alopecias for possible hair restoration. When I […]

Following a hair transplant, many surgeons have differing ways to manage and guide a patient through that process so if you are not my patient I always differ to your surgeon who did your procedure. For my patients, here are the basic things to know in your after care. Immediately following the procedure, there can […]

Trichotillomania describes a condition in which an individual repeatedly pulls his or her hair out of one’s head or other body parts due to an obsessive-compulsive disorder (OCD). Sometimes trichotillomania is accompanied by ingesting the hair causing a condition of indigestible hair products in the stomach known as a trichobezoar that may require surgical excision. […]

A burning question I receive all the time is when does hair start to grow after a hair transplant. Obviously, everyone is different, and I have seen a wide range of times that hair starts to grow after a procedure. However, there are averages of time that are worth expressing herein so as to guide […]

Over the past 8 years, I have explored and now ultimately embraced the beauty of the punch instrument when dealing with bald scalp. The punch instrument is tiny, encompassing 0.75 mm, 1 mm, and 1.25 mm, and do not at all look like the old 4 mm punch instruments that were used during the old […]

One of the most frequently asked questions that I receive is “How much do you charge per graft?” The answer is that I don’t, which usually puzzles my patients to no end (Please review our hair transplant cost page for additional information) I decided to write a blog article explaining my philosophy more in-depth. First, […]

A question that I receive several times a month is, “Can I use my friend’s hair for my hair transplant?” The answer is no. The reason for this case is that hair transplanted from another individual into your body will be treated as foreign and attacked by your immune system and ultimately rejected. This is […]