Robert Leonard, MD, founder and chief surgeon at Leonard Hair Transplant, is widely sought after for his soft touch, artistic eye and extensive knowledge about advanced hair loss. He is licensed in six states, including Rhode Island, Massachusetts, and Connecticut, and currently sees patients in seven offices – in Cranston, Rhode Island; Newton, Massachusetts; Braintree, Massachusetts; Hyannis on Cape Cod; Boston, Massachusetts; Worcester, Massachusetts; and Salem, New Hampshire. In addition to performing hair restoration surgery, he acts as a hair loss expert for ROGAINE®, educating others of the potential hair loss treatments hold.
Dr. Leonard is a past President of the International Society of Hair Restoration Surgery and was recently appointed to the American Society of Hair Restoration Surgery Advisory Council. He was also one of the early adopters of the innovative ARTAS ROBOTIC SYSTEM®, the first and only FDA cleared robotic hair transplant device.
He recently answered some questions about the evolution of hair transplantation for Beauty in The Bag.
How long have you specialized in hair restoration?
I began my training in hair restoration surgery in 1986 after I met my mentor, the late Dr. C. P. Chambers. This was during the days of the no-archaic “plug” transplant era. Transplants in those days required several sessions in order to provide a natural look.
What has been the biggest change that you have seen in your practice?
The biggest change in my practice was the revolutionary miniaturization of transplanted hair grafts. This occurred in a very few years beginning in the early 1990’s. Today’s transplants contain only one to four hairs, which provides hair loss patients a very natural result even after only one surgical session. There are two different harvesting techniques that I utilize today: strip harvesting and Follicular Unit Extraction Technique (FUE). Each method offers wonderful aesthetic results. It is very important, however, that patients know that it will take several months to achieve these great results.
What do today’s hair transplant really look like?
Unlike in the past where grafts were very large (about the size of a pencil eraser), today’s grafts contain only one to four hairs. In the past, these big grafts needed to be spaced significantly apart so they could grow properly; they also were planted in sort of a “corn row” configuration, providing a not-so-natural effect with only one surgical session. The whole world of hair transplantation has thankfully changed today—and, for the better—much better! We now transplant tiny grafts, very closely together, in order to provide patients with very natural results.
Do you treat many women, and can they benefit from transplants too?
I have welcomed women as patients from the earliest days of my career. I am asked by my colleagues throughout the world to speak about my approach to treating the female hair loss patient. Not all women are candidates, mostly due either to unrealistic expectations of results or because they do not have enough donor hair to provide a proper result. It is critically important that women do as much as possible to stabilize their progressive hair loss with minoxidil and/or low level laser therapy—I personally use the Capillus Laser Cap. If they have enough donor hair, women are excellent candidates for hair restoration surgery. I must say that these patients are the most appreciative of my care as it is not “normal” for women to lose hair or get bald.
What role does technology play in hair restoration today?
We are in a wonderful time in the history of hair loss treatment. The tools we have really work very well to both slow down the progression of male and female pattern hair loss as well as to regrow hair. However, the patients need to be willing to use them. For men, I treat hair loss with finasteride (Propecia), minoxidil (Rogaine, Keranique, etc.), and Low Level Laser Therapy (Capillus Laser Cap, etc.). For most women, I do not use finasteride; however, for some, it is a good option for them especially post-menopausal women. The more of these treatments the patient does at the same time, the better effectiveness. Two are better than one; three are better than two.
There are no other medically proven, scientifically sound therapies available yet to treat genetic hair loss. Some doctors are using purported “treatments” such as PRP (Platelet Rich Plasma), Stem Cell injections, and various lotions and potions. None of these have had proper scientific studies to prove that they are at all effective to treat hair loss.
To provide the latest in hair restoration treatments and offer our patients superior results, we have also added the advanced ARTAS® Robotic System to our line of surgical technology. This minimally invasive, outpatient procedure allows us to transplant the patient’s own hair without stitches or visible scarring. Recovery time is fast, we can achieve fuller, natural looking hair that will last a lifetime.
Tell us about your fellowship at the International Society of Hair Restoration Surgery?
The Board of Governors of the International Society of Hair Restoration Surgery (ISHRS) recently offered the “Fellow” designation in order to recognize members who meet its exceptional educational criteria. It is a great honor for a member to achieve the Fellow designation (FISHRS). This recognizes the surgeon who strives for excellence in this specialized field. To maintain this status, the surgeon must continue to meet established educational criteria over time. I am proud to be one of 61 Fellows of the ISHRS.
