HEAD AND NECK: QUANTITATIVE THERMAL MEASUREMENT & A MEDICAL COMPLETEMENT TO THE ULTRASOUND

By: Robert L. Bard, MD     |     Edited by: Graciella Davi

The patient is a 65-year-old military veteran who sustained a fall, leading to a concussion that required a three-day hospital observation period. Upon discharge, he reported persistent shoulder pain. Ultrasound imaging of the shoulder revealed an inflamed biceps tendon, which was appropriately treated with physical therapy or targeted injection—avoiding unnecessary rotator cuff surgery, which had initially been planned. Given the patient’s recent concussion, ultrasound assessment was extended to the optic nerve, which was imaged within minutes and confirmed as normal, ruling out increased intracranial pressure.

Optic nerve swelling is also another a critical indicator of elevated intracranial pressure and is widely used in emergency medicine for concussion assessment. While hospital concussion screenings may clear a patient, they do not eliminate the risk of delayed-onset intracranial bleeding. Subdural hematomas, for example, can develop over days, weeks, or even months post-injury, gradually increasing intracranial pressure. Early detection using noninvasive imaging techniques is therefore essential and timely.

Case Study: Post-Concussion Symptoms / Cerebrovascular Blood Flow and 3D Ultrasound Imaging Findings: Head: There are signs of reduced blood flow—by about 50%—in the right and left ophthalmic arteries (which supply blood to the eyes and surrounding areas). Further testing suggests that the main arteries supplying the brain (the carotid arteries) may be partially narrowed (by about 50-70%). To compensate for this, smaller blood vessels in the face have grown larger to help maintain circulation. Neck: The thermal scan suggests that the thyroid gland (located in the front of the neck) may be functioning at a lower-than-normal level. There are also signs of increased activity in lymph nodes under the jaw on both sides of the neck, which may be a reaction to an infection, inflammation, or exposure to toxins. These findings are not definitive for a specific disease but could indicate an underlying issue that may need further evaluation.

This report examines the application of quantitative thermal measurement in assessing cerebrovascular blood flow, utilizing the science of thermometry corroborated by 3D ultrasound imaging. This approach is significant because conventional carotid ultrasound primarily focuses on the carotid arteries, while transcranial Doppler imaging targets intracranial circulation. Similarly, ocular ultrasound is highly effective for evaluating the optic nerve, retinal vascular patterns, and temporal artery blood flow. However, a comprehensive, functional assessment of cerebrovascular circulation (considering dynamic blood flow changes due to factors such as physiological state, trauma, or medication) requires an integrative imaging approach.

The ability to predict abnormal flow patterns is crucial for early prognosis in conditions such as stroke. The cerebrovascular system comprises multiple collateral circulatory pathways, both inside and outside the brain, that can compensate for major vascular obstructions. An individual’s survival following a massive stroke is heavily influenced by the presence and functionality of these collateral pathways.

In this case study, ultrasound scans of the ophthalmic artery, carotid artery, and internal cerebral vessels—performed using transcranial Doppler—validated the thermal imaging findings. Extracranial vascular thermography enables real-time mapping of facial perfusion via the ophthalmic arteries, which originate from the internal carotid artery. This technique provides valuable insight into vascular function and offers a noninvasive screening tool for identifying potential interventional strategies.

The ability to perform noninvasive cerebrovascular screening allows for early detection of arterial supply abnormalities, which may warrant further evaluation using arteriography, vascular MRI, or targeted ultrasound imaging. This predictive capability is particularly relevant for stroke prevention.

Part 2: EXPANDED REVIEW on APPLICATIONS IN PREDICTIVE CARDIOVASCULAR AND DERMATOLOGICAL HEALTH

Beyond cerebrovascular applications, noninvasive thermal imaging is also emerging as a valuable predictor of cardiovascular disease, particularly in women, who often exhibit fewer symptoms before experiencing a catastrophic vascular event. Moreover, inflammatory skin conditions such as rosacea and psoriasis are systemic disorders with vascular implications. Quantitative thermal imaging can assess localized arterial involvement and track treatment response more effectively than visual monitoring of redness reduction, which is the conventional clinical endpoint.

A potential application of this technology in menopausal health screening involves assessing extracranial carotid blood flow in the face and neck. Given the increased cardiovascular risk in postmenopausal women, thermal imaging could serve as an early indicator of cerebrovascular and cardiovascular abnormalities.

