What questions should I be asking in a consultation?

[crackershoes]

Hi everyone. I'm 28 with approximately a Norwood 2 considering FUE treatment with Dr Feriduni, Dr Farjo or the Harley Street Clinic. I say considering, i'm at the stage of arranging consultations and I just wondered if there was any advice people can give me with regards to what questions I need to be asking.

 

I have had one consultation with Dr Shahmalak previously and was left distinctly unimpressed with his demeanour, attitude and available resources i.e. photographs. He was very keen to book me in as soon as possible so I thought sod that, anyone who seems overly keen to get my money is out of the question.

 

Having browsed these forums for a while i'm keen to get your advice as there seem to be many of you with varying levels of success. Currently i'm on Rogaine Foam and Caffeine Shampoo twice daily, having discontinued the use of Finasteride due to some very unpleasant side effects. Whilst I intend on waiting to see if the Regaine stabilises my hair loss (taken it for 1 month on its own) I want to start putting the feelers out for a consultation. So what should I be asking of my potential surgeon?

 

Ash

[1978matt]

Hi everyone. I'm 28 with approximately a Norwood 2 considering FUE treatment with Dr Feriduni, Dr Farjo or the Harley Street Clinic. I say considering, i'm at the stage of arranging consultations and I just wondered if there was any advice people can give me with regards to what questions I need to be asking.

 

I have had one consultation with Dr Shahmalak previously and was left distinctly unimpressed with his demeanour, attitude and available resources i.e. photographs. He was very keen to book me in as soon as possible so I thought sod that, anyone who seems overly keen to get my money is out of the question.

 

Having browsed these forums for a while i'm keen to get your advice as there seem to be many of you with varying levels of success. Currently i'm on Rogaine Foam and Caffeine Shampoo twice daily, having discontinued the use of Finasteride due to some very unpleasant side effects. Whilst I intend on waiting to see if the Regaine stabilises my hair loss (taken it for 1 month on its own) I want to start putting the feelers out for a consultation. So what should I be asking of my potential surgeon?

 

Ash

 

Hi there. Norwood 2 isnt too bad so don't be surprised if these doctors advise you to wait. (BTW Harley Street Hair Clinic doesnt particularly have a good reputation despite the whole Rooney thing).

 

If youre willing to upload some photos some folks on here will give you some really great advice.

 

I'd recommend Nizoral shampoo which is thought to have some DHT blocking effect. You can get it from Boots (also in big Tesco stores I've noticed). It should only be used a maximum of twice a week.

[Shampoo]

I agree with everything Spex suggests except #19.

Those are some great questions to ask.

 

One other question might be "is the Doctor's name on the clinic, the surgeon that will actually be doing my surgery?".

 

On my first and thus far only hair transplant surgery back in the mid-late 90's my doctor basically handed me over to some jr doctor he was training. Everything turned out ok but it kind of pissed me off that I did not see the main doctor and the one that did my consult except when he greeted me at the start of the surgery day.

 

Also as far as asking about post-op, ask if you can come in to let them examine the donor site and grafts for a day or two afterwards and give you and show you how to wash your hair post-op. Ask them if this is normally something they do.

 

Also ask how many patients your doctor will perform surgery on or be seeing on the day of your surgery.

[England]

Copying this from another thread, a structured idea of what you need to gain from the consultation:

 

1 - What is your long term strategy for my hair transplant journey?

 

This is a broad question which will necessitate the doctor analysing your donor density, the loss you have seen already as well as looking at any miniaturisation elsewhere on the head, planning the best utilisation of the available donor and ensuring that if your hair loss progresses you will have sufficient donor to cover those areas too. They may mark the areas which need to be treated, in most cases this involves the drawing of a hairline. The doctor should tell you his vision for numbers of grafts required in areas (present and future) as well as the cosmetic improvement you should expect to see given said plan.

 

2 - Can I meet some of your patients and see some of your results?

 

VERY very important that you actually meet with multiple people who were treated by this surgeon, as well as see results they present similar to yours, online or on their computer. Not only does this help you review the surgeon, it also gives you realistic expectations. If you can find someone independently (ie, not someone the surgery recommend you see) that is even better.

