Hair Restoration in New York: Physician-Performed Micrograft FUE

Who performs the procedure matters in New York

On January 31, 2020, the New York State Board for Professional Medical Conduct issued a position statement that hair restoration surgery should only be performed by qualified physicians. The International Society of Hair Restoration Surgery (ISHRS) consumer-advocacy materials advise patients to ask specific questions before agreeing to any procedure: who will evaluate your candidacy, who will perform each step of the surgery, what their licensure and training are, whether anyone not licensed by the state will make incisions or harvest grafts, and whether everyone involved is covered by malpractice insurance. At Springs Rejuvenation Hair in NoMad, the answer to "who performs the Micrograft FUE procedure" is straightforward. Dr. Charles Pereyra, MD—a board-certified emergency physician at NewYork-Presbyterian Brooklyn Methodist and a member of the ISHRS—performs both the extraction and the placement of follicular units himself. Over the course of more than 7,000 procedures and drawing on his emergency-medicine training in precision and patient safety, Dr. Pereyra has built a practice that reflects the regulatory and professional expectations articulated by the New York State Board and the ISHRS. The clinic holds more than 350 Google reviews, many from patients who traveled from across the tri-state area and beyond.

245 Fifth Avenue, Suite 307: the NoMad clinic

The New York location occupies Suite 307 on the third floor of 245 Fifth Avenue, a twenty-four-story office building constructed in 1927 at the corner of East 28th Street in the NoMad neighborhood, a few blocks north of Madison Square Park. Patients arriving by subway will find the 28 St station on the N, R and W lines along Broadway about a two-minute walk from the building entrance; the 6 train's 28 St station on Park Avenue South is a few minutes to the east. The F and M trains stop at 23rd Street, and the PATH station at 23rd and Sixth Avenue serves commuters from Hoboken and Jersey City. For those arriving by commuter rail, Penn Station and Moynihan Train Hall—serving the Long Island Rail Road, NJ Transit and Amtrak—are roughly a fifteen-minute walk west, while Grand Central Terminal, the Metro-North hub, is about twenty minutes on foot to the northeast. Out-of-state and long-distance patients typically fly into LaGuardia, JFK or Newark; from JFK the AirTrain connects to the LIRR at Jamaica Station for a direct run to Penn Station, or passengers can take the E train into Manhattan. Newark Liberty travelers use NJ Transit to reach Penn Station. The clinic draws from NoMad, Flatiron, Gramercy, Murray Hill, Kips Bay, Chelsea, Midtown, the Upper East Side and Upper West Side, Brooklyn neighborhoods including Park Slope, Williamsburg and Brooklyn Heights, Queens communities such as Astoria, Long Island City and Forest Hills, and the broader tri-state region encompassing Westchester, Long Island, northern New Jersey and southwestern Connecticut.

No-Shave Micrograft FUE for people who go back to the office

The ISHRS 2025 Practice Census, a survey of member activity in 2024, found that follicular-unit excision was used in 85.4 percent of male and 68.2 percent of female surgical procedures, with an average case size of 2,262 grafts. Traditional FUE involves shaving the donor zone—usually the back and sides of the scalp—to allow the physician to visualize and extract individual follicular units under magnification. No-Shave Micrograft FUE, one of the options most frequently requested at the Manhattan clinic, harvests donor grafts without a visible clipper cut, leaving the patient's existing hair length intact. This approach suits professionals returning to client-facing roles, Wall Street offices or midtown law firms where a shaved band would draw questions during the weeks immediately following the procedure. The trade-off is session size and procedural duration: because the physician must part through longer hair to reach each follicular unit, a no-shave case typically yields fewer grafts per session than a fully shaved extraction, and the procedure itself takes longer. Candidacy depends on donor density, hair color and contrast against the scalp, and the overall restoration plan. Dr. Pereyra evaluates these factors during the Follicular Health Assessment and discusses whether no-shave extraction will serve the patient's goals or whether a different approach—such as a partially shaved extraction confined to an area easily hidden by surrounding hair—makes more sense.

The first visit: Follicular Health Assessment in Manhattan

The American Academy of Dermatology notes that candidacy for hair restoration requires two elements: enough healthy hair in the donor area, and the ability to grow hair in the thinning or balding region. During the in-person consultation at 245 Fifth Avenue, Dr. Charles Pereyra, MD, reviews the patient's medical history, examines the scalp under magnification to assess follicular-unit density and caliber, evaluates the donor zone for elasticity and scarring, and discusses any medications the patient is taking or considering—minoxidil, finasteride, platelet-rich plasma or others. Blood tests or a scalp biopsy may be recommended when the pattern of loss is atypical. The Academy also points out that a dermatologist may ask a patient to start a hair-loss medicine before proceeding with surgery, and that restoring a completely dense appearance may be unrealistic, but a fuller appearance can be the goal. At the end of the assessment the clinic provides one all-in price quotation that covers the physician's work, the surgical team, and facility use; Springs does not publish per-graft rates or ranges because the final cost reflects the individualized plan. Patients traveling from Westchester, Long Island, northern New Jersey or Connecticut may begin with a virtual consultation—video review of photographs and scalp close-ups, medical-history discussion and preliminary candidacy assessment—followed by an in-person visit to confirm the plan before scheduling the procedure.