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Part 2:

DEFINING MEDICAL-GRADE THERMAL IMAGING
Transcribed from an interview with Dr. Phil Hoekstra (from Feb 22, 2025)

MEDICAL-GRADE THERMAL IMAGING is a term I use with a level of precision that differs from many others in the field. Let me clarify what I mean by it. Thermographic instruments were already in use before the FDA gained oversight over medical devices. Initially, they were grandfathered in as medical devices when the FDA assumed regulatory authority, but the standards set at the time were quite limited. Over the years, thermographic technology has advanced at a pace similar to personal computers. Just as we wouldn’t want to rely on a 1980s-era computer today, we shouldn't be using outdated thermal imaging standards for medical applications. Unfortunately, the FDA still maintains the original 1980s standards for medical thermographs. If a camera meets these older benchmarks, it can be FDA-approved—but this does not necessarily mean it is suitable for modern medical diagnostics. The performance of such cameras is inadequate for properly distinguishing breast cancer from benign conditions that may present with similar thermal patterns. (See Full report)

SPOTLIGHT ON MEDICAL CONFIRMATION OF THERMAL IMAGING: MEET THERMA-SCAN

DIRECT FROM THE SOURCE-  HealthTech reporter is proud bring you a mini-autobiographical tour of the science of THERMOLOGY.  We introduce Dr. Phil Hoekstra, a medical physiologist specializing in medical-grade thermal imaging. He is the Laboratory Director at Therma-Scan Reference Laboratory in Mesa, Arizona. With decades of experience in thermal imaging, Dr. Hoekstra has contributed extensively to the field, enhancing the clinical application of infrared imaging in medical diagnostics. Therma-Scan Reference Laboratory stands as the premier facility for medical thermal imaging, setting the standard for accuracy and reliability. The laboratory provides advanced thermographic analysis for various clinical applications, ensuring the highest level of diagnostic precision.

Dr. Hoekstra’s expertise extends beyond laboratory operations; he actively contributes to the advancement of thermal imaging technology and its integration into medical practice. His work has helped establish best practices and protocols that elevate diagnostic thermal imaging as a reliable tool in healthcare.

 

DEFINING MEDICAL-GRADE THERMAL IMAGING
Transcribed from an interview with Dr. Phil Hoekstra (from Feb 22, 2025)

MEDICAL-GRADE THERMAL IMAGING is a term I use with a level of precision that differs from many others in the field. Let me clarify what I mean by it. Thermographic instruments were already in use before the FDA gained oversight over medical devices. Initially, they were grandfathered in as medical devices when the FDA assumed regulatory authority, but the standards set at the time were quite limited. Over the years, thermographic technology has advanced at a pace similar to personal computers. Just as we wouldn’t want to rely on a 1980s-era computer today, we shouldn't be using outdated thermal imaging standards for medical applications. Unfortunately, the FDA still maintains the original 1980s standards for medical thermographs. If a camera meets these older benchmarks, it can be FDA-approved—but this does not necessarily mean it is suitable for modern medical diagnostics. The performance of such cameras is inadequate for properly distinguishing breast cancer from benign conditions that may present with similar thermal patterns.

When I refer to a medical-grade thermograph, I mean a state-of-the-art camera with the necessary precision and reliability for accurate medical diagnostics. While thermal cameras vary widely—from basic models used for home insulation inspections to advanced systems on the James Webb Space Telescope—medical thermographs fall somewhere in between. They must be both practically affordable and sufficiently high-performing. Specifically, a true medical-grade thermograph must be capable of resolving at least 0.001 degrees Celsius over a one-square-millimeter area of skin at the working distance of the lens, with repeatable accuracy. 

Beyond the equipment, medical-grade imaging also refers to the methodology applied in thermal imaging, which must align with the principles of medical oncology. Additionally, the laboratory handling these images must adhere to HIPAA regulations and the same rigorous standards and practices found in top-tier medical centers.

Medical-grade imaging starts with the facility performing the scans. The imaging process must follow strict protocols, utilizing high-quality equipment that meets our specifications. At Therma-Scan Reference Laboratory, we prefer to work with FLIR cameras, which are FDA-listed as medical devices. These cameras are radiometric, meaning each pixel functions as a thermometer that provides quantitative temperature data rather than merely producing a colorized image.

Our analysis relies heavily on specialty software, which is also FDA-listed. This software enables precise temperature measurements at various points, allows us to track changes over time, and facilitates diagnostic evaluations through dynamic applications such as a functional challenge procedures. This process involves taking baseline images, subjecting the patient to a controlled cooling stimulus, and capturing post-exposure images to assess physiologic responses. This level of quantification ensures that our results are not just qualitative interpretations but rigorously analyzed data.

(L) Dense Breast mammography
(R) Breast Thermology

THE ROLE OF NEOANGIOGENESIS IN BREAST CANCER DETECTION

One of the core principles of medical thermography is detecting physiologic changes associated with cancer. Neoangiogenesis—the formation of new blood vessels—is critical for tumor growth. Without it, cancerous cells would be unable to obtain the nutrients they need to proliferate. The abnormal structure of these new blood vessels was not well understood until the late 1980s, when studies revealed their unique porous nature.

Unlike normal blood vessels, which have a structured, three-layered composition, neoangiogenic vessels are disorganized and resemble a natural sponge, with an erratic, unregulated flow. Lacking smooth muscle and autonomic nervous system regulation, these vessels exhibit excessive and uncontrolled blood flow. As a result, areas of neoangiogenesis appear as "hot spots" in thermal imaging. Because breast tissue is located in the outer shell of the body, where body heat is regulated to maintain a stable core body temperature, these hot patterns can indicate malignancy, setting medical thermology apart as a functional imaging modality distinct from structural imaging techniques like mammography, ultrasound and MRI.

