posted by ISHRS on September 4, 2012
This topic examines how to talk with a hair restoration doctor to get the most out of your hair loss treatment program.
Q: What’s the best way to get the best possible outcome from a hair restoration program?
A:The outcome should be the best possible result for you at this time in your life.
Q: How does one accomplish that?
A:By a full and frank pre-program discussion with a physician hair restoration specialist.
Q: Why should you have to talk it over with the physician if you already know what needs to be done? Isn’t it just a matter of telling the physician what you want?
A:The physician may eventually agree with you—that your assessment of what needs to be accomplished is what should be done. But, not always. Listen to what the physician has to say after a full examination and assessment of your hair loss. The training and experience of a professional may provide you with insight and recommendations that will change your perspective. The resulting dialogue between you and the physician can lead to the optimum outcome you seek.
Q: What are some examples of perspectives a physician may open?
A:One of the most important is to make certain that you make decisions that are in your own best interest. For example:
Is hair restoration something that you want, or were you “talked into it” by someone else? If you are comfortable with the way you look—in spite of hair loss—are you sure you want to change your appearance to please another person? Will the other person be pleased with the outcome of a hair restoration program, or will you and the other person both be unhappy with the outcome? Remember that the optimum outcome is one that results from your decisions, made for yourself.
Are you modeling your anticipated outcome on the appearance of a celebrity? Remember that the best outcome of hair restoration is to restore your appearance insofar as possible, not change it to make you look like someone else. It is almost always a mistake to seek surgical or nonsurgical hair restoration in order to look like someone else, even if that “someone else” is an admired celebrity. Occasionally a physician hair restoration specialist may offer the possibility of improving your appearance—for example, by making minor revisions in your hairline. This is not done to make you look like someone else, but rather to maximize the best features of your own appearance.
Another important point is to explore any previous experience you may have had with hair restoration, and how you feel about that experience.
Have you tried numerous “miracle cures for hair loss” that failed to deliver their promised results? Did these experiences leave you somewhat cynical about all programs of hair restoration?
Have you had previous experience with surgical or nonsurgical hair restoration that left you with a result you found to be unsatisfactory? If so, what do you expect to achieve by another program of surgical or nonsurgical hair restoration? Your previous experiences and your current expectations should be shared and discussed with the physician hair restoration specialist before any treatment program is undertaken. You and the physician should agree that the best possible outcome is the goal you both seek, but a goal of 100% perfection may be impossible to achieve—for example, if your hair loss is so extensive that donor hair for transplantation is in short supply, it may be impossible to surgically restore you to the appearance of a luxuriously full head of hair. However, surgical hair restoration supplemented by nonsurgical techniques and complemented by hair styling may provide a “look” that is highly satisfactory.
The physician’s assessment of your hair loss, and need for hair restoration, may be different from your original assessment.
In the most simple case, when you look in the mirror you see yourself on a flat plane—essentially in two dimensions. The physician conducts a global scalp examination in three dimensions. The physician sees more than you see in the mirror.
In the course of a global examination, including your medical and family history, the physician determines the probable cause of your hair loss. While androgenetic alopecia (male and female pattern hair loss) is the most common cause, other causes must be considered (Click on Hair Loss—Why?) If a disease is found to be the cause, effective treatment of the disease is the first priority. The physician will also determine the relative ratio of your scalp hairs that are in growing, resting or shedding phase—a determination that can influence a recommendation for hair restoration. The physician’s recommendation can also be influenced by your age and your degree of hair loss—for example, the physician’s recommendation for hair transplantation in a young man with rapidly progressive hair loss may be influenced by the need for a progressive program of hair transplantation to replace future loss of hair.
The physician may raise issues you had not previously considered. Hair color, scalp color, hair texture, and the condition of scalp skin may be important factors in the physician’s recommendation for a surgical hair restoration program. These are considerations that may influence the choice of hair transplantation, scalp reduction or scalp flap as the procedure most likely to produce the best outcome (Click on Hair Restoration Surgery to learn about the surgical procedures).
Timing may be a consideration you need to discuss with the physician. Some patients express a wish for an optimal result as quickly as possible—for example, a one-step surgical procedure rather than multiple sessions required for a successful transplantation program. The physician may understand this wish for a “quick” result, but may or may not recommend such a procedure as the one most likely to achieve an optimal outcome. Issues such as timing should be thoroughly discussed, and agreed upon by both you and the physician before hair restoration is undertaken.
The physician may recommend that the optimal approach is a combination of surgical hair restoration and topical or oral hair restoration pharmaceutical agents. (Click on Minoxidil® and Propecia®) for discussion of the only hair restoration drugs approved by the Food and Drug Administration).
The Bottom Line
The optimal outcome of a hair restoration program is most likely to result from decisions based upon your unique, individual needs, arrived at by joint decision-making with the physician hair restoration specialist.
Mayer TG, Fleming RW. Aesthetic and Reconstructive Surgery of the Scalp. St. Louis: Mosby Year Book; 1992:47-62.
Roenigk RK, Roenigk HH, Jr. Roenigk & Roenigk’s Dermatologic Surgery. Priciples and Practice, 2nd ed. New York: Marcel Dekker, Inc.; 1996:1185-1268.
posted by ISHRS on September 4, 2012