Procedure day at 245 Fifth

According to the American Academy of Dermatology, hair restoration surgery usually takes four to eight hours and is performed under local anesthesia with the patient awake. On procedure day at the NoMad clinic, Dr. Pereyra administers local anesthesia to the donor and recipient areas, then uses a small punch instrument—typically 0.8 to 0.9 millimeters in diameter—to excise individual follicular units from the donor zone. Each unit is inspected under magnification, trimmed of excess tissue and kept in chilled holding solution while the recipient sites are created. Dr. Pereyra makes the recipient incisions at the angle, depth and density required by the restoration design, then places each graft by hand. Both the harvesting and the placement are performed by the physician; no portion of the surgical work is delegated to a physician assistant or technician. At the end of the session the patient receives written aftercare instructions, prescriptions if indicated, and the direct contact information for post-procedure questions. Most patients take a taxi or rideshare home on the first day, avoiding the crowded subway cars and the risk of an accidental bump to the newly placed grafts during the evening commute.

Recovery in a walking city across four seasons

New York's climate presents four distinct seasons, and typical aftercare guidance acknowledges each. Humid summer heat and the perspiration that comes with walking from the subway to the office or crossing midtown on foot call for gentle rinsing per the written instructions; patients are advised to let sweat air-dry rather than rubbing the scalp with a towel during the early days. Cold, dry winter air and indoor heating can leave the scalp feeling tight—misting instructions are part of the standard protocol—and once the initial recovery period has passed, a loose, clean beanie may be worn, though tight hats should be avoided early on. Crowded N and R trains during rush hour and the jostle of umbrellas on a rainy midtown sidewalk mean protecting the recipient area from accidental contact in the first few days; many patients work from home or take a few days off to let the initial crusting form undisturbed. Okochi and colleagues reported in 2024 in Aesthetic Plastic Surgery on risk factors for temporary recipient-site effluvium—commonly called shock loss—after follicular-unit excision, a phenomenon in which transplanted grafts and nearby native hairs are shed in the weeks following surgery and then, in most cases, grow back over the following months. The written discharge instructions given after the procedure take precedence over any general summary, but patients are typically advised to pause strenuous gym workouts, saunas, steam rooms and saltwater swimming—including summer trips to Rockaway Beach or the Hamptons—for about two weeks, and to use physical shade such as a hat when walking outdoors in strong sun, since the top of the scalp receives direct ultraviolet exposure during a midday crosstown walk.

Regenerative adjuncts: exosome protocol and peptide program

A portion of the clinic's Manhattan patients ask about regenerative approaches to scalp and follicular health. Springs offers an investigational Stem Cell Exosome Scalp Protocol and a Peptide + Lifestyle Program, both of which are positioned as adjuncts and are not FDA approved to treat any disease. The FDA issued a public safety notification in December 2019 noting that there are no FDA-approved exosome products and that the agency had received reports of serious adverse events in patients in Nebraska who received unapproved exosome formulations. A subsequent FDA consumer alert on regenerative medicine products, including stem cells and exosomes, emphasized that such products are not approved for any use outside of approved clinical trials and warned patients about clinics marketing them. Early studies in animals and small human cohorts have suggested that exosomes—nanoscale vesicles secreted by cells—may carry signaling molecules that influence inflammation, angiogenesis and cell survival, but the evidence remains mixed and investigational. Some published series have reported modest improvements in hair density or caliber when exosomes are combined with microneedling or platelet-rich plasma, while other trials have found no statistically significant benefit over control interventions. The peptide program incorporates oral and topical agents intended to support metabolic and hormonal pathways that influence hair growth, alongside nutrition and lifestyle counseling; like the exosome protocol, it is investigational and individual responses vary widely. Dr. Pereyra discusses the current state of the literature, the limitations of the data, and the out-of-pocket cost during the consultation, so that patients can make an informed choice about whether to add these approaches to their care plan.

