Before and during your contact with your prospective hair transplant surgeon and clinic, you need to look for signs and signals that this surgeon and clinic is capable of providing you with a quality result – a natural looking hair transplant. Unfortunately there are a number of clinics and surgeons out there that do poor quality work. A bad hair transplant is very difficult to fix – it is much better to get a good hair transplant first time around. Before, during and after the clinic interview there are some questions to ask to try and reduce the risk of getting a hair transplant from a cowboy surgeon.
1) How did you find out about the clinic and the surgeon? From an advertisement or by personal recommendation? A personal recommendation by someone who has already had a transplant from the clinic / surgeon you are considering may be best. Then you can see the results of their work for yourself and you can ask the person who had the hair transplant about their experience as a patient. If you don’t have a friend or colleague who can give you a recommendation, it’s okay to start with an advertisement, but you need to do more groundwork to find out whether the surgeon and clinic is any good.
2) How long has the clinic and surgeon been in business? If the clinic / surgeon has been around for a few years it suggests they must have a regular stream of customers to stay in business. It is not a guarantee, but it can help build confidence if the clinic and surgeon are well known and have been active in hair transplantation for several years.
3) What reputation does the surgeon / clinic have? With the availability of powerful search engines on the internet it is fairly easy to find out other peoples’ opinions of the clinic and surgeon involved. Just type in their name or the name of their clinic and see what comes up. Scroll a few pages of results to get an idea of both good and any bad reviews.
4) What reputation does the clinic / surgeon have in the business and legal arena? You could check with the better business bureau or equivalent in your area and check for any lawsuits brought against the clinic and surgeon. Often this can be done online. You could also contact the state medical board to see if any complaints have been filed against your prospective hair transplant doctor or hair transplant clinic.
5) What qualifications does the surgeon have? Is he/she a member of a professional organization specifically for the hair transplant profession? There are a several professional organizations around the world (eg. In North America – The International Society of Hair Restoration Surgeons (ISHRS)) that attempt to improve hair transplant standards and ensure members do quality work. Membership of these organizations is not a guarantee that the surgeon is good, but it helps.
6) In your contact with the clinic what is your general impression? Is the clinic in its own physical location or is it run from the office of a general practice? Many hair transplant and cosmetic surgery clinics are in standalone buildings, others may be attached to larger dermatology clinics. Each situation is valid, but some “clinics” are run by renting time in a surgery to do the operation and the only physical location for the transplant clinic may be a rented office not directly connected to a medical establishment. These small operations with a limited or no permanent location give cause for concern. They are harder to monitor and more difficult to contact if things go wrong.
7) What is your impression in the interview? Does the surgeon sounds like he / she knows what they are talking about? Do they show pictures of their own work? Do they explain the risks as well as the benefits of hair transplantation? All surgery involves risks, and the relevant risks should be explained to you are part of the interview process prior to making any decision on a hair transplant.
8) Do you feel some personal compatibility with the surgeon? You will be having a relatively intimate, albeit professional, relationship with this individual over a period of time if you have multiple hair transplant sessions. You need to feel comfortable with who you are dealing with.
9) How pressured do you feel to sign up for the hair transplant? If you feel unduly pressured it may be better to walk away. Give yourself time to think about it. You can always sign up later or find a different clinic. Clinics and surgeons that push hard to get you to sign up may be losing sight of their professional conduct requirements – to put the patient before profit.
10) Prior to the surgery, did you actually meet with the surgeon who will oversee the transplant? Or did you just interview with a representative consultant, a nurse, or a technician? You should expect to see the surgeon at least once prior to the actual surgery. It is fairly normal to have your first interview with a representative who just explains the basics and talks about costs, but at some point prior to the surgery taking place you should interview with the surgeon who will conduct the hair transplant, and have them design a specific transplant approach for your particular hair loss situation. This interview should be quite in depth, not a brief “hello”. The surgeon should explain the procedure to you in detail and explain risks involved. If you don’t see the surgeon before the procedure, or get only limited information, find a different clinic.
11) Who will actually conduct the surgical procedure? It is not necessarily going to be the surgeon who will conduct the procedure from start to finish. Hair transplants usually involve quite a lot of people. There are usually several technicians and a couple of nurses in addition to the surgeon. The technicians will look after the processing of the donor skin to isolate the hair follicles ready for transplantation. The nurses will look after you in general, get the surgical instruments ready, and maybe give you the anesthetic injections. The nurses may also actually do some of the hair follicle implantation. Whether nurses are allowed to do the transplantation, depends on the legal requirements which vary significantly between different countries. However, you should expect the surgeon to be there to oversee what is going on. For example, in the United Kingdom, nurses cannot make incisions into the skin – only a doctor is allowed to do this. However, once the incisions have been made, nurses can take over transplanting the hair follicles into the incisions.
Almost always, the surgeon him/herself will deal with the most important parts of the procedure. The removal of the donor skin is very important and needs to be done by the surgeon. Implanting the hair line should also be done by the surgeon. But filling in behind the hair line may be done by nurses under the surgeon’s guidance. There are a lot of hair follicles to transplant to cover a large area of skin so with two people working either side of the head you can get the implantation done in half the time. This is important as the longer the hair follicles sit around in saline the slower they will recover and start growing hair once they are implanted. Although nurses may do some of the hair follicle implanting, you should expect the surgeon to be present or in close proximity so they can be called upon during the procedure if there is any issue. If the surgeon is not going to be present and the procedure is to be done entirely by nurses or technicians, this is cause for concern.
12) Is your hair transplant surgeon’s practice dedicated solely to surgical hair restoration? And if not, what percentage of his/her practice is? How many hair transplant operations does the surgeon conduct in a week/month/year? Some clinics and surgeons are exclusively focused on hair transplantation, they do nothing else. This is another indicator that the clinic and surgeon have extensive experience in hair transplantation. Other surgeons divide their time between hair transplantation and other clinical duties. This is not unusual, especially if the dermatologist works at an academic institution or is in public health. In many countries such as Canada and the UK, it is not unusual for a hair transplant surgeon to have a job in the state health program consulting with outpatients, but to also work part time in a private hair transplant clinic. However, you should expect your surgeon to be conducting hair transplants on a regular basis averaging one a week and preferably more. More prior patients, means more practice, means more expertise in producing a good transplant result.
The above is not a comprehensive list of questions to consider, but it may help get you started. For other questions and points to consider when choosing a hair transplant surgeon, take a look at the website of professional hair transplant organizations such as; The International Society of Hair Restoration Surgeons (ISHRS), British Association of Hair Restoration Surgery (BAHRS), or Asian Association of Hair Restoration Surgeons (AAHRS). There are many other professional societies – check the ISHRS website for a full list.
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