Robert M. Bernstein

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Robert M. Bernstein, M.D., F.A.A.D., is Associate Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. Dr. Bernstein is recognized for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction.

Dr. Bernstein received his Dermatologic training at the Albert Einstein College of Medicine in New York, where he served as Chief Resident. He graduated with honors from Tulane University achieving the status of Tulane Scholar. He received the degree of Doctor of Medicine at the University of Medicine and Dentistry of NJ where he was the recipient of the Dr. Bleiberg Award for “Excellence in Dermatology.” Dr. Bernstein holds an MBA from Columbia University, graduating Beta Gamma Sigma.

Dr. Bernstein is Board Certified in Dermatology and is a Fellow of the American Academy of Dermatology. He is certified by the American Board of Hair Restoration Surgery and has served on the editorial board of Dermatologic Surgery. He is a member of the American Academy of Aesthetic and Restorative Surgery, American Society for Dermatologic Surgery, International Society of Hair Restoration Surgery and the American Academy of Cosmetic Surgery.

Dr. Bernstein is the recipient of the "Platinum Follicle Award” for "Outstanding Achievement" in scientific and clinical research in hair restoration. This is the highest honor awarded by the International Society of Hair Restoration Surgery. “Dr. Bernstein has contributed to the field of hair transplantation in dramatic and substantial ways, revolutionizing the advancement of Follicular Unit Hair Transplantation. His published articles have become ‘Bibles’ for this methodology. Dr. Bernstein's contributions extend beyond the application of Follicular Unit Transplantation, such as studies in examining the power of sorting grafts for density, yield by method of graft production, local anesthetic use, and suture materials.” Dr. Bernstein's contributions to the field of hair transplantation have earned him the honor of both "Pioneer of the Month" and "Surgeon of the Month" in Hair Transplant Forum International, Connolly Guide’s “America’s Top Doctors,” and New York Magazine's "The Best Doctors in New York” from 2000 through 2006.

As the most widely published author on the subject of Follicular Unit Transplantation and Follicular Unit Extraction, with over fifty articles, editorial reviews, books and textbook chapters.[1] Dr. Bernstein’s landmark scientific papers are considered to be seminal works in the field of hair restoration surgery. He lectures both nationally and internationally on the treatment of hair loss and is active in clinical research and teaching.

[edit] Contributions to Follicular Unit Hair Transplantation

Definitions, Concepts, and Logic

In 1995, Robert M. Bernstein, MD and colleague William R. Rassman, MD publish “Follicular Transplantation”[2] and define a new hair restoration technique. In their landmark publication Follicular Transplantation, Bernstein and Rassman state that hair transplantation should be performed using only naturally occurring, individual follicular units. The paper introduces the term "Follicular Unit" to the field and describes both the technique and planning needed to get the best long-term aesthetic results. In 1996, Dr. Bernstein presents the theory behind Follicular Transplantation at the International Society of Hair Restoration Surgery and shows results of this technique to physicians at the International Meeting.

1997 Bernstein and Rassman publish the paired Follicular Transplantation Articles that become the "classic" reference in the field. The papers "Follicular Transplantation: Patient Evaluation and Surgical Planning" and "The Aesthetics of Follicular Transplantation" are published in the prestigious journal, Dermatologic Surgery. These papers literally define the new field of Follicular Unit Transplantation. The Editor of Hair Transplant Forum international writes "Whatever happens, we will still be using something close to the Bernstein-Rassman technique in decades to come, as it provides convincing results with nature's own building blocks…there is no doubt that their techniques are revolutionizing hair restoration surgery and almost every practitioner in this field has already been influenced by their past writings…"

At the 5th Annual Meeting of the International Society of Hair Restoration Surgery in Barcelona, Spain in 1997, Dr. Bernstein presents "The Art of Follicular Transplantation." In the presentation, he quantifies the characteristics of follicular units and details the ideal way to distribute follicular unit grafts to produce the best aesthetic results. The same year, the American Academy of Dermatology requests Dr. Bernstein to give a Focus Session at its annual meeting that is solely devoted to Follicular Unit Transplantation. This request underscores the fact that the AAD recognizes the importance of this new old procedure. The focus session runs for five years.

In 1998, Bernstein organizes a group of world-renowned hair restoration surgeons in an attempt to unify the field of surgical hair restoration by setting standards for defining the most commonly performed hair transplant procedures. The purpose is to allow surgeons to be able to compare the results of scientific studies and to improve communication with their patients. The paper, "Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques" formally changes the name "Follicular Transplantation" to "Follicular Unit Transplantation" and strictly defines the procedure as requiring stereo-microscopic dissection and single strip harvesting.