 

3 - What process will I have to follow before, during and after the surgery?

 

The surgeon should tell you key information like whether you have to shave your head, costs, how long the surgery will take and who will perform which parts (it's very important that you understand what will happen before hand so you arent unnerved during the operation). This may include understanding the process of injections, the extraction, incisions, placement, and who on their team performs what. The surgeon should also inform you of the necessary after-care process, what you have to do and how long it'll be before you can go out in public, what to expect after surgery eg swelling, and growth timescales. Finally, the surgeon may recommend taking preventative hair loss medication such as Propecia to stabilise your hair loss. This will give you a much more precise feel for what you are committing to - how long it will take, how much it costs, what will happen, and what you will have to do for the rest of your life.

 

-----------------------------------------------

 

For any of the above question to be relevant at all, you have to be absolutely sure that the surgeon you're meeting with is an ethical one (and that you're meeting with THE surgeon who will perform your procedure). You can't tell this from the surgeon, and that's where sites like this one come in - a poor surgeon could answer the questions above dishonestly and you would have no way of knowing - this is how many guys get sucked in. It's also important for the same reasons to consult with multiple top top surgeons and compare their recommendations. By 'top surgeons' I mean IAHRS registered surgeons who are recommended on this site and for whom you have found numerous patient posted stories online which you like the results of. I really want to emphasise the point to you that the difference between a transplant from a poor surgeon and a world class surgeon is LIFE changing.

[crackershoes]

Thank you to all who have replied those were some excellent suggestions and I will certainly make sure I get answers to them all in addition to my own queries. Fantastic I really appreciate your help guys. I have attached a few photos and i'm afraid my mohawk makes it a little difficult to properly see the level of recession of my hairline as i've only just recently shaved the sides and tops off fully, but I hope you can make it out kinda.

 

Matt the Nizoral shampoo you mention, is this the dandruff treatment? Have other members had success with this and is there evidence it does block DHT? Couple washes a week with that would be preferable to using Alpecin every day.

 

Also does anyone who has had FUE surgery have any info to give me on scarring? I'm still of the mindset that if everything goes tits up and i've had surgery, used products and my hairline receeded away from my transplated area i'd just whip the whole lot off. What kind of scarring are we talking about from the punch technique. I know they are supposed to be a lot smaller these days but if my head is going to look like a pepperpot where i've had the surgery then i'd never consider doing it. Are they visible to the naked eye if you shave down without a guard?

 

Thanks again everyone, i've sent the same pics and queries to Mick at Farjo so i'm waiting on his response too at the moment.

[MTL30]

you can shave at grade 1# lower than that you will see small withe dots

[zenmunk]

crackershoes,

 

If you get FUE, then you should go in expecting to have white-dot scarring. You may be one of the lucky ones whose scars don't show even shaved bald, but I think they are the exception to the rule. In other words, be pleasantly surprised if you have no visible scarring after your donor heals, but do not count on it.

 

I'd suggest that you ask your doctor to use punches between 0.75mm and 0.9mm whenever possible to help reduce the appearance of scarring. Try to avoid using punches which are 1mm or larger. Of course, sometimes the doctor must use a larger punch in order to give you the best result possible. It really depends on your specific hair characteristics.

 

Dr. Carlos Wesley (a recommended surgeon on this forum) has been conducting some interesting trials with what he calls "scarless surgery." He claims it "may lead to both increased graft survival as well as elimination of any donor area scarring (i.e. less than FUE)."

 

Regarding availablilty, Dr. Wesley says, "we are hoping to carry out a follow-up investigation near the end of this summer with the hope of having the instrument available for more widespread use in late 2013." On his site it says, "the surgical technique patented by Dr. Wesley will be made available to patients worldwide," so any doctors interested in this technology will be able to use it on their patients.

 

I have no idea if this is legit, but if you're very concerned about FUE scarring, it may be prudent to postpone your HT until you know what this technology is.

 

Please see this thread for more info.: http://www.hairrestorationnetwork.com/eve/162173-invitation-participate-hrs-enhancement-investigation.html

 

z