Michael Roizen, MD: You are listening to you The Owner's Manual Radio podcast on Podcast Health where you should get all your information, radio md, iHeart, or wherever you download us. Thank you for doing it. I'm your. Host Dr. Mike Rozen. This is 1262 B. The B'S are always great guests, the a's the latest medical news of the week, And we had a humdinger for you this week.

You'll wanna get the a segment of 1262. our guest today is Dr. Breath Bolton, B-O-L-T-O-N. You can find out more about him@greathairtransplants.com slash. Dr. Bolton, he located in Fort Lauderdale, Florida. Dr. Bolton, how did you get involved in transplants?

Bret Bolton, MD: first of all, thank you so much for having me. I appreciate it. I'm very honored to be on the show. I got to hair transplants. My dad was a obstetrician gynecologist. my idol when I was a little boy he's my idol to this day. I wanted to be a doctor, like my dad.

so my plan was to, be a doctor, from early childhood. And as I grew up, lived in Michigan and I wanted to get outta Michigan. I never liked the cold. And so I went to medical school, Michigan State, And then ended up going to, undergrad state And then medical school in Iowa.

And then I ended up doing my training down in Florida. So I went from cold to colder. Then I got to where I wanted to be in the nice, hot, sunny south Florida, and I was gonna do orthopedic surgery. And at that time, the whole managed care system was taking over, in South Florida where they were telling the doctors which medications they could or could not prescribe or who they may or may not, admit to the hospital.

And I was seeing the writing on the wall with, how the healthcare system was changing. And so I was talking to my dad about it and he's like, well, you should look into doing something in cosmetics. You know, where you could have a cash, clientele and you don't have to deal with insurance companies, because it was really upside down at that time.

And one of my friends was in the same position he was doing, radiology and he wanted to get out as well So basically he got hired with a company based outta Canada and they were doing hair transplants and he was basically a higher doctor traveling around the country doing hair transplants.

he and I were friends and he asked if I wanted, To find out about the, procedure and it would be interested in a job. 'cause they were looking to hire another doctor. So the owner came down and he met me and we hit it off they showed me the procedure.

I fell in love with the procedure and I said, that's what I want to do. So I got hired when I was in my internship and I came straight out and went straight into heroin and that's all I've ever done.

Michael Roizen, MD: Now tell us the difference between, in other words, who needs a hair transplant? what's the defining factor? in other words, I get asked by a lot of women. Who are in early menopause, that they're losing hair. And they say, measure my zinc. Measure my iron. Find out what's wrong with me.

so tell us about, when women start losing hair, when men start losing hair, and, what should the average doctor do before they refer to you?

Bret Bolton, MD: So they're completely two different worlds, men and women. the men are super simple, straightforward. Attic hair loss where they just have male pattern hair loss 99.9% of the time. And that, as I'm sure you're aware of, they're having the hormone conversion taking place where their testosterone in their bodies converting into the dihydrotestosterone, the mucusy secretion called seum builds up, miniaturize the hair follicle, and it keeps it from making its way through.

that's pretty straightforward for male pattern hair loss. so for, Preventative treatments, which is great. you can always start 'em off with preventative treatments. We'd want to start 'em off with Finasteride one milligram, which I know you're well aware of, which was originally Proscar been out 50 plus years. the one milligram came out in the nineties.

It's currently now generic. that's my number one go-to FDA approved treatment to prevent future hair loss that's stopping that testosterone from converting into the DHT. the other f FDA-approved treatment that I know you're aware of is, minoxidil brand, name Rogaine been out since the seventies. Works excellent. It allows us to.

treat the patient topically if they don't want to be on oral medication, it's a vasodilator. It's allowing the, blood vessels to open up, allowing more oxygen, minerals, and nutrients to go where they need to go to make a better environment for those miniaturized hairs to make the way through.

So that's always gonna be step one, for the men, is to get 'em on the preventative treatment. So at the very least we can. Help keep what they have. And in a lot of cases, if the guys just can keep what they have, they're satisfied. some patient's, I hate to say this, but some patient's might get a bounce back from the treatments where the miniaturized follicles might be able to get restored.