 

ADVANCING THE FIELD OF MEDICAL THERMOGRAPHY
Therma-Scan Reference Laboratory is at the forefront of innovation in medical thermography. Our approach is defined by strict adherence to quantitative, repeatable standards that ensure reliability. Many of the advances in the field—including the objective analytic standards, the adaptation of the Marseille system (later incorporated into the American College of Radiology’s BI-RADS system) and the high-caliber equipment used—originated with our work.

Unlike traditional thermographic assessments that relied on static images and pattern recognition, the future lies in dynamic thermology. This emerging field involves capturing real-time, streamed thermal images and applying digital subtraction analysis to detect physiological responses to stimuli. At Therma-Scan, we pioneered the adaptive challenge, in which we capture baseline thermal images, expose the patient to a mild cooling stimulus, and then record post-exposure images to assess changes. The next step in our research is refining this process with advanced digital subtraction techniques, enhancing diagnostic precision.

 Unfortunately, medical thermology has not benefited from significant funding or institutional support comparable to what mammography has received through organizations like the American College of Radiology. As a result, progress has been largely self-funded, requiring careful resource allocation to keep services affordable while driving innovation forward. Although medical thermology is recognized with CPT codes, it is not currently covered by insurance, adding another layer of financial challenge.

 

A LEGACY IN MEDICAL SCIENCE
My journey in medical thermology has been shaped by mentorship from pioneering experts in the field. I was fortunate to train under multidisciplinary leaders, including Harold Isard, a student of Jacob Gershon-Cohen, a key figure in early thermographic research. Through four separate fellowships, I gained hands-on experience and contributed to the field's development. To achieve professional certification, I submitted 50 cases to the American Board of Thermology for rigorous review, defending each case before a physician board in a process akin to a dissertation defense. As far as I know, I am the only individual who has pursued this level of certification across four different specializations in medical thermology. This dedication reflects my commitment to ensuring the highest standards in medical thermography and advancing the field through research, innovation and clinical application.

By continuously refining our methodologies, investing in new technologies and upholding the strictest standards, Therma-Scan Reference Laboratory remains the leader in the evolving landscape of medical thermal imaging. The future of thermology lies in dynamic, quantitative analysis—and we are proud to be paving the way.

 

 

MENOSCAN: HEALTH RISKS & DIAGNOSTIC MEASURES

Menopause marks a significant transition in a woman’s life, bringing hormonal shifts that can increase the risk of several health conditions. As estrogen levels decline, various physiological changes take place, making postmenopausal women more susceptible to cardiovascular disease, osteoporosis, metabolic disorders, and cognitive decline. Understanding these risks and undergoing appropriate screenings can help in early intervention and preventive care.

1. CARDIOVASCULAR DISEASE (CVD):
One of the most concerning risks associated with menopause is heart disease. Estrogen plays a protective role in maintaining healthy blood vessels and cholesterol levels. Its decline leads to increased LDL (bad cholesterol), reduced HDL (good cholesterol), higher blood pressure, and arterial stiffness, all of which contribute to cardiovascular disease.

IMAGING HEART HEALTH
Ultrasound plays a vital role in assessing heart health in premenopausal women by providing a non-invasive, real-time evaluation of cardiac function. Echocardiography offers detailed imaging of the heart’s chambers, valves, and function, aiding in early detection of cardiovascular disease. As estrogen declines during menopause, risks like hypertension, arrhythmias, and reduced arterial elasticity increase. Early ultrasound detection helps guide lifestyle changes and medical interventions to prevent complications.

Carotid ultrasound is also crucial for detecting early atherosclerosis, a key driver of heart disease. By evaluating plaque buildup and arterial thickness, it identifies cardiovascular risks before major events occur. Since heart disease risk rises postmenopause, early vascular screening allows for timely preventive strategies.

Incorporating ultrasound into routine assessments enables early intervention, guiding lifestyle and medical management to reduce heart disease risks. Given that cardiovascular disease is the leading cause of death in women, proactive imaging supports a healthier transition into menopause.

Recommended Checkups:
• Lipid Panel: Monitors cholesterol and triglyceride levels.
• Blood Pressure Monitoring: High blood pressure is a silent risk factor for heart disease.
• Blood Glucose and Hemoglobin A1c: Helps detect diabetes or prediabetes, which increases heart risk.
• Electrocardiogram (ECG) or Stress Test: Assesses heart rhythm and function, especially for those with symptoms or risk factors.

2. BREAST AND REPRODUCTIVE HEALTH
The risk of breast cancer and other gynecological conditions increases with age, making routine screenings crucial.

Recommended Checkups: • Mammogram: Detects early signs of breast cancer. • Pap Smear and HPV Test: Screens for cervical cancer. • Pelvic Ultrasound: Assesses the uterus and ovaries for abnormalities.

3. OSTEOPOROSIS AND BONE HEALTH
Estrogen is crucial for bone density maintenance. Its decline accelerates bone loss, increasing the risk of osteoporosis and fractures, particularly in the hips, spine, and wrists.