New York City cosmetic dentist Debra Glassman, DMD, is well known for her sparkling smile as well as the signature feminine touch she provides to the smiles of her patients—many of whom are women. Of late, Glassman has joined forces with GlaxoSmithKline, the makers of ProNamel Toothpaste, to draw attention to the deleterious effects that acid erosion can have on a smile and the surprising foods that can contribute to acid erosion.
She answered some questions about the new campaign, the latest and greatest in cosmetic dentistry, and what a healthy smile really looks like for Beauty in the Bag.
Here’s what she had to say:
Why does our oral health matter so much?
Taking care of your teeth is essential for so many reasons. By routinely flossing, brushing and using mouth rinse, you can decrease your risk of heart disease, high blood pressure, diabetes and cancers. Also, it’s especially important for pregnant women to take care of their teeth, because not doing so can lead to low birth weight in babies and even miscarriages.
What does a healthy beautiful smile look like?
While I see beautiful smiles every day, a healthy one results from regular brushing, flossing, and going to the dentist. I recommend flossing before brushing, so any leftover food particles can be cleared away in the rinsing process. It’s also a good idea to use a soft-bristled tooth brush and change out your tooth brush every three months; six months for electric tooth brushes.
What are some of the newest trends in cosmetic dentistry?
We’re seeing lots of of pre-filled whitening trays which are very user-friendly and especially great for travelers. These trays whiten teeth eight to 10 shades whiter through half hour-a-day usage over a 10-day period. Invisalign is also an invisible way to straighten teeth, and because of the trays and excellent technology, we can now speed the process up by 40-50 percent, making it quicker and more comfortable for patients.
We also have the ability to do crowns and bridges without using any metal and instead using all white, very strong materials. These substances look like natural teeth and make it easier for dentists to see future decay and diseases at a very early stage.
Do any of the over-the-counter products (whitening strips, for example) make a difference?
OTC products work if they’re the proper choice for the patient. For example, whitening strips work well on small teeth, because they cover the entire tooth and crevices between teeth. Strips are not good for larger teeth, because they can’t cover the whole area for whitening. Those with larger teeth should instead use gels so that all of their teeth are covered and the whitening will be even. As always, make sure to follow product directions properly. I also personally recommend using ProNamel toothpaste, which is specially formulated to strengthen tooth enamel and can help reduce your risk for acid erosion. It’s also the #1 dentist-recommended brand for protection against the effects of acid erosion.
What does acid erosion do to a smile?
Acid erosion is a condition where your tooth enamel can become weakened and softened, which can then be more easily brushed away over time. While only a dental healthcare professional can assess tooth enamel appropriately, the five signs of acid erosion that you should be on the lookout for include tooth enamel that is weakened, thinning, transparent/see through, yellowing, or dull. And what’s surprising is that everyday foods and drinks, even healthier choices like oranges, apples, and other citrus fruits that are high in acid, yet common in today’s modern diet, can increase your risk for acid erosion.
Fortunately, you don’t have to make any dramatic changes to your lifestyle or diet to reduce your risk for acid erosion. Ther are five simple, proven steps that everyone can take to help reduce their risk for acid erosion.
What are these steps?
1. Don’t give up healthy food in your diet, particularly fruit, but do take a fresh look at how you eat it.
2. Don’t swish, swirl, or hold acidic foods in your mouth for too long.
3. Many drinks, especially carbonated ones, can contribute to acid erosion. Try drinking through a straw or substituting the soft drinks with water or milk.
4. Avoid brushing your teeth immediately after eating or drinking and make sure you’re using a soft-bristled tooth brush.
5. Consider using a fluoride toothpaste, like ProNamel, along with a fluoride mouthwash, to help protect your teeth from the effects of everyday acidic foods and drinks
How can you tell if you consume too many acid-rich foods in your diet?
All Americans should know their own Acid Truth—they should consider how many acid-rich foods they are consuming per day and how they can best take action to reduce their risk. That’s why I encourage everybody to visit www.pronamel.us to take a 4-question quiz to determine their own Acid Truth.
Ask San Francisco-based dermatologist Jason Emer, MD to list his favorite skincare products and he can go on and on … and on. It is clear that he knows his stuff, and truly appreciates what the right products can bring to the table.
Emer often recommends the very same products that he uses on himself to his patients. Of course, there is more to his practice than his stellar product picks. He is widely sought for his expertise in lipocontouring, body sculpting, and fat transfer. Another niche of Emer is “sports dermatology” or the treatment of various skin conditions that are caused or worsened by sports-related overuse or injury. He also caters to growing numbers of male patients who are looking to prevent skin cancer, improve their appearances, and turn back the hands of time through neuromodulation, facial fillers, lasers, and skin tightening devices. When he is not seeing patients, Emer is lecturing across the globe and running clinical trials that will help advance the field of dermatology.