Tri-state and fly-in patients

The NoMad location serves a regional and national patient base. Commuters from Westchester arrive via Metro-North to Grand Central, Long Island patients take the LIRR to Penn Station, and New Jersey residents use NJ Transit or the PATH system. Out-of-state patients typically fly into LaGuardia, JFK or Newark Liberty and stay in Manhattan for the procedure and the initial recovery check. The clinic's travel program follows a structured sequence: a virtual consultation to review photographs, scalp images and medical history; a written restoration plan and scheduling; travel to New York for the procedure; an in-person recovery check the following day or within the first few days, depending on the travel distance; and then departure home with remote follow-up by video and photograph submission over the following months. The in-person recovery check before the patient flies or drives home allows Dr. Pereyra to examine the grafts, address any early questions about swelling or crusting, and confirm that recovery is proceeding as expected. Remote follow-up continues through the shedding phase, the dormant period and the gradual emergence of new growth, with scheduled check-ins at three months, six months and one year. Patients calling from Connecticut, Pennsylvania, Washington D.C., Boston or farther afield can begin the process with a phone call to (888) 503-4482 to arrange the initial virtual consultation.

What patients say about Springs Rejuvenation Hair

The clinic has received more than 350 Google reviews from patients who have undergone procedures in New York and at the other Springs locations.

John R., Google review: “This review is for a stem cell scalp injection for hair regrowth at Springs Rejuvination in NYC. I definitely grew alot of hair back as a result of the procedure. I saw new hairs coming in after a few months and as late probably as ten months or so.. [...] I definitely didnt grow all of my hair back, but Springs Rejuvination has done the impossible for me and i have some pretty good options now”

Jimena A., Google review: “I literally had no results for 4 months, and I started to worry. I must have called every day. Thanks for your patience, haha. I'm about 8 months in, and I'm seeing incredible progress.”

Reviews are individual patient experiences shared publicly on Google. Individual results vary, and no review is a promise of any outcome.

Frequently asked questions

Can I take the subway home after the procedure?

Most patients prefer to take a taxi or rideshare home on the day of the procedure to avoid the crowding and jostling common on the N, R, W and 6 trains during evening rush hour. An accidental bump to the newly placed grafts in a packed subway car can dislodge a graft or cause discomfort. By the second or third day, when the initial crusting has formed and the grafts are more stable, many patients return to their usual subway commute, though they remain mindful of crowded platforms and train cars. The written discharge instructions provided after the procedure include specific guidance on activity and transit.

When can I wear a winter hat after the procedure?

Once the initial recovery period has passed—typically within the first week to ten days, though the exact timeline depends on individual recovery and should be confirmed with Dr. Pereyra—a loose, clean beanie or winter hat may be worn to protect against the cold, dry air and wind that characterize New York winters. Tight hats, wool caps that shed fiber onto the scalp, or any headwear that compresses the newly placed grafts should be avoided during the early weeks. Indoor heating in subway cars, office buildings and apartments can dry the scalp, so patients are instructed to follow the misting protocol outlined in their aftercare paperwork.

How does No-Shave FUE affect my return to the office?

No-Shave Micrograft FUE leaves the donor hair at its existing length, so there is no visible clipper-cut band at the back or sides of the head when a patient returns to a midtown office, a Wall Street trading floor or a client meeting. The recipient area will show some redness, small crusts and possibly mild swelling for the first several days, and colleagues who look closely may notice that something has been done, but the absence of a shaved donor zone reduces the visual footprint considerably. Many professionals working in Manhattan schedule the procedure on a Thursday or Friday, use the weekend for initial recovery, and return to work the following week wearing their hair in the usual style.

Do patients come from New Jersey and Connecticut for hair restoration in New York?

Yes, a significant portion of the clinic's patient base travels from northern New Jersey via the PATH train or NJ Transit into Penn Station, and from Connecticut via Metro-North into Grand Central Terminal or Amtrak into Penn Station. The ISHRS 2025 Practice Census found that over half of surgical hair-restoration patients were aged thirty to forty-nine and that the most common patient-stated reasons for pursuing a procedure were to become or feel more attractive and to appear younger in competitive workplace environments—demographics and motivations that align with the tri-state commuter population. Patients from Hoboken, Jersey City, Stamford, Greenwich, Westport and other nearby communities often begin with a virtual consultation, then travel into Manhattan for the in-person assessment and the procedure itself.

About the author: Dr. Charles Pereyra, MD, is a board-certified emergency physician (NewYork-Presbyterian Brooklyn Methodist), a member of the International Society of Hair Restoration Surgery (ISHRS), and the physician who personally performs Micrograft FUE procedures at Springs Rejuvenation Hair.

Medical disclaimer: Stem cell and exosome therapy is not an FDA approved therapy and is considered to be in the experimental stages; it is not FDA approved to treat any disease. These statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. Reviewed for medical accuracy by Dr. Charles Pereyra, MD, Medical Director, Springs Rejuvenation.