Recommended Checkups: • Bone Density Scan (DEXA Scan): Measures bone mineral density and assesses fracture risk. • Vitamin D and Calcium Levels: Ensures adequate levels for bone strength. • Parathyroid Hormone (PTH) and Thyroid Function Tests: These help assess calcium metabolism and overall bone health.

STEP UP TO BONE HEALTH SCREENING Proactive health screening is designed to detect potential health problems earlier, so you have more options and potentially better outcomes. That said, here are a few additions commonly recommend for women as they enter menopause. All of these can be done through your regular ObGyn or PCP, but it’s important to understand that they are looking for disease, not imbalances that can lead to disease. • Bone Density Test • Request a bone density scan if you have not had one by menopause or age 50. • Blood Work • Get comprehensive blood work that goes beyond the basic CBC and chemistry panel, including vitamin D, omega 3 and 6 fatty acids, ferritin; hsCRP, homocysteine, fractionated lipid panel, uric acid; TSH, Free T4, Free T3, Reverse T3; HbA1c. • Pelvic Exam • Even though routine pelvic exams are no longer recommended for asymptomatic women, changes related to menopause such as atrophy and lichen sclerosus, both of which can contribute to painful sex, as well as skin cancer can be detected early.

4. COGNITIVE DECLINE AND BRAIN HEALTH
Studies suggest that estrogen has neuroprotective properties, and its decline may contribute to an increased risk of cognitive decline and conditions like Alzheimer’s disease.

Recommended Checkups: • Cognitive Screening (e.g., MoCA or MMSE): Helps detect early signs of cognitive impairment. • Vitamin B12 and Folate Levels: Essential for brain function and mental clarity. Neurological Assessment: For those experiencing memory loss or cognitive difficulties.

5. METABOLIC SYNDROME AND WEIGHT GAIN
Menopausal women often experience weight gain due to hormonal changes and a slower metabolism. This increases the risk of metabolic syndrome, a cluster of conditions that heightens the risk for heart disease, stroke, and diabetes.

Recommended Checkups: • Body Mass Index (BMI) and Waist Circumference Measurement: Evaluates obesity-related risk factors. • Fasting Blood Sugar and Insulin Levels: Screens for insulin resistance and diabetes. • Liver Function Tests: Helps detect fatty liver disease, often linked with metabolic syndrome.

6. HORMONAL AND THYROID FUNCTION 
Hormonal imbalances, including thyroid dysfunction, are common in menopausal women and can mimic menopause symptoms such as fatigue, weight gain, and mood swings.

Recommended Checkups: • Thyroid Panel (TSH, Free T3, Free T4): Screens for thyroid dysfunction. • Sex Hormone Levels (Estrogen, Progesterone, and Testosterone): Helps assess hormonal imbalances.

Menopause brings significant changes that can impact long-term health, but proactive checkups and lifestyle modifications can help mitigate these risks. Women should work closely with their healthcare providers to create a personalized health monitoring plan. Early detection and preventive care are key to maintaining optimal health and well-being during and after menopause.

For more information about our MENOSCAN program, visit: www.BARDDIAGNOSTICS.com or contact our NYC office at: 212.355.7017

The Art and Science of Hair Restoration: A Journey to Confidence - by Diane Pinson (Clinical version)

 

The Hair Restoration Process: Step by Step

From the moment a patient arrives to the post-procedure care, each step is carefully designed to ensure optimal results and patient comfort.  Upon arrival, we prioritize the patient’s well-being by ensuring they have had a nourishing breakfast to maintain their comfort throughout the procedure. The journey begins in the consultation room, where we take detailed photographs to document the starting point and discuss the patient’s goals.

A crucial part of this step is designing a natural-looking hairline that is age-appropriate and harmonious with the patient’s facial structure. The hairline is carefully marked, considering the original hairline and adjusting based on the patient’s age to achieve a realistic and flattering result. Once the patient approves the plan, we administer medication such as Valium or Versed to help them remain relaxed during the procedure.

For men, we shave only the donor area at the back of the head, blending it into a fade for a natural appearance post-procedure. For women, we take a different approach—shaving only a small portion of the donor area while keeping the longer hair intact to conceal the shaved section. This allows women to maintain their usual hairstyle throughout the process.

Follicle Extraction (Harvesting)

The next phase takes place in the surgery room, where the patient is positioned face down for follicle extraction, also known as harvesting. I prefer using the SAFE System, a technology designed to minimize trauma and maximize the survival rate of extracted follicles. Unlike other extraction methods, this system uses a blunt punch that carefully oscillates around each follicle, preserving the integrity of surrounding hairs and reducing the risk of transection.

The punch size is carefully selected based on the diameter of the hair, not the depth. For scalp hair, we typically use a 1.0 or 1.2 mm punch, while finer areas such as the eyebrows require a smaller punch (usually 0.9 mm) to accommodate the delicate nature of the hair. Each follicle is extracted with precision and placed in a saline dish on ice to preserve its viability. Throughout the process, we meticulously follow the natural direction of hair growth to ensure optimal survival and seamless results.

