Choosing A Hair Transplant Physician Part 2

Local versus National Hair Transplant Doctors

The cash nature of the business and large population with hair loss has sprouted a large industry. Many national and international firms employee physicians to perform hair restoration procedures. While some of these physicians are very good at what they do, caution should be taken. Patient’s should remember  that they are often entering into a contract with a large corporation whose focus is on the bottom line and not the hairline. Local physicians with roots in the community will be interested in obtaining good results for a patient, not only for the patient’s benefit but to maintain their reputation in the community. Local physicians are more likely to make accommodations for patients when things do not turn out as expected. Most physicians performing cosmetic surgery understand that the surgery is a large investment and only the beginning of the doctor/patient relationship.

Hair Technicians

Not enough can be said about choosing a physician with experienced hair technicians. Follicular unit grafting techniques require dissecting hundreds if not thousands of individual hair follicles. This can not be undertaken by just one person. Technicians are vital to assisting the physician in dissecting the individual follicles and placing them. Ensure that any physician you are considering working with utilized only highly trained and experienced hair technicians. This will decrease the operative time and improve hair survival in the long run. Be sure to ask what part the technician plays in the procedure though. Unless they are appropriately licensed in the state, such as nurses or some surgical technicians, hair technicians should not be performing injections. They should definitely not be left to perform either donor site harvesting or recipient site incisions. These are procedures which should be performed only be the physician.

Some physicians will employ hair technicians full time. Others may opt to contract with certain hair technicians on an as needed basis. There are many hair technicians who fly around the country assisting doctors in transplants but do not work with only one physician. In either case, ensure that your physician is employing hair technicians who are experienced and not simply employing untrained man power to perform the dissections and placement.

Microscope Usage

Much attention has been focussed on microscope usage for hair dissection. Studies have indicated a slightly greater yield and slightly decreased follicular transection rate with microscopes over other methods of magnification. There have been no studies which indicate if this results in a difference in the outcome for the patient though. Magnification is the key to dissection. Loupe magnification is available which is as powerful as some microscopes. Ensuring that some type of magnification is used is essential to ensuring the best results.

Consultation

The consultation is the time for the patient to become familiar with the physician’s practice, develop a rapport with the physician, and  receive a diagnosis and treatment plan. It is not the time for high pressure sales pitches. Any treatment relies on a specific diagnosis and for patients contemplating hair transplants informed consent is vital before undertaking a procedure. Any consultation must include a visit with a physician. While consultants can be excellent resources to introduce patients to a physician’s practice and inform patients about routines before and after surgery, only a physician can ensure that a patient has an accurate diagnosis of the cause of the patient’s hair loss and an accurate treatment plan.

Fellowships

There are no fellowships certified by the American Board of Medical Specialties or any of its member boards. Physicians may advertise that they did a fellowship in hair restoration but this often reflects a time under the tutelage of someone who performs hair restoration. Since there is no accrediting organization their is no method to determine if standards are maintained of if the fellowship is teaching the current technology.

Facility and Equipment

Most hair restoration procedures are performed in a physician’s office. This is very safely done but a couple of pitfalls must be pointed out. There are no national organizations which certify a physician’s office as safe and in compliance with industry standard safety principles. Although hair restoration surgery has very few serious risks, anytime anything is injected into the body and surgical procedures are undertaken, there is the risk of allergic reactions. Instruments are often reused and must be sterilized between uses. To ensure that you are in a safe environment, ensure that your physician and his office have at least basic safeguards. These basic safeguards include:

• Autoclave with regular spore testing for sterility
• Protocols for cleaning equipment between patients
• If multiple procedures are performed at the same time, protocols for ensuring that donor hair is not mixed between patients
• Basic life support and/or advanced life support current certification for the physician and his staff
• Oxygen
• Defibrillator
• Advanced life support medications

Having an autoclave is important, but ensuring that it is functioning correctly with regular spore testing is essential. The testing is usually carried out by outside laboratories and your physician should be able to produce a log or other evidence that routine testing is being performed.

The physician and his staff should be trained in basic life support protocols through the American Heart Association and have the basic equipment necessary to deal with medical emergencies until paramedics can arrive. Simply knowing what to do without the proper tools is useless.

Obatin A Second Opinion

As you will read in the advertising pitfalls section, there are very few, if any, procedures in the world which are performed by only one surgeon. It is wise to obtain a second opinion, especially about hair restoration procedures where diagnosis and design of the treatment plan are probably more important than the technical skill of the surgeon. Be careful though and make sure if you are shopping price that you are comparing apples to apples.