Hair Transplant Surgery - Scientific Papers

EXPECTATIONS vs. WHAT CAN BE OFFERED in hair transplant surgery

INTRODUCTION: Each patient is unique with varying degrees of demand and different expectations. In our daily routine, we have had difficulty in dealing with these expectations more in terms of hair volume and density rather than the naturalness of the result. How can we guarantee the patient will be satisfied in terms of density? How can we quantify this? What can we promise and how far can get in achieving that?

OBJECTIVE: In this paper, the author will attempt to approach these aspects, one of the most common topics in the day to day practice of hair transplant surgeons: how to deal with the different degrees of DEMAND AND expectation of each patient, how to measure and detect “hard” and VERY demanding patients IN ORDER TO minimize possible frustrations and future dissatisfaction.

MATERIALS AND/OR METHODS: We know that each patient will have a different result in terms of density, depending on the donor area (density, hair type, percentage of follicular units of 1, 2 and 3 hairs, and elasticity), the recipient (bald) area to be treated (size and location) and the progression of hair loss.

Before all else, we must educate patients, fully explaining the differences of hair density of the donor area of each patient, about the types of follicular units, etc., and if possible, using layman vocabulary , 3D animation (the author will show this in the presentation), etc...

From this point we begin a microscopic analysis of the scalp of our patients, who participate in this exam, showing the different follicular units and giving a score of 0 to 10 for their donor area in terms of density. We attempt to show the difference between a donor area with low, medium and high hair density, and finally we show various before and after photos with different results in terms of density. All of these steps have the intention of educating patients and guide them to a more realistic expectation in terms of the result.

DISCUSSION / RESULTS
After, so that we may determine the degree of demand and expectation of the patients, we show them results that we consider “poor”, average, good and exceptionally good in terms of density. During the process of showing each before and after photo we ask the patients if they would be satisfied with that particular result and observe his reaction . If they say “no”, we present the next result, better (denser) than the prior, and so on, until we reach the moment in which the patients say that they would be satisfied with that particular result or until we reach the last of the photos (representing exceptionally good). If even in this last photo, and with all of the information provided, the patients say that they would not be satisfied or we detect some disappointment this is a warning sign. The author will present other warning signs and other forms of measuring this degree of expectation that is so subjective.

CONCLUSION
Even with the most informed patients, they will always “edit” what they want and find to be appropriate for them, independent of what the doctor says. Therefore, we must be honest, never promising beyond that which we can offer.