Eyebrow Hair Transplants: A Specialized Technique

Eyebrow transplants demand even greater precision than scalp procedures. Each follicle must be implanted at the correct angle and density to replicate the natural eyebrow growth pattern. Using a smaller punch size (typically 0.9 mm), we extract the follicles and implant them at a low, flat angle, ensuring they align naturally against the skin.

The natural growth pattern of eyebrows varies across different sections, requiring careful placement to create a soft, realistic arch. Unlike microblading, which is semi-permanent, eyebrow transplants offer a permanent, natural solution using the patient’s own hair.

Our sponsor

Creating Recipient Sites and Graft Placement

Once the necessary number of grafts has been harvested, we transition to the critical step of creating recipient sites. This phase is as important as extraction, as the placement, density, and angle of the new hair must mimic natural growth patterns.

One of the most common mistakes in hair restoration is placing grafts too closely together, which can compromise blood supply. To ensure long-term survival, each graft must be spaced appropriately, allowing optimal circulation. Additionally, the incisions must be made at the correct angle to prevent hair from growing in unnatural directions. For eyebrow transplants, positioning is even more meticulous, ensuring the implanted hair seamlessly blends with the natural brow hair.

Platelet-Rich Plasma (PRP) Therapy

Patients also have the option of Platelet-Rich Plasma (PRP) therapy, which is highly beneficial in stimulating healing, strengthening hair follicles, and promoting better graft survival. I prefer incorporating PRP immediately after extraction to maximize its regenerative effects on the transplanted follicles.

Post-Procedure Care and Hair Growth Timeline

Proper aftercare is essential for optimal healing and successful results. Each patient receives a comprehensive aftercare kit with detailed instructions, and we maintain continuous follow-ups at three, six, and twelve months post-procedure. For patients who cannot visit in person, virtual consultations are available to monitor progress and address any concerns.

Hair typically begins to grow within a few months, with full results visible at 12 to 18 months. Women may experience a slightly longer growth timeline compared to men. To support long-term hair health and prevent further loss, we may recommend additional treatments or medications tailored to the patient’s needs.

A Collaborative Effort for Natural, Lasting Results

Successful hair restoration requires a combination of advanced technology, skilled technique, and a dedicated team. By utilizing the SAFE System, carefully planning extraction and placement, and ensuring proper aftercare, we achieve natural-looking results that restore confidence and self-esteem.

---

MENOPAUSE NEWS: FACING HAIR LOSS LATE IN LIFE- A REVELATION 

Edited by Gina Adams / Women's Health Digest editorial team

Mary had always taken pride in her thick, beautiful, curly hair. It was more than just a feature of her appearance—it was a part of her identity, a symbol of her femininity, confidence, and presence in the world. So when she first noticed changes, she tried to convince herself it was nothing. Maybe she was imagining it. Maybe it was just a trick of the light. But deep down, she knew something was wrong. And when the truth became undeniable, she was devastated.

The realization hit her like a wave—an uncontrollable force of anxiety and grief. She felt sick to her stomach, overwhelmed by the thought that she might lose her hair entirely. She had always believed that something like this could never happen to her. Her hair was too thick, too strong. But now, standing in front of the mirror, she saw the signs staring back at her.

SOCIAL VALUE vs PERSONAL MOJO
It was in that moment that she truly understood the emotional weight of hair loss—not just for herself, but for others who had faced the same struggle. She thought of the men and women she had encountered throughout her life who had experienced hair loss. She had always been aware of it, of course, but it had never felt personal. Now, it was different. Now, she understood the depth of loss, the fear, the frustration. And she realized how little she had known about helping others who had gone through the same thing.

Hair, she came to understand, was not just an aesthetic feature. It was deeply tied to a person’s identity, their sense of self-worth, and even their place in society. The ideal of beauty, so often portrayed in magazines and movies, revolved around thick, healthy hair. It was a marker of youth, vitality, and even power. Losing it felt like losing a piece of herself. The stigma attached to hair loss weighed on her heavily. For some, like those undergoing chemotherapy, hair loss had been embraced with bravery, slowly reducing societal stigma. But for those experiencing unexplained or gradual thinning, the shame and emotional toll remained significant.

PATHOLOGY
As she sought answers, Mary discovered the complexity of hair loss, particularly in women. She learned that there were multiple causes—immune disorders, inflammation, hormonal shifts, and genetic predispositions like androgenic alopecia. She read about how certain conditions, like eczema and psoriasis, could disrupt hair follicles through inflammation. She learned about how pregnancy, menopause, and hormonal imbalances could trigger shifts in hair growth cycles, sometimes leading to temporary loss, but other times causing permanent changes.

One of the most striking revelations was how little research had been dedicated to female hair loss compared to male hair loss. Most treatments had been developed based on studies conducted on men, largely because their hormonal stability made them easier test subjects. Finasteride, minoxidil—these treatments were designed with men in mind, with women’s unique biological differences often overlooked. What limited research existed showed that women’s hair loss did not always follow the same mechanisms as men’s, but there were still too many unanswered questions.

