Consultation at hair restoration clinic helps both the surgeon and the patient

Hair restoration interview A summary of what to expect in your interview for a hair transplant

What to expect at the Hair Restoration Clinic

Each clinic and surgeon has their own preferred interview method, but below is a generalised list of elements a typical interview would include.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

At the end of the interview, make sure you have asked all the questions you wanted answers to!