In the same year Bernstein and Rassman quantify the benefits of the Stereo-Microscope in Hair Transplants in their paper "Dissecting microscope versus magnifying loupes with transillumination in the preparation of follicular unit grafts." It is the first scientific paper to show the advantages of using a dissecting stereo-microscope for Follicular Unit Transplantation. This bilateral controlled study validates the benefits of the technique that had been introduced to the field by Dr. Bobby Limmer.

In 1999 "The Logic of Follicular Unit Transplantation" is published. Dow B. Stough, MD, a founding member of the ISHRS and editor of Hair Transplant Forum International writes: "Everything you wanted to know about follicular unit transplantation, and then some. This monograph, presented by Bernstein and Rassman, can be thought of as a thesis on the subject of the follicular unit, this may be perhaps the most comprehensive accumulation of thoughts on the subject thus far."

Refinement of Technique

In 2000, Bernstein cautions on the excessive use of adrenaline in hair transplants in the paper "Limiting Epinephrine in Large Hair Transplant Sessions." He warns that very high concentrations of epinephrine to control bleeding during a large follicular unit hair transplant may be dangerous. The authors describe other ways that bleeding can be easily controlled in hair transplant procedures of up to 2,400 grafts without the need for these high concentrations of epinephrine which may cause palpitations, anxiety, irregular heart rhythms and increase the risk of the hair restoration surgery.

In 2001 Bernstein and Rassman publish “A New Suture for Hair Transplantation: Poliglecaprone 25”, where they introduce to the field of hair restoration surgery a new absorbable suture that is shown to be superior to other types of donor closures with respect to level of comfort, convenience, and healing.

In 2002 Rassman and Bernstein publish the first paper on Follicular Unit Extraction (FUE) in the journal Dermatologic Surgery. The article "Follicular Unit Extraction: Minimally invasive surgery for hair transplantation" describes the technique of Follicular Unit Extraction, the indications for the procedure and the limitations of the technique. The doctors explain the role of FUE as a complement to, rather than a replacement of, FUT.

Bernstein and Rassman publish an extensive work on corrective hair restoration surgery.In the paired articles "The Art of Repair in Surgical Hair Restoration - Part I: "Basic Repair Strategies" and Part II: "The Tactics of Repair" that appeared in Dermatologic Surgery, Bernstein and Rassman present both the conceptual framework for repairs and a practical approach to fixing the poor hair restoration procedures of the past. An important conclusion from their studies is that microscopically dissecting and redistributing existing large grafts prior to camouflage with follicular units is critical to get the best correction.

In 2005, Dr. Bernstein Presents "New Instrumentation for Follicular Unit Extraction" at the 13th Annual Scientific Meeting of the International Society of Hair Restoration Surgery in Sydney, Australia, Dr. Bernstein’s specially designed instrument minimizes trauma to hair follicles, a major limitation in Follicular Unit Extraction (FUE). The research is published the following year in Hair Transplant Forum International.

In 2006, Bernstein uses scientific methodology to determine exactly how much time it takes after a hair restoration procedure for the transplanted grafts to be securely anchored in place. In the study, "Graft Anchoring in Hair Transplantation" published in Dermatologic Surgery, Dr. Bernstein showed that by 9 days following a follicular unit hair transplant, grafts could not be dislodged. In addition, this interval could be shortened to one week if patients can prevent crusts from forming during the immediate post-op period. This information helps physicians refine the post-op advice they give to their patients after follicular unit hair transplant procedures.

[edit] Scientific Publications

Held JL, Bernstein RM, Kohn SR: Hair Casts or Pseudonits Acquired Following Psychological Trauma. Cutis 1989; 43: 380-1.

Bernstein RM, Rassman WR, Szaniawski W, Halperin A: Follicular Transplantation. Intl J Aesthetic Restorative Surgery 1995; 3: 119-32.

Bernstein RM, Rassman WR: What is delayed growth? Hair Transplant Forum Intl. 1997; 7(2): 22.

Bernstein RM, Rassman WR: Wall Mounted Placing Stand. Hair Transplant Forum Intl. 1997; 7(4): 17-18.

Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning. Dermatol Surg 1997; 23: 771-84.

Bernstein RM, Rassman WR: The Aesthetics of Follicular Transplantation. Dermatol Surg 1997; 23: 785-99.

Bernstein RM. Measurements in Hair Restoration. Hair Transplant Forum Intl. 1998; 8(1): 27.

Rassman WR, Bernstein RM. Rapid Fire Hair Implanter Carousel: A new surgical instrument for the automation of hair transplantation. Dermatol Surg 1998; 24: 623-7.

Bernstein RM, Rassman WR. Dissecting microscope versus magnifying loupes with transillumination in the preparation of follicular unit grafts. A bilateral controlled study. Dermatol Surg 1998; 24: 875-80.

Bernstein RM, Rassman WR, Seager D, Shapiro R, et al. Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. Dermatol Surg 1998; 24: 957-63.

