Esentials to ask before committing to a clinic

[GraftChaser]

I've taken online assessments from some of the clinics. All of them have mentioned the number of grafts required. Most have not said anything about density (achievable) and refuse to put a number on it. One or two have given re-growth guarantees in percentage terms (90 or 95), others say there can be no guarantees.

What do people here think are the absolutely essential pieces of info one must have before committing to a procedure with a clinic. The final results of a transplant are one thing, but shouldn't the surgeons provide some minimum parameters to which one can hold them once the procedure is done. 

When a surgeon is evasive with pre-op info, it shakes one's confidence in the clinic.

Can we list 4 or 5   (or more) must-haves that must be included in a pre-op assessment?

Thanks all.

 

 

[Dr. Glenn Charles]

There are some very important questions that should be asked of the clinic and doctor by the potential patient before choosing clinic to have procedure at. 

1) How many procedures are performed each day at that clinic

2) How many technicians are involved in the procedure

3) How many years of experience do the techs have and how long have they worked at that particular clinic

4) What parts of the surgery does the doctor perform and what parts do the techs perform

5) No Hair restoration physician should guarantee and specific percentage of growth because every patient responds differently. They can tell you what they generally get with majority of patients. However, you can have two patients with same hair loss pattern , same number of grafts are placed by the same doctor and the results come out very different.  

 

[GraftChaser]

Dr Charles, thanks a lot for your response.

While i appreciate the value of the info questions 1-3 could elicit, we would have no way to verify the truthfulness of the replies. For instance, the number of years of technicians' experience could well be inflated and we wouldn't know better.

Question no. 4 is mostly answered by the clinics, either by way of general info on the website or in specific replies.

As for point no. 5, Turkish clinics Asmed and Cosmedica clearly mention 90% and 95% regrowth assurances respectively. Why can't the other clinics do the same? At least it reassures the candidate that if there is a huge variation in the percentage achieved, the clinic will attend to the consequences. Else, if a clinic botches up 50% of the transplanted grafts, it will just turn round and say the patient responded differently.

When i raised this question here, what i really meant was parameters specific to the patient's assessment in terms of pre-op status and post-op prospects.

Like why can't a clinic state upfront what kind of density would be achievable. If it has figured out the graft numbers, it has measured the area to be covered, density then should be a matter of calculation. If not with pictures, at least on a personal examination, a surgeon should be able to give that figure.

To me, a surgeon who's unwilling to give a clear picture to the candidate "appears" to be just leaving escape routes for poor results, and that shakes the confidence in the surgeon. I'm not saying the surgeon should over-promise every candidate. What i am saying is that after taking all factors into consideration during an assessment , a surgeon should  provide some clarity to the patient, a certain minimum result that the surgeon was willing to stand behind.

I have with me assessments from 5 very popular clinics. Two offer some specifics.

I wish there was a standardized format or template which all clinics would follow by way of a patient's assessment.

[JayLDD]

50 minutes ago, GraftChaser said:

Dr Charles, thanks a lot for your response.

While i appreciate the value of the info questions 1-3 could elicit, we would have no way to verify the truthfulness of the replies. For instance, the number of years of technicians' experience could well be inflated and we wouldn't know better.

Question no. 4 is mostly answered by the clinics, either by way of general info on the website or in specific replies.

As for point no. 5, Turkish clinics Asmed and Cosmedica clearly mention 90% and 95% regrowth assurances respectively. Why can't the other clinics do the same? At least it reassures the candidate that if there is a huge variation in the percentage achieved, the clinic will attend to the consequences. Else, if a clinic botches up 50% of the transplanted grafts, it will just turn round and say the patient responded differently.

When i raised this question here, what i really meant was parameters specific to the patient's assessment in terms of pre-op status and post-op prospects.

Like why can't a clinic state upfront what kind of density would be achievable. If it has figured out the graft numbers, it has measured the area to be covered, density then should be a matter of calculation. If not with pictures, at least on a personal examination, a surgeon should be able to give that figure.

To me, a surgeon who's unwilling to give a clear picture to the candidate "appears" to be just leaving escape routes for poor results, and that shakes the confidence in the surgeon. I'm not saying the surgeon should over-promise every candidate. What i am saying is that after taking all factors into consideration during an assessment , a surgeon should  provide some clarity to the patient, a certain minimum result that the surgeon was willing to stand behind.

I have with me assessments from 5 very popular clinics. Two offer some specifics.

I wish there was a standardized format or template which all clinics would follow by way of a patient's assessment.

