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A
summary of what to expect in your interview
Each clinic and surgeon has their own preferred interview method,
but below is a generalised list of elements a typical interview
would include.
1) The surgeon will ask you about your general health to make
sure you are healthy enough to undergo an operation. Be honest
with the surgeon and give all the information you can. Don’t
withhold information because you might think the surgeon may refuse
to give you a hair transplant. Bald may be bad, but dead is an
untreatable diagnosis. In fact very few medical conditions prohibit
hair transplantation. Even hypertension, once it is under control
with drugs, does not stop a hair transplant from being conducted.
But the surgeon does need this information in advance so that special
care arrangements can be made for the hair transplant surgery.
You will be asked about heart, liver, kidney and other organ diseases;
whether you have diabetes, ulcers, hypertension, bleeding disorders,
epilepsy, and fainting spells. You will be asked about any allergies
and whether you have had adverse reactions to any drugs. You will
be asked to take a blood test if you have not had one done recently
(within the last 1-2 years). The surgeon should review the risks
involved in hair transplant surgery based on your health situation.
2) The surgeon will examine your hair loss. They will be looking
for the typical indicators of pattern baldness, scarring alopecia,
or whatever hair loss condition you have. As part of the examination
your scalp will be examined by hand. The surgeon is looking at
the color, hair texture and coarseness, hair calibre, hair curl,
and density. They will look at both the alopecia affected areas
and at the donor area to gauge how much hair your have available
for transplantation and how much bald skin needs to be covered.
The surgeon will be judging the eventual end stage extent of hair
loss he/she expects you to reach in the future as well as the actual
hair loss you have today.
3) You will be asked about the history of your hair loss. When
it started, how quickly it has progressed. You will also be asked
about any hair loss history in your family. The surgeon will probably
want to know how much hair loss your father and grandfathers had
(or mothers and grandmothers for women).
4) The surgeon may show you a chart showing different degrees of
hair loss. There are several different classifications in use – see
the androgenetic alopecia section of this web site for the different
classification systems. The surgeon may ask you to classify how
much hair loss you think you have as well as judging you hair loss
extent for him / her self.
5) In some of the fancy clinics, the surgeons take a picture of
you and scan it into a computer. Then using software they change
your appearance to show how much hair loss you might have in the
future and then to show what they think you might look like with
a hair transplant. However, the validity of these software programs
is open to question. The programs may make hair loss seem far worse
than it is or will be and can also give you an overly optimistic
view of what can be achieved with a hair transplant. Most good
surgeons do not use these software programs – they seem more
of a sales pitch tool than a tool to provide you with really useful
and accurate information.
6) The surgeon should give you a brief review of the different
hair transplant techniques and then describe in more detail the
one he/she prefers and believes is suitable for you. They might
ask you how much you know about hair transplants to judge how much
detail they need to give you. If you have questions – ask.
The surgeon may show you photographs before and after hair transplants
to show you what is achievable. They can also use the photos to
explain how different transplant procedures are used for different
hair loss presentations and on different areas of the scalp. Ideally
the pictures you are shown are of patients the surgeon he / she
has worked on. Ask them to make sure this is correct and the surgeon
isn’t showing you pictures of work done by someone else – this
is especially relevant in hair transplant chains where more than
one clinic or surgeon goes under the same brand name. The pictures
will give you an idea of the quality to expect from the surgeon.
Make sure you like what you see. The surgeon may well show you
pictures of patients from other clinics and surgeons, but here
the objective is to show you the many different hair loss presentations – and
possibly to match one to your particular hair loss presentation – so
you can see the various results achievable for different hair loss
situations. The surgeon may not have pictures of a hair transplant
that is similar to what he/she predicts for you, especially if
you have an unusual hair loss presentation, and so he/she may have
to resort to showing you what to expect using another surgeon’s
pictures. However, the surgeon should make it clear to you what
is his work and what is someone else’s work.
7) The surgeon will outline what he/she feels is the most appropriate
plan for your hair transplant. As part of this many surgeons often
use a grease pencil to draw in a hair line on your scalp. Almost
always the patient thinks the hair line drawn is too high. It may
well be higher than normal, but remember you only have so many
hair follicles that can be transplanted and you have to be realistic
as to what is achievable. Also remember that the hair will hang
over somewhat so the hairs growing from the hair line will be lower
than the actual hair line (where the hair follicles will be implanted).
Some patients may ask for a hair line that is way to low – a
child’s hair line. These look fine on a child but for an
adult a child’s hair line looks very odd. Hair that is implanted
too low is very difficult to get rid of and usually requires laser
hair removal or electrolysis. At least if a hair line is implanted
too high you can undergo another transplant procedure to lower
it later. The surgeon will discuss the hair line with you and might
redraw it depending on your wishes, but remember there are limits
to what a transplant surgeon can do and that the hair line you
think you need may not be possible or appropriate.
8) With the hair line determined, the surgeon will discuss the
lateral boundaries and filling in behind the hair line and whether
or not the vertex needs attention. When determining what areas
need attention the surgeon will be considering the future hair
yet to be lost as well as your current hair loss state. If the
surgeon does not address the issue of future hair loss then you
may be in a situation of “chasing” the progressing
alopecia in future years with another hair transplant. As a result,
the surgeon may suggest transplanting to areas that are thinning
but not yet bald as well as transplanting truly bald areas so as
to reduce or avoid the need for future hair transplant procedures.
9) Eventually you should reach an agreement on how the hair transplant
should look. The surgeon may take pictures of the grease marks
on your scalp as a record of what was agreed and to review with
you on the day of the first surgery.
10) The surgeon will probably explain in more detail what you
should expect with your first transplant session and the effects
immediately
afterwards. These details are listed elsewhere on in this section
of the web site.
11) The surgeon will then probably explain the long term planning.
You may need multiple surgical sessions to achieve the hair
transplant plan you have agreed upon. These multiple sessions,
the time
between sessions, and what to expect from the results of
each session will
be explained to you. Rather than spread hair transplanted
hair follicles throughout the area to be treated at each session,
hair transplant surgeons will concentrate on one area in
the
first session,
usually the hair line, and then work on a different area
in the next session (behind the hair line, the vertex, etc).
Gradually
a full transplant is built up with multiple transplant sessions.
How many hair transplant sessions you need depends on the
size of the alopecia area to be covered and the particular
transplant
technique the surgeon will use.
12) At the end of the interview, make sure you have asked
all the questions you wanted answers to!
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