| Hair Transplant decision | | | | virtually assures the need for future surgery to |
| When a prospective patient consults a physician | | | | correct the poor result. |
| hair restoration specialist, he comes with a set of | | | | Pattern of Hair Loss to Date |
| reasons for seeking hair restoration. The patient | | | | An important aspect of hair loss to date is an |
| may be a man or woman; most often, the | | | | estimate of the amount of hair that is likely to be |
| patient is a man whose hair loss is due to | | | | available for transplantation (if transplantation is |
| hereditary androgenetic alopecia. | | | | the procedure of choice), and the amount of bald |
| For both patient and physician, the patient's | | | | scalp that will need to be covered. |
| expectations for hair restoration must be clarified. | | | | History of Hair Loss in the Patient's Family |
| After expectations are fully explored and | | | | While it is not entirely predictive of a patient's |
| understood, patient and physician can begin to | | | | eventual hair loss, a history of hair loss in the |
| discuss surgical and/or nonsurgical approaches to | | | | patient's nearest male relatives provides some |
| satisfying the patient's wishes. | | | | guidance as to the type and extent of hair loss to |
| A patient's reasons for seeking hair restoration | | | | expect in the patient over his lifetime. |
| contribute to shaping his expectations. Among the | | | | Hair Characteristics |
| most common reasons for a man to seek hair | | | | Hair caliber (diameter of the hair shaft), hair color, |
| restoration are: | | | | hair color in the context of scalp color, and hair |
| - To avoid an appearance and feeling of | | | | curliness/frizziness are all important characteristics |
| premature aging due to hair loss, and | | | | to consider in planning hair restoration surgery. |
| - To restore self-confidence that waned as his | | | | They can be essential esthetic considerations in |
| hair thinned. | | | | planning for an appearance of "fullness" in |
| Hair loss can be a significant event in a man's life, | | | | transplanted areas of the scalp |
| influencing how he sees himself in social and | | | | Patient's Health |
| business environments, and how he believes | | | | Surgical hair restoration is an invasive procedure |
| others perceive him. For some men, an | | | | that requires the administration of anesthetic |
| appearance of premature aging may be the most | | | | medication. While hair restoration surgery can be |
| disturbing effect of hair loss. Other men may | | | | considered "minor" in comparison to procedures |
| come to believe that hair loss overshadows their | | | | involving the removal or repair of an internal |
| personality and character-that what others see | | | | organ, the patient must be able tolerate the |
| when they look at him is a "balding man" rather | | | | procedure. The physician will require a full medical |
| than a distinct and interesting person. | | | | history and physical examination of the patient |
| Thus, a man's stated or unstated reasons for | | | | before surgery is undertaken. |
| seeking hair restoration can profoundly influence | | | | Psychological Status |
| his expectations for hair restoration. The patient | | | | The physician may rarely encounter a patient who |
| and physician hair restoration specialist must work | | | | appears psychologically unfit for surgical hair |
| together to plan hair restoration that is | | | | restoration-for example, a patient whose hair loss |
| appropriate, surgically and/or nonsurgically | | | | is due to compulsive hair plucking (the condition |
| achievable, within reasonable time constraints, and | | | | called trichotillomania) would be considered unfit |
| at a cost acceptable to the patient. | | | | for hair restoration until the psychological problem |
| If a patient's reasons for seeking hair restoration | | | | is successfully treated. |
| give rise to unrealistic expectations (for example, | | | | History of Previous Attempts at Hair Restoration |
| to restore a 35-year-old man's appearance to his | | | | Many men with hair loss will have tried |
| appearance at age 20), the expectation for | | | | self-administered hair restoration medications. The |
| outcome must be placed in a realistic context. | | | | physician should be given a list of these, which |
| When a patient's reasons for seeking hair | | | | could be useful in planning nonsurgical approaches |
| restoration, and his expectations for outcome, are | | | | to hair restoration. If the patient has undergone a |
| placed in context with other information about the | | | | previous surgical hair restoration procedure, this |
| patient, the basis for realistic approach to hair | | | | should be discussed with the current physician hair |
| restoration begins to emerge. | | | | restoration specialist in terms of (1) the patient's |
| Information that strongly influences hair | | | | feeling about outcome, and (2) what needs to be |
| restoration planning, and eventual outcome, | | | | done to repair an unsuccessful outcome, or to |
| includes: | | | | incorporate the previous transplanted area in |
| Age | | | | current planning. |
| Androgenetic alopecia (in men, often called | | | | Cost Considerations |
| male-pattern hair loss) is usually progressive. When | | | | Both patient and physician must be willing to |
| a man is in his 20s or early 30s, it can be difficult | | | | engage in full and open discussions regarding the |
| to predict accurately how much hair he will lose, | | | | cost of hair restoration. Some patients may |
| and in what pattern, over the course of the next | | | | consider cost to be secondary to the |
| 10 to 30 years. Planning for hair restoration in a | | | | achievement of the best possible outcome. Other |
| young man must take account of the likelihood of | | | | patients will wish to seek the best possible |
| future hair loss. A "one-time" hair transplantation | | | | outcome within given cost constraints. Both |
| procedure in a young man can result in | | | | patient and physician should be willing to explore all |
| increasingly poor result if hair loss continues, and | | | | cost-benefit options. |