Emer spoke to Beauty in the Bag about his practice, his background, and, of course, his product picks. Here’s what he had to say:
What is sports dermatology?
Sports and physical exercise can be associated with a wide variety of skin problems. Sports dermatology is the prevention, diagnosis, and treatment of skin conditions related to athletics. For example, sports-related skin conditions can result from mechanical trauma or from exposure to environmental and infectious agents. Making the appropriate diagnosis requires familiarity with characteristic clinical presentations, which may not be initially apparent to dermatologists unfamiliar with skin problems related to athletic activities.
How did you become interested in sports dermatology?
My lifetime involvement in athletics and physical exercise influenced my interest in taking care of patients with similar backgrounds who had concerns for preventative skincare/health.
What is the biggest trend you are seeing in your practice today?
I am increasingly observing men of all ages presenting to the office not only for skin cancer prevention visits but also for preventative anti-aging treatments including aesthetic peels, fractional laser, neurotoxins, and fillers. I have had an increase in men desiring body contouring procedures such as abdominal and flank liposculpting, breast (gynecomastia) surgery, sweat reduction treatments, eyelid surgery, skin tightening procedures, and laser hair removal. Men appear to be less ashamed of their desire for a more attractive appearance than in the past.
What are your go-to skincare products?
To be honest, it depends on what skin conditions, if any, we are trying to treat. However, for the majority of my patients interested in anti-aging and preventative skincare treatments I recommend a daily glycolic cleanser. My go to cleanser is either Jan Marini Bioglycolic Face Cleanser or Dermaceutic Foamer 15. These cleansers are non-irritating and help enhance normal skin exfoliation, which improves the penetration or benefit of the other products applied to their skin. All my patients are recommended to have a vitamin A/retinol containing product at bedtime. My favorite prescription agent is a tretinoin gel (Atralin), approved for the treatment of acne, but has anti-aging properties by exfoliating the skin more rapidly and supplying moisture through its fish oil additive. Some physicians also believe topical retinoids are skin cancer prevention agents—the jury is still out. My favorite non-prescription product is SkinMedica Retinol Complex or Glo Therapeutics Retinol CS, which also contains 5% glycolic acid. These products refresh and brighten the skin, giving it a glowing, softer appearance. In the morning, I recommend a vitamin C containing product to help decrease skin pigmentation and supply extra sun-protection factor. My patients have gotten great results from the Obagi Professional-C serum products or SkinCeuticals CE Ferulic or Phloretin CF. Other products I love, recommend, and use myself include:
- SkinMedica’s TNS essential serum for anti-aging.
- DNA Youth Recovery Facial Serum from PrecisionMD for its anti-oxidant properties and DNA repair capabilities, reversing the signs of aging such as wrinkling and textural changes.
- SkinMedica’s Lytera Skin Brightening Complex or Pigment Gel HQ free from PCA skin care for improvement of skin tone and texture, without the use of hydroquinone ,which many consumers are afraid of and sometimes is irritating.
- Jan Marini BioShield for post-procedural (peels, lasers, microdermabrasion) skincare that is not greasy, primarily because of its silicone-based formulation, and has skin growth factors to promote faster wound healing and decreased recovery times.
- EltaMD Laser Balm is formulated with petrolatum, wax, and paraffin, and is a fantastic humectant. It is ideal for those who like greasy products and feel they are more protective and hydrating, especially for more aggressive procedures
- Nia24 Intensive Recovery Complex or SkinMedica’s Redness Relief Calmplex for facial, neck, or chest redness. Especially great after laser procedures and for those patients with very sensitive, easily-irritated skin.
- Dermalogica Daily Microfoliant is an exfoliating rice-based powder formula that micro-exfoliates dead skin cells, leaving the skin smoother, softer, and brighter.
- EltaMD UV Aero is a zinc sunspray that makes applying sunscreen easy, plus its non-greasy and transparent (no residue).
- Headhunter Products that are non-irritating and easy applying sunscreen facial balm and sticks products that fit easily into your bag. Perfect for the person on the go!
What is your most popular treatment these days?
Neuromodulation with Botox, Dysport or Xeomin is my most common non-invasive cosmetic procedure. Coming in a close second are soft tissue fillers and fractional laser (Fraxel) treatments. Body contouring procedures such as liposuction/lipocontouring of the abdomen, flanks, arms, and neck, and upper eyelid surgery (blepharoplasty) are my most common invasive procedures.
When is your busiest time of year and why?
I am quite busy all year round. However, liposuction/lipocontouring procedures such as abdominal etching is most common 3-6 months before the “beach” months and more aggressive laser procedures such as carbon dioxide resurfacing are less popular in the summer months.