posted by ISHRS on August 8, 2012
Touching All the Bases: Questions and Discussion Points Should All be Addressed Before Hair Transplantation is Undertaken
Hair transplantation is a cosmetic surgery procedure and that means its outcome is on view all day, every day-to the patient every time he/she looks in a mirror and to everyone else. There is no better argument for making certain that the outcome is what the patient anticipated, and what the patient and the physician hair restoration specialist agreed was the optimum outcome for the patient. The outcome should have no unanticipated “surprises” for either the patient or the physician hair restoration specialist.
An unanticipated outcome can be the result of a preoperative failure in patient-physician communication-for example, a question that was unasked or inadequately answered by the physician or not fully understood by the patient.
No Question is Too Unimportant or Too Embarrassing to Ask
A patient should never feel constrained about asking questions of the physician hair restoration specialist before hair transplantation is undertaken. The physician will always be pleased to know what is on the patient’s mind, and will do his/her best to provide a complete answer to the patient’s question. If the patient believes the answer is incomplete or hard to understand, the patient should ask follow-up questions until the answer is satisfactorily understood. There are questions that some patients may hesitate to ask, but which should be asked and answered in full. For example:
How Much Will It Cost?
The patient should share all financial concerns about cost with the physician hair restoration specialist during pre-procedure discussions. The patient and physician should discuss all options and eventually agree on a surgical plan (See Surgical Hair Restoration) that the patient honestly believes he/she can reasonably afford, and that will provide an outcome satisfactory to the patient.
Will It Be Painful?
Fear of pain is one of the most frequent concerns of patients considering surgical hair restoration. It may be a concern that the patient either hesitates to voice, or voices with great trepidation regarding how much pain to expect. Patients who have undergone a surgical hair restoration procedure may have experienced pain (1) at a level they expected and accepted, or (2) an unexpected level that makes them less accepting of additional procedures that may be necessary to achieve the optimum esthetic outcome.
Fear of pain and psychological anxiety can go hand-in-hand. If fear of pain can be alleviated, the patient may become less anxious and more able to participate in pain-control methods described and offered by the physician hair restoration specialist. Both patient and physician should be dedicated to assuring that fear of pain does not deter the patient from undergoing a procedure that the patient desires.
A prospective patient concerned about operative and postoperative pain should express these concerns to the physician. Questions that a patient can ask include:
What causes surgical pain?
What level of pain may the patient expect from the procedure(s) being considered? (If the patient believes that he/she is very sensitive to pain [“low pain threshold”] this should be discussed with the physician).
What anesthesia does the physician propose to use? (If the patient has had a previous reaction, side effect or allergy in association with an anesthetic, the patient must reveal this to the physician).
The physician may recommend a preoperative course of an anti-anxiety medication to make the patient more relaxed prior to surgery.
The physician should explain what anesthetic agent(s) will be used, and the rationale for using them. The physiologic and pharmacologic understanding of anesthesia is very advanced today and is still advancing. While pain cannot be eliminated, effective anesthesia lowers pain and also usually helps to control operative bleeding. The patient should be allowed to become acquainted with the nurses and technicians who will assist the physician, and to become comfortable in the environment where surgery will be performed.
How Much Time Will It Take?
How many procedures will be needed for optimal outcome and how much time will be required for each procedure? If multiple sessions will be required for optimal outcome, the patient should make time constraints clear to the physician hair restoration specialist before sessions are undertaken.
Will My Hair Transplantation Be Apparent to Other People?
Loss of hair is more troubling for some persons than for others. Hair transplantation is an option chosen by many persons to correct loss of hair. However, some persons who undergo hair transplantation want the procedure to be undetectable; they do not want others to know they are undergoing, or have undergone, hair transplantation. The question about undetectability should be raised with the physician hair restoration specialist-“Can my hair transplantation be undetectable by others?”
If the physician is aware of the patient’s concern, options for making a hair transplant less detectable during and after transplantation can be discussed. Options may include hair styling (See Surgical Hair Restoration and Hair Styling After Transplantation).
A patient’s concern about looking “natural” after hair restoration may be addressed by showing the patient how his new hairline will look. The hairline is a critical area for “naturalness” (See Surgical Hair Restoration and About Your New Hairline).
Preference for Post-Transplant Appearance
The patient may have had a preferred hair style before hair loss and would like to reclaim that appearance if possible. Other patients, however, may prefer a “new look”. The patient should raise these concerns in pre-transplant discussions with the physician hair restoration specialist. Many factors will go into pre-transplant planning, including the patient’s preference for post-transplant appearance. In some cases the patient’s initial preference for post-transplant appearance may have to be modified due to such factors as (1) extent of hair loss, (2) pattern of hair loss, (3) likelihood of continued progressive hair loss, and (4) availability of adequate amounts and quality of donor hair for grafting (See to Harvesting of Donor Hair)
Many factors may be considered in planning for how the patient will look over a period of years (See The Right Choice for Your Hair Loss Treatment). Rational expectations for outcome are derived from full and frank discussions between patient and physician hair restoration specialist prior to hair transplantation. No question is too unimportant to ask. The patient should not be hesitant to ask questions that seem embarrassing. No concern of the patient is “off limits” if it is a question related to the procedure and the procedure’s anticipated outcome.
Read some of the questions commonly asked by patients at and Hair restoration FAQ.
Choosing a Physician Hair Restoration Specialist
What qualities should a patient look for in choosing a physician hair restoration specialist? How should the patient weigh qualities such as training, credentials, experience? (See Find the right hair restoration doctor).