As she continued her research, Mary realized another significant challenge—the fragmentation of medical expertise in addressing hair loss. Dermatologists, gynecologists, endocrinologists, and hair restoration specialists each had their own body of knowledge, but there was little cross-collaboration between them. The lack of an integrated approach meant that many patients, like herself, were left navigating conflicting information and incomplete solutions.

GLOBAL VILLAGE
She discovered organizations and researchers dedicated to bridging these gaps, such as Learn Skin, which was pioneering integrative dermatology approaches. Their work incorporated functional medicine, aiming to identify root causes rather than just treating symptoms. It was a slow process to change conventional medicine, but Mary found hope in these emerging perspectives. If medical professionals could collaborate more effectively and approach hair loss from multiple angles—genetic, hormonal, and environmental—perhaps future generations would have better solutions.

Mary’s journey was one of transformation. What began as personal devastation evolved into a mission to understand and advocate for better awareness and treatments. She had once felt powerless, but through knowledge, she gained strength. She learned that early diagnosis and prevention could make a difference and that, like so many other health conditions, research and understanding had the potential to change lives.

Though she still faced the challenge of her own hair loss, Mary no longer felt alone. She was part of a broader conversation—one that was just beginning to acknowledge the true impact of hair loss on women. And with every new discovery, she grew more determined to ensure that no one else would have to face it without answers, without support, or without hope.

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CHECKOUT THE AFTERMATH OF THE 2025 WOMEN'S HEALTH EMPOWERMEET

The Art and Science of Hair Restoration: A Journey to Confidence - by Diane Pinson (Patient's version)

 

The Hair Restoration Process: Step by Step

From the moment a patient arrives to the post-procedure care, each step is carefully designed to ensure optimal results and patient comfort.  Upon arrival, we prioritize the patient’s well-being by ensuring they have had a nourishing breakfast to maintain their comfort throughout the procedure. The journey begins in the consultation room, where we take detailed photographs to document the starting point and discuss the patient’s goals.

A crucial part of this step is designing a natural-looking hairline that is age-appropriate and harmonious with the patient’s facial structure. The hairline is carefully marked, considering the original hairline and adjusting based on the patient’s age to achieve a realistic and flattering result. Once the patient approves the plan, we administer medication such as Valium or Versed to help them remain relaxed during the procedure.

For men, we shave only the donor area at the back of the head, blending it into a fade for a natural appearance post-procedure. For women, we take a different approach—shaving only a small portion of the donor area while keeping the longer hair intact to conceal the shaved section. This allows women to maintain their usual hairstyle throughout the process.

Follicle Extraction (Harvesting)

The next phase takes place in the surgery room, where the patient is positioned face down for follicle extraction, also known as harvesting. I prefer using the SAFE System, a technology designed to minimize trauma and maximize the survival rate of extracted follicles. Unlike other extraction methods, this system uses a blunt punch that carefully oscillates around each follicle, preserving the integrity of surrounding hairs and reducing the risk of transection.

The punch size is carefully selected based on the diameter of the hair, not the depth. For scalp hair, we typically use a 1.0 or 1.2 mm punch, while finer areas such as the eyebrows require a smaller punch (usually 0.9 mm) to accommodate the delicate nature of the hair. Each follicle is extracted with precision and placed in a saline dish on ice to preserve its viability. Throughout the process, we meticulously follow the natural direction of hair growth to ensure optimal survival and seamless results.

Eyebrow Hair Transplants: A Specialized Technique

Eyebrow transplants demand even greater precision than scalp procedures. Each follicle must be implanted at the correct angle and density to replicate the natural eyebrow growth pattern. Using a smaller punch size (typically 0.9 mm), we extract the follicles and implant them at a low, flat angle, ensuring they align naturally against the skin.

The natural growth pattern of eyebrows varies across different sections, requiring careful placement to create a soft, realistic arch. Unlike microblading, which is semi-permanent, eyebrow transplants offer a permanent, natural solution using the patient’s own hair.

Our sponsor

Creating Recipient Sites and Graft Placement

Once the necessary number of grafts has been harvested, we transition to the critical step of creating recipient sites. This phase is as important as extraction, as the placement, density, and angle of the new hair must mimic natural growth patterns.

One of the most common mistakes in hair restoration is placing grafts too closely together, which can compromise blood supply. To ensure long-term survival, each graft must be spaced appropriately, allowing optimal circulation. Additionally, the incisions must be made at the correct angle to prevent hair from growing in unnatural directions. For eyebrow transplants, positioning is even more meticulous, ensuring the implanted hair seamlessly blends with the natural brow hair.

Platelet-Rich Plasma (PRP) Therapy

Patients also have the option of Platelet-Rich Plasma (PRP) therapy, which is highly beneficial in stimulating healing, strengthening hair follicles, and promoting better graft survival. I prefer incorporating PRP immediately after extraction to maximize its regenerative effects on the transplanted follicles.

Post-Procedure Care and Hair Growth Timeline

Proper aftercare is essential for optimal healing and successful results. Each patient receives a comprehensive aftercare kit with detailed instructions, and we maintain continuous follow-ups at three, six, and twelve months post-procedure. For patients who cannot visit in person, virtual consultations are available to monitor progress and address any concerns.

