Don’t under estimate the need for a consultation!

Depending on the risk, we all like to cut corners, if it isn’t needed then let’s not do it! This is the thought pattern of the many and I am also party to it in many ways. Let’s not re-invent the wheel if it is not needed, is how I usually roll.
Like I used to,  a lot of patients are asking if a pre-surgery consultation is necessary and if they need to attend to get a more thorough inspection and data.  Patients know already how they would like to look after surgery, where their natural hairline would ideally be placed because they have all of these old pictures from when they were younger, or even as teenagers and this is their dream to roll back the years. They will by en-large have a good idea of graft numbers needed, from personal research, following blogs, forums, websites, and social media. So, if I know how many grafts I need and what I want to look like, why just not do it? The question is largely rhetorical! For many, it is a settled subject.
If you decided to have the transplant and you have your own vision – it is a good starting point and can be worked on once we get the data to see what is possible, some idea is often better than none. If you do not have your own vision and idea of how you would wish to look after the surgery, or are not convinced of the benefits, then maybe this is not for you. Usually, between wants and what is possible, there is going to be a compromise, because hair transplantation is not like wearing a hair system, whereby you get unlimited density over an unlimited area! The reality is, even in the best hands, we will have boundaries to face and limits to respect.

Even the best surgeon in the world is not a wizard. We cannot chant a spell and you will become the owner of the most beautiful and healthy hairline or head of hair in the world, in-fact the lesser clinics use this type of sales hype to catch the fish, but it is often far removed from reality! In short, avoid a clinic or a doctor who says yes to everything!  That said, it doesn’t mean we won’t do our best to make you proud of your result and while meeting your goals, it does mean however that we will abide by ethics and limitations to approach the surgery. 
The surgeon is like an artist who creates a piece of art by using the best-selected tools, materials, and vision to get to the end product or a painter who is painting the brush strokes and images on patient’s head, it may look strange until the portrait is complete, or a sculptor who by making cuts by a chisel, he knows what to remove to make the kept better, even when the passerby may not see it, he does and now he will materialize his vision. A hair surgeon, by keeping the right depth, angle and direction of his work will make your future result. Finally, it’s like an artisan, who has honed his skills and styles through the years to achieve the perfection he longs for. All this is the finality, the dream, and vision of the end product, but the material, the source, is checked first to see if the outcome is possible as we see the most important part of any structure is the foundation, and this is what we will examine in the consultation and something that photos and videos, although an indicator, are not definitive by nature.
So, at the BHR clinic and with Dr.Bisanga and Dr.Kostis, we will go deeper in this stage than most if not all clinics, and yes it may be inconvenient to come for this, but the outcome will for most pay dividends because it really will, with our experience, expertise, and state of the art equipment, build a picture that we need to then approach your case. It will be bespoke and not general and tailored specifically for you.
What can I expect? 
During the consultation, the doctor will require details of the patient’s medical history, medication is taken, past surgeries, and overall health situation. The reviewing of this data should be the first step taken for consideration for future actions. The consultation will also go over the patient’s goals, we cannot and must not assume we know them! The proposed hairline and any specific wishes or information will be discussed as a preliminary to the real data we will harvest.
The next stage is the unknown, with a small snipping of hair on the donor regions, we pass from the theory to the real and both the hair and scalp will now be examined, and under magnification.  This is the last test before making a decision if the patient is a good candidate for transplantation, and if so, what are the limits?
There are several factors determining good candidacy and all go beyond an initial casual glance as we look at the donor condition, the density throughout, any miniaturization, numbers of hair follicles per square centimeter and how many hairs per follicular unit, the skull shape, hair condition such as thickness, structure, and even growth or resting phases!  The examination of the scalp and hair will give us a fuller vision and then we can with authority balance what the patient expects versus what can we do. We are not a yes man clinic, but yes, if once we have completed an examination, it is right to do, it is not then a feeling but more factual and solid.

Another important factor is the age of the patient. If our candidates are too young for transplantation, and there is no hard and fast rule of this but in general mid-20s, then we look primarily at other solutions, and often medication can bring the change needed. We try to avoid offering surgery to very young patients. we do need to have longevity in anything we offer and surgery is often not the answer and one that in essence will have the opposite effect on their well-being, both physically and mentally.  With age the donor can change, the type of loss and the progress of alopecia can be different in terms of extensive and speed for patients. 
The most important thing for the consultation is to future proof it, so even in the hair-line design, we need to take into account all factors, aside from bone structure, that will determine what is best now and for the years to come to make the “new you”.
After extensive research, and in-depth consultation and examination of the hair and scalp, we can make the last step prior to surgery in confidence, aka the design. We collected all the information about the material and the subject. Now the artist can do the first draft. 
At this stage of consultation, the patient can see the sketch of their future hairline. This will be visible, by drawn lines on their scalp, where today is just a skin in the near future, these new hairs will grow. Now the patient is looking at the mirror and imagines the future to come. The surgeon will explain why the design has been chosen in liaison with the patient and why it is the best for the candidate, once all factors have been covered. It is not about imposing the will of the doctor on the patient, but coming to an agreement on what is ethical, possible, and also in line with the patient’s wishes, and most importantly will be natural and age well, i.e there is some longevity to it.
The life-changing decision.
The pre-surgery consultation is a detailed and multi-staged process. If the candidate failed on one of them, we may advise to not make the step for a hair transplant, this is not easy as you break a dream, and some will listen while many will go elsewhere and make a regrettable decision. A poorly planned or executed hair transplant is far worse than not having one and at times it is best to look for other options, be it medical or through SMP or other avenues. 
A hair transplant is a very important life decision, the first thing people usually see is your face and then your hair, a bad decision they often see the hair then the face!  So, you will carry it forever, your future life depends on it. Unlike buying a new home, car or phone, this is part of you, it will form your character, your look, and your happiness to a huge degree, so make sure you invest time to do it right!  Yes, it may not be convenient to come for a consultation, but it may also be the best thing you did and will carry for the rest of your days.
Take care and all the best in your research!


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