I say, listen, if that happens to you, that's a bonus. Don't plan on getting that bounce back. You have to be more realistic that we're just trying to help keep what you have. Because, step one is always to keep what we have, so we're not going backwards And we don't have a moving target when we're trying to do a procedure or hair transplant on you.

with the women, it is a whole nother ballgame. It's everything from, like you mentioned, thyroid pituitary, it's collagen vascular disease, menopause with all the hormonal changes. So there's so many different factors with women, but. they can also have a male pattern, as well. So females can have a male pattern just the same as a man might have.

And of all the choices they have for hair loss, that's gonna be their best choice because we can. Easily help well, you can put 'em on the, female minoxidil, which is just a lower percentage. It's a 2% versus a 5%. but step one with the females is to figure out what is causing that hair loss, because we don't wanna waste your money or your time doing a surgery on you if you're just gonna lose more hair.

I mean, we're not in business just to take your money. We're trying to treat you. so step one is to figure out what's causing it. What's the root cause of the loss? Stopping that, And then doing the hair transline.

Michael Roizen, MD: And in addition to iron and zinc, what else we should be measuring? And then when should we refer them to you?

Bret Bolton, MD: great question. My answer to That is. You have to figure out the root cause of the hair loss. And it could be anything from thyroid, pituitary, collagen, vascular disorders, any, abnormalities with hormones. I mean, there's so many different reasons. female patient's are losing their hair. so That is the magic question is what's causing their hair loss?

And diagnosing that, once that's diagnosed and stabilized, then they're a candidate to come to us after that's under control. we don't wanna treat you unless you have whatever is causing that hair loss under control.

Michael Roizen, MD: Now tell me about, we see ads on tv, about hair transplants that say, this isn't your father's hair transplant process. Tell us what's different about the new techniques. Uh.

Bret Bolton, MD: I love, that it's comical to me because, when I started, I started doing hair transplants in 1997. I went out to the conference in Barcelona, in Spain. And all the American doctors were talking about flaps and they were talking about, scalp reductions. They, we were talking about, these plugs where the, back in the day they were doing the plugs.

And a Japanese guy gets up and he says, I do a one hair graft. So I'm at the conference where they introduced the one hair graft And the whole audience gasps. And so we went from where we were doing, multiple hair graft where they were taking a punch biopsy from the back of your head, punching a hole on the top of your head, And then.

Henceforth they'd call plugs, plugging in that spot. But because these plugs were so big, they had to space 'em out. The directions and angles of the plugs were. Affected and they would look like do hair. So they had that term. But once they came out with the one hair graft, it just kinda revolutionized hair transplants because now we're able to do these nice soft one hair at a time.

then they, we do a follicular unit behind those one hairs. The follicular unit is a naturally occurring bundle of hair we all have in the back, throughout our head. group is of one hair, two hair, three hair. Very rarely you might have a four hair follicular unit. so we start off with the little ones And we create a nice soft pattern.

We follow it with the little twos and threes, And then they're saying that, it's not your father's transplant because they're using today. not using the big plugs, but they're still doing the, The new technique that they're talking about is the latest and greatest. It is called a follicular unit extraction, where they're just using a smaller punch biopsy so they're taking the old worst procedure out there.

The plug procedure reinvented it and gave it a new name and saying it's the latest and greatest. When, in my opinion, it's not, I currently do not offer follicular and extraction because I feel it's a inferior way to do the procedure. causes a lot of damage to the follicles.

you have to take the hair out of the safe zone. if it was a better procedure, I would do it.

Michael Roizen, MD: Let's give our readers a place to get in touch with you. you're in Fort Lauderdale and it is great Hair transplants.com/. Dr. B-O-L-T-O-N is how you get in touch with Dr. Brett Bolton and you can find out more about the whole subject@greathairtransplants.com. Dr. Bolton, I wanna thank you very much.

Bret Bolton, MD: Thank you very much. Thanks for having me.

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Our other one for young jevity.com and I wanna thank you Dr. Bolton, the 50,000 of you who download US Weekly. This has been 1262 B. The BS are great guests like Dr. Bolton, the a's the latest medical news of the week And what it means to you. Thanks again.

We'll be back next week. We hope you are too.