Hair typically begins to grow within a few months, with full results visible at 12 to 18 months. Women may experience a slightly longer growth timeline compared to men. To support long-term hair health and prevent further loss, we may recommend additional treatments or medications tailored to the patient’s needs.

A Collaborative Effort for Natural, Lasting Results

Successful hair restoration requires a combination of advanced technology, skilled technique, and a dedicated team. By utilizing the SAFE System, carefully planning extraction and placement, and ensuring proper aftercare, we achieve natural-looking results that restore confidence and self-esteem.

---

MENOPAUSE NEWS: GETTING HAIR LOSS LATE IN LIFE- A REVELATION 

Edited by Gina Adams / Women's Health Digest editorial team

Mary had always taken pride in her thick, beautiful, curly hair. It was more than just a feature of her appearance—it was a part of her identity, a symbol of her femininity, confidence, and presence in the world. So when she first noticed changes, she tried to convince herself it was nothing. Maybe she was imagining it. Maybe it was just a trick of the light. But deep down, she knew something was wrong. And when the truth became undeniable, she was devastated.

The realization hit her like a wave—an uncontrollable force of anxiety and grief. She felt sick to her stomach, overwhelmed by the thought that she might lose her hair entirely. She had always believed that something like this could never happen to her. Her hair was too thick, too strong. But now, standing in front of the mirror, she saw the signs staring back at her.

SOCIAL VALUE vs PERSONAL MOJO
It was in that moment that she truly understood the emotional weight of hair loss—not just for herself, but for others who had faced the same struggle. She thought of the men and women she had encountered throughout her life who had experienced hair loss. She had always been aware of it, of course, but it had never felt personal. Now, it was different. Now, she understood the depth of loss, the fear, the frustration. And she realized how little she had known about helping others who had gone through the same thing.

Hair, she came to understand, was not just an aesthetic feature. It was deeply tied to a person’s identity, their sense of self-worth, and even their place in society. The ideal of beauty, so often portrayed in magazines and movies, revolved around thick, healthy hair. It was a marker of youth, vitality, and even power. Losing it felt like losing a piece of herself. The stigma attached to hair loss weighed on her heavily. For some, like those undergoing chemotherapy, hair loss had been embraced with bravery, slowly reducing societal stigma. But for those experiencing unexplained or gradual thinning, the shame and emotional toll remained significant.

PATHOLOGY
As she sought answers, Mary discovered the complexity of hair loss, particularly in women. She learned that there were multiple causes—immune disorders, inflammation, hormonal shifts, and genetic predispositions like androgenic alopecia. She read about how certain conditions, like eczema and psoriasis, could disrupt hair follicles through inflammation. She learned about how pregnancy, menopause, and hormonal imbalances could trigger shifts in hair growth cycles, sometimes leading to temporary loss, but other times causing permanent changes.

One of the most striking revelations was how little research had been dedicated to female hair loss compared to male hair loss. Most treatments had been developed based on studies conducted on men, largely because their hormonal stability made them easier test subjects. Finasteride, minoxidil—these treatments were designed with men in mind, with women’s unique biological differences often overlooked. What limited research existed showed that women’s hair loss did not always follow the same mechanisms as men’s, but there were still too many unanswered questions.

As she continued her research, Mary realized another significant challenge—the fragmentation of medical expertise in addressing hair loss. Dermatologists, gynecologists, endocrinologists, and hair restoration specialists each had their own body of knowledge, but there was little cross-collaboration between them. The lack of an integrated approach meant that many patients, like herself, were left navigating conflicting information and incomplete solutions.

GLOBAL VILLAGE
She discovered organizations and researchers dedicated to bridging these gaps, such as Learn Skin, which was pioneering integrative dermatology approaches. Their work incorporated functional medicine, aiming to identify root causes rather than just treating symptoms. It was a slow process to change conventional medicine, but Mary found hope in these emerging perspectives. If medical professionals could collaborate more effectively and approach hair loss from multiple angles—genetic, hormonal, and environmental—perhaps future generations would have better solutions.

Mary’s journey was one of transformation. What began as personal devastation evolved into a mission to understand and advocate for better awareness and treatments. She had once felt powerless, but through knowledge, she gained strength. She learned that early diagnosis and prevention could make a difference and that, like so many other health conditions, research and understanding had the potential to change lives.

Though she still faced the challenge of her own hair loss, Mary no longer felt alone. She was part of a broader conversation—one that was just beginning to acknowledge the true impact of hair loss on women. And with every new discovery, she grew more determined to ensure that no one else would have to face it without answers, without support, or without hope.

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CHECKOUT THE AFTERMATH OF THE 2025 WOMEN'S HEALTH EMPOWERMEET

Revolutionizing Musculoskeletal Treatment: The Power of SHOCKWAVE THERAPY

An Interview with Gerhard Kinas (Founder of Kinas Medical Technologies) by: Graciella Davi / Lennard Goetze

Shockwave therapy, a cutting-edge, non-invasive treatment (sometimes also referred to as acoustic wave therapy) has emerged as a game-changer in musculoskeletal care. Known as The Miracle Wave®, this FDA-approved acoustic therapy is backed by decades of research and is widely used to aid in pain management and tissue regeneration. We sat down with Gerhard Kinas, founder of Kinas Medical Technologies, to discuss the evolution, applications, and future potential of this groundbreaking technology.