Bernstein RM, Rassman WR, Seager D, Unger WP, et al. The future in hair transplantation. Journal of Aesthetic Dermatology & Cosmetic Dermatologic Surgery 1999; 1(1): 55-89.

Bernstein RM, Rassman WR: The logic of follicular unit transplantation. Dermatologic Clinics 1999; 17 (2): 277-95.

Bernstein RM: Unified terminology for hair transplantation. Hair Transplant Forum International 1999; 9(4): 121-3.

Bernstein RM, Rassman WR: Hemostasis with minimal epinephrine. Hair Transplant Forum International 1999; 9(5): 153.

Bernstein RM, Rassman WR, Stough D: In support of follicular unit transplantation. Dermatologic Surgery 2000; 26(2): 160-2.

Bernstein RM, Rassman WR: Limiting epinephrine in large hair transplant sessions. Hair Transplant Forum International 2000; 10(2): 39-42.

Bernstein RM, Rassman WR, Rashid N: A new suture for hair transplantation: Poliglecaprone 25. Dermatol Surg 2001; 27(1): 5-11.

Bernstein RM, Rassman WR: Follicular unit graft yield using three different techniques. Hair Transplant Forum International 2001; 11(1): 1, 11-13.

Rassman WR, Bernstein RM, McClellan R, Jones R, et al. Follicular Unit Extraction: Minimally invasive surgery for hair transplantation. Dermatol Surg 2002; 28(8): 720-7.

Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part I: Basic repair strategies. Dermatol Surg 2002; 28(9): 783-94.

Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part II: The Tactics of Repair. Dermatol Surg 2002; 28(10): 873-93.

Rassman WR, Bernstein RM, Jones RG, McClellan RE, et. al. Back to the future with the “dissected–punch” technique. Hair Transplant Forum International 2003; 13(5): 409.

Bernstein RM, Rassman WR, Anderson KW: Follicular Unit Extraction Megasessions: Evolution of a technique. Hair Transplant Forum International 2004; 14(3): 97-99.

Bernstein RM, Rassman WR: Follicular Unit Transplantation: 2005, Issue on Advanced Cosmetic Surgery. Dermatologic Clinics 2005; 23(3): 393-414.

Bernstein RM, Rassman WR: New Instrumentation for Three-Step Follicular Unit Extraction. Hair Transplant Forum International 2006; 16(1): 229, 237-9.

Bernstein RM, Rassman WR: Graft anchoring in hair transplantation. Dermatol Surg 2006; 32: 198-204.

Rassman WR, Bernstein, RM: From Scalp to Brow. Plastic Surgery Products 2006; 34-8.

Bernstein RM, Rassman WR: Hair Transplantation. In: Gerson J, editor: Malady’s Standard Textbook for Professional Estheticians, 8th Ed. New York, Delmar Publishers, 1999.

Rassman WR, Bernstein RM. The Automation of Hair Transplantation: Past, Present, and Future. In: Harahap M, ed. Innovative Techniques in Skin Surgery. New York, Marcel Dekker, Inc., 2002: 489-502.

Bernstein RM, Rassman WR: The Rational for Follicular Unit Transplantation. In: Unger WP, editor: Hair Transplantation, 4th ed. 4 New York: Marcel Dekker, Inc., 2004: 388-406.

Bernstein RM, Rassman WR: Techniques for Limiting the Amount of Epinephrine in Large Hair Restoration Surgeries. In: Unger WP, editor: Hair Transplantation, 4th Ed. New York: Marcel Dekker, Inc., 2004:245-250.

Bernstein RM, Follicular Unit Hair Transplantation. In: Robinson JK, Hanke CW, Siegel DM, Sengelmann RD, editors: Surgery of the Skin, Chapter 34. Elsevier Mosby Inc., London UK. 2005: 549-574.

Bernstein RM, Rassman, WR. Follicular Unit Transplantation. In: Haber RS, Stough DB, editors: Hair Transplantation, Chapter 12. Elsevier Saunders, 2006: 91-97.

Rassman WR, Harris J, Bernstein RM. Follicular Unit Extraction. In: Haber RS, Stough DB, editors: Hair Transplantation, Chapter 17. Elsevier Saunders, 2006: 133-137.

Bernstein RM: Are scalp reductions still indicated? Hair Transplant Forum Intl. 1996; 6(3): 12-13.

Bernstein RM, Rassman WR: Laser hair transplantation: Is it really state of the art? Lasers in Surgery and Medicine 1996; 19: 233-5.

Bernstein RM: Microscopophobia. Hair Transplant Forum International. 1998; 8(5): 23.

Bernstein RM: Blind graft production: Value at what cost? Hair Transplant Forum International 1998; 8(6): 28-29.

Bernstein RM, Rassman WR: The scalp laxity paradox. Hair Transplant Forum International 2002; 12(1): 9-10.