"Like why can't a clinic state upfront what kind of density would be achievable. If it has figured out the graft numbers, it has measured the area to be covered, density then should be a matter of calculation. If not with pictures, at least on a personal examination, a surgeon should be able to give that figure."

The coverage value system used by ASMED and Lorenzo is the best mechanism I've seen for that calculation at this point. This vid on recent improvements to it and use of a new robot for recording and calculating these is quite interesting. Looks like it would be extremely effective at counting exact growth rates which will be helpful too.

 

 

Obviously graft numbers also dependent on the type of hairline and area to be covered and most top surgeons have differing approaches to this so it will never be exact from surgeon to surgeon. I suspect the reason behind the different graft numbers you're getting ultimately relates to the total area they want to cover. Without in person consults examining your hair and asking  exactly what you want to achieve  its impossible to get these numbers anywhere close to exact.

 

Also the guarantee of Cosmedica or ASMED isn't a guarantee that they'll definitely grow, just that they'll offer a touchup if it is below that number. Maybe the clinics misunderstood the question, better to just ask them if they will provide a refund or touchup of any kind in the case of growth below a certain point.

 

 

 

 

 

Edited September 19, 2018 by JeanLDD

[Dr. Glenn Charles]

A standardized format or template would be of great value in our field of medicine. I do offer a touch up if a particular area doesn't grow in as well as the other areas transplanted. I do this even though the consent form the patient signs states we cannot guarantee hair growth. I try very not to let patients expectations get beyond what is achievable. You can explain the best and worst scenarios and tell patient they will likely be somewhere in between .

[GraftChaser]

17 hours ago, JeanLDD said:

 

 

The coverage value system used by ASMED and Lorenzo is the best mechanism I've seen for that calculation at this point. This vid on recent improvements to it and use of a new robot for recording and calculating these is quite interesting. Looks like it would be extremely effective at counting exact growth rates which will be helpful too.

 

 

Obviously graft numbers also dependent on the type of hairline and area to be covered and most top surgeons have differing approaches to this so it will never be exact from surgeon to surgeon. I suspect the reason behind the different graft numbers you're getting ultimately relates to the total area they want to cover. Without in person consults examining your hair and asking  exactly what you want to achieve  its impossible to get these numbers anywhere close to exact.

 

Also the guarantee of Cosmedica or ASMED isn't a guarantee that they'll definitely grow, just that they'll offer a touchup if it is below that number. Maybe the clinics misunderstood the question, better to just ask them if they will provide a refund or touchup of any kind in the case of growth below a certain point.

 

 

 

 

 

JeanLDD, thanks for the video. I hadn't seen it, even though I've had an in-person consult with Dr Koray. He does provide as much info as possible and that inspires confidence. Unfortunately, i couldn't afford his price so had to look at others.

My concern is not the different graft numbers from different clinics. That is perfectly understandable. My concern is with the clinics giving a graft number but not saying what the density would/could be with that number.

As for the guarantee, of course it goes without saying that it's not about definite growth. We all understand that. But at least  if the results are below a certain minimum, the clinic would offer some way of rectifying it, like Dr Charles here mentions that he does offer a touch up. That's good enough.

And no i don't think the clinics misunderstood because most of them are quite aware of what their competitors offer. In any case i gave them examples of other clinics and explained what i meant by "re-growth" , which in any case is terminology they are all too familiar with.

16 hours ago, Dr. Glenn Charles said:

A standardized format or template would be of great value in our field of medicine. I do offer a touch up if a particular area doesn't grow in as well as the other areas transplanted. I do this even though the consent form the patient signs states we cannot guarantee hair growth. I try very not to let patients expectations get beyond what is achievable. You can explain the best and worst scenarios and tell patient they will likely be somewhere in between .

Dr Charles, it's great to know you offer a touch up  even though you are not bound to.

Maybe the senior members here and the admin/moderator could pool their wisdom to draw up a format of the most common and useful pieces of information that a clinic could provide in every assessment of a patient. As Dr Charles says, it would be of value to the doctors also.

[man without hairloss]

Honestly, I think every hair transplant surgeon should at least tell what is the average density that he/she achieved for similar cases.

How many graft per square centimeter that the doctor is planning to transplant should also be told, regardless of later survival/growth rate. 

If the doctor said he did 50 graft/cm^2 and only 25 graft/cm^2 survived, the patient would know about it. That's just fair.

Edited September 20, 2018 by man without hairloss

[Melvin- Admin]

Stay tuned, I will be writing an article for this very subject. When im done I will create a thread.