The Science Behind Shockwave Therapy
Originally developed in the 1980s for breaking up kidney stones in urology, extracorporeal shockwave therapy (ESWT) has since demonstrated remarkable benefits in musculoskeletal healing. "Shockwave therapy has been found to remodel dysfunctional tissue, aiding in tendon injuries, bone healing, and other chronic pain conditions," Kinas explains. Over time, its applications have expanded, proving effective for various orthopedic and sports-related conditions.

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Common Applications and Clinical Benefits
Shockwave therapy is widely used to accelerate healing in chronic tendon injuries, including plantar fasciitis, rotator cuff injuries, and tennis elbow. "Tendons, due to their limited blood supply, often take a long time to heal. Shockwave therapy stimulates the body's own growth factors and stem cells, expediting the regeneration process," says Kinas.

The technology gained significant traction in sports medicine, with Kinas himself introducing it at the 1996 Atlanta Olympics. Today, over 60 professional sports teams across the NFL, NBA, MLB, and NHL use shockwave therapy to keep athletes in peak condition.

Regulatory Approval and Technological Differentiation
Shockwave therapy is categorized into focused and radial shockwaves, each with distinct uses. Focused shockwaves, similar to lithotripsy but at lower energy levels, are FDA-approved for specific conditions like plantar fasciitis and diabetic foot ulcers. Radial pressure waves, while not FDA-approved for specific medical indications, are registered for improving blood circulation and relieving muscle tension. "Healthcare providers leverage both technologies for a wide range of pain conditions, ensuring tailored treatment for their patients," Kinas notes.

Scientific Backing and Industry Recognition
With over 9,000 published research papers, shockwave therapy is one of the most extensively studied treatment modalities in regenerative medicine. "It surpasses laser and extracorporeal magnetotransduction therapy (EMTT) in published research, underscoring its credibility and effectiveness," Kinas affirms.

The Evolution and Future of Shockwave Therapy
The journey of shockwave therapy began with its unexpected benefits in orthopedic healing. Initially explored for hip implant procedures, researchers discovered its ability to enhance bone regeneration and reduce pain. This discovery paved the way for broader applications, including treatment for frozen shoulder, epicondylitis, and other conditions where conventional therapies had fallen short. 

Kinas Medical continues to innovate, integrating shockwave therapy with complementary technologies like Extracorporeal Magnetotransduction Therapy (EMTT), a non-invasive treatment that uses electromagnetic pulses to stimulate the body's natural healing processes), and on the future horizon Transcranial Pulse Stimulation (TPS), a series of single, ultrashort, and high pressure pulses for non-invasive brain stimulation currently CE approved in Europe only.

Expanding into Preventive Medicine
Beyond pain management, shockwave therapy is being explored for preventive care and performance enhancement. "We envision a future where this technology is not just used for treating injuries but also for preventing them," says Kinas. Research into applications for neurodegenerative diseases, such as Alzheimer's, is ongoing, though regulatory clearance in the U.S. is still in progress.

Conclusion
Shockwave therapy has established itself as a powerful tool in modern medicine, offering a non-invasive, research-backed solution for chronic pain and tissue regeneration. Under the leadership of Gerhard Kinas, Kinas Medical is at the forefront of advancing this technology, ensuring that patients and healthcare providers continue to benefit from its transformative potential. As research progresses, shockwave therapy is set to redefine the future of musculoskeletal and regenerative medicine.

With over 35 years of experience, GERHARD KINAS has led the expansion of shockwave therapy and other advanced technologies to healthcare providers across the U.S. Early in his career at STORZ MEDICAL AG, he worked directly with product development teams to advance the technology. In 2000, Gerhard founded Kinas Medical Technologies to provide practitioners with clinically proven, non-invasive solutions. Today, Kinas Medical continues to drive healthcare innovation, offering technologies that help providers deliver healing amplified® to their patients, improve outcomes, and support practice growth.

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A WORD FROM THE PUBLISHER
The concept of non-invasive health and medical innovations has paved the movement that harnessed the functional medicine community since the '60's -or earlier. Recognizing the science behind SHOCKWAVE helped set the stage to the continued movement that drives today's conventional and personalized /alternative care, pursuing quantitative response to a vast array of disorders. Learning Gerhard Kinas' restorative solutions is an inspiring view of this development for clinicians and researchers alike. Not only does this solution expand our choices for pain management, but it is also (now) being poised as a remarkable preventive option.   In addition, knowing about their exploration to address Alzheimer's disease is astonishing to say the least.  Regarding scientific evolution, our academic publishing and clinical team highly supports the expansion of this science and applauds the development behind Kinas Medical's shockwave therapy as a viable innovation for consideration in the wellness society.                - R. Bard, MD (Founder, AngioMedical Publishing)