Choosing a Physician

Finding Your Doctor

In general, the best way to find a physician is through a referral either from your dermatologist, general practitioner, or another patient. Perhaps the worst way to choose a doctor is through infomercials or aggressive marketing campaigns. You should be wary of any medical practice that is spending lots of money on marketing, rather than on patient care. Once you have found a doctor that you are interested in, further research on the net will be helpful.

The Doctor’s Background and Training

In choosing a hair transplant surgeon, the first thing you need to know is the doctor’s specialty. Ideally, he or she is board certified as a dermatologist or plastic surgeon. If they do not specialize in one of these two fields, ask them why they have chosen to work in hair restoration. If they chose to be trained as an urologist or an internist, ask why they are now interested in hair. The benefit of seeing a dermatologist is that their residency training is in the medical and surgical treatment of diseases of the skin, hair and nails, so they are best capable of making an accurate diagnosis of your hair loss and balancing all the treatment options.

Doctors to consider should be members of the International Society of Hair Restoration Surgery (ISHRS) and be Diplomats of the American Board of Hair Restoration Surgery (ABHRS). The most coveted awards in the field of hair restoration are the Golden and Platinum Follicle Awards given by the ISHRS for outstanding achievements in science or clinical research relating to hair restoration. If the prospective doctor is the recipient of either of these awards, this would show the confidence that their peers have in their skills and abilities as a hair restoration surgeon.

Inquire if the doctor has helped contribute to the science of hair restoration through research and publications. Publishing medical papers shows that the physician is sharing ideas and experience with other doctors in order to promote patient care. If the publications are in peer reviewed medical journals, the medical community holds them to be of significant value.

Surgical Technique

Perhaps the biggest decision to make once you have decided to have a hair transplant is whether to have the doctor harvest the donor hair through a long, thin strip via Follicular Unit Transplantation (FUT) or as individual follicular units using Follicular Unit Extraction (FUE). There are advantages and disadvantages to each, so it is important to have a good understanding of both techniques so you and your doctor can decide which is best for you.

Clearly, if a doctor does only one type of procedure, i.e. either FUT or FUE, they are going to be biased towards the technique that they perform and are unlikely to give you a balanced view. When making a decision, be certain to consult with a doctor who performs all of the procedures that you are considering, or consult with multiple doctors to hear all sides of the discussion. Once you have decided on a technique, it is then OK to go to a doctor who just does that one type of procedure well.

When considering FUT ask whether the surgical staff uses microscopes for dissection, loop magnification, or simply the naked eye. Stereo-microscopes allow the surgeon and his team to perform the most accurate graft dissection and best preserve donor hair. Take a look at the operating room to make sure it has clean up-to-date equipment, and that there are plenty of microscopes on hand, as each clinical staff member will need one. If you have decided to have an FUE procedure, you then need to decide if you want it performed by one of the standard manual techniques or with the newer robotic technology.

At Your Consultation

Here are some tips to consider at your consultation.

1. Make sure that you are actually being evaluated by a physician – the one who will be performing your actual surgery – and not a salesman or “senior consultant.” Although it is fine for a non-physician to answer general questions, your examination should be conducted by the doctor and he or she should be the one to make all treatment recommendations.
2. Ask your doctor what percentage of patients he or she recommends for surgery. If the doctor recommends surgery for most patients, that may be a problem as many patients are not good candidates at the time of their consult (due to a young age and other factors) or may not be good surgical candidates at all (due to an inadequate donor supply). Many men with early hair loss should be first treated with medication. Many women are not good candidates for surgery because of the diffuse pattern of thinning and the unstable donor area commonly seen in female pattern hair loss.
3. Make sure to have a thorough examination, including having your density checked with a densitometer and your scalp assessed for laxity (looseness). Beware of the doctor who takes a quick glance at your head and exclaims, “You’re a great candidate for a hair transplant!”
4. Be certain that your doctor listens to you, addresses your concerns and answers your questions in a way that is easy to understand.
5. Be sure your doctor is focused on a long-term plan. A good doctor will be thinking about where your hair loss is headed many years to come and consider how a procedure performed now will affect that future. It is important to think aesthetically about what the hair restoration will look like 5, 10, 20 years down the road as you lose additional hair with age.
6. Make sure you are not being rushed into surgery. A hair transplant is a cosmetic procedure so the doctor should discuss all medical and surgical options, including opting for no treatment at all. You should have plenty of time to think about these options before making a decision that will be with you for the rest of your life.
7. When choosing any kind of health care practitioner you should go with your gut. If you feel uncomfortable with a doctor, it is usually a sign that you are in the wrong place.

Dr. Bernstein contributed this article to TheHairPlan.com