I have been working as a consultant on the subject of hair transplants since 2004. In my role, I also help sufferers find reputable, experienced clinics (doctors) with sufficiently proven results.
Unfortunately, in the ongoing boom of hair surgery and with the growing number of providers, I observe a worrying trend: hair transplants are underestimated.
And by patients and doctors and clinics alike!
Even doctors far away from the field risk a hair surgery procedure
Thus, even doctors who are not specialised in the field dare to perform hair surgery and those affected are often under the impression that a hair transplant is not a “real” surgery.
This combination is a recipe for disastrous results, as a visit to the website of Christoph Bomke, lawyer for medical law, shows.
The fact that the possibilities of hair surgery are attracting more and more attention is actually welcome. Hair loss affects so many people and yet is often a taboo subject, especially for younger people.
Celebrities who admit to their procedures not only promote market growth, but also help to take the shame out of the subject. But the way hair transplants are presented is problematic: as a minor procedure that carries hardly any risks and can actually be performed by any doctor.
Clinics sell hair transplantation as virtually free of complications, but there are high risks, especially when performed by inexperienced hands.
The fact that cosmetic surgery procedures are sold as quasi complication-free is not new and hair surgery is no exception. Since these are not medically necessary operations, the possible risks and consequences are gladly, if not concealed, then sold under their seriousness.
I definitely think this is the wrong approach: a patient must be sufficiently informed to make an informed decision.
While it is true that the health risks of a hair transplant are manageable, even a hair operation is not guaranteed to be free of complications.
ON the contrary, hair transplantation performed by inexperienced hands can even lead to fatal results. From poor growth rates, to thick grafts with wrong growth direction and toilet brush design, to completely excluded donor areas, as can also be read in the chapter “Hair transplant risks”.
Since those affected have taken the step of accepting an operation in order to improve their own initial situation, a botched result hits particularly hard here and can have psychological consequences that should not be underestimated.
Especially when the result has failed to such an extent that there are no more options for repair.
In that case, patients have to cope with a sometimes catastrophic hair situation for the rest of their lives. In order to avoid this, educational work is therefore particularly close to my heart. I want to ensure that those affected end up in expert hands and can enjoy their well-done hair transplant for the rest of their lives.
This may require some effort: travelling for a hair transplant is not uncommon, as the number of truly renowned doctors and clinics is still limited.
Of course, this is difficult in times of COVID. But simply choosing the nearest possible clinic cannot be the way to go.
I have compiled in five points why finding a reputable specialist in hair surgery is hugely important.
1. A hair transplant is an surgery and carries serious risks
Every surgery is accompanied by possible complications. Hair transplants are no exception.
If the FUE procedure is used, donor areas may be decimated and cannibalised if not removed properly, making subsequent procedures difficult, if not impossible.
If the FUT procedure is used, in which the doctor removes a hairy strip from the scalp, a wound is created which then has to be sutured.
Such interventions always carry the risk of infections, wound healing disorders or excessive scarring.
In the case of FUT, improper skin strip removal can also lead to permanent numbness or painful feelings of tightness.
There are other dangers in the receiving area, such as poor growth rates can be caused by inexperienced hands, or unsightly thick grafts with the wrong growth direction and toilet brush design can be transplanted into the hairline.
2. Hair surgery is not taught at any university, even a specialist title is of little help!
Many people are not aware that hair surgery is NOT taught at universities. Even if a doctor has been trained as a plastic surgeon, this is completely new territory for them! A specialist title alone is therefore of no significance and says nothing about quality.
3. successful hair transplants require a lot of experience ► There are many different constellations – our hair is as different as we are as people.
It should not be underestimated how different the conditions of the patients are. Hair structure, scalp condition, hereditary conditions – these are all factors that vary and with which a hair surgeon must be familiar.
People with thin hair, thick hair, straight hair, wavy hair, curly hair. Different hair colours, blond, brunette, brown, red, black, different scalp-hair-skin contrasts, e.g. dark hair on light scalp, or light hair on light scalp, cases with long hair follicles under the skin, short hair follicles, in some the follicles sit rather softly in the scalp, in others firmly, we have different growth angles, individual hair densities per qcm. In some, the groups of follicular units are larger, in others smaller, and depending on the follicular unit density per qcm and the size of the follicular unit, for example, a different punch size is recommended for extraction.
Some patients bleed more during the surgery, others less. I hope I could make it a little clear with my examples: There are many individual things that a doctor can be confronted with during a hair transplant and which he has to be prepared for and know.
There must be no mistake in the aesthetic design either: the aim is that the result looks natural and suits the patient.
This knowledge only comes with experience and also a certain artistic flair.
4. Long learning curves: hair transplantation is a time-consuming procedure, the result of which is only finally visible after months.
In the case of a hair transplant, it is only possible to assess how the transplanted hair will develop after about six months, and only after one year is there talk of the final result.
This means two things: the treating doctor can only judge after this time whether his own work meets the requirements. The same applies to the patient. Whether the hair surgeon was able to fulfil the expectations only becomes apparent after months.
For the doctor, it means a very long learning curve – for the patient, in the worst case, a long path of suffering! Even if it is already foreseeable that the hair transplantation has failed, the damaged party must wait to see how the transplanted hair behaves over months before the possibilities of a corrective intervention can be assessed.
5. hair surgery is not a subcategory but an independent speciality
Hair surgery is not a separate branch of study and also not a separate training path, as already mentioned, the subject of hair surgery is not taught at any university.
Instead, a doctor who aims to become a hair surgeon must find his or her own way.
There are private training centres, congresses and medical associations dedicated to the education and training of hair surgeons and the training of practice staff.
But this already shows that this area of cosmetic surgery requires a great deal of personal initiative.
Hair surgery is definitely not an area of expertise that every plastic surgeon can easily master.
The knowledge required is too specialised for this and a specialist needs to have some separate skills to become an expert in their field.
Placing the grafts is a job that requires a lot of sensitivity and aplomb, designing a hairline requires artistic skill, it also requires a more artificial vein.
Hair surgeries can take hours and each step – placing the receiving orifices to harvesting and transplanting the grafts – requires a high level of concentration.
A kind of effort that must suit a specialist.
But tedious and monotonous steps are not the only part of the daily routine of hair surgery: at the same time, a doctor must have a good understanding of facial shapes and aesthetics.
The art is to achieve a result that no outsider would suspect is not naturally grown.
Conclusion: Long-experienced hair surgeons do not fall from the sky and the costs and the journey to the doctors/clinics should not be in the foreground
I have experienced several times that doctors who dedicated themselves to hair surgery for a short time, then took a different medical path after all – because to become a renowned hair surgeon requires a lot of persistence, very special skills and also basically an extraordinary enthusiasm for the subject of hair transplantation and understanding for the people who suffer psychologically from hair loss.
So it takes years for a specialist to develop into a luminary.
A path that is documented by consistently good results and satisfied patients.
I understand the pressure of suffering for those affected and that a spontaneous, quick choice of clinic can therefore be tempting.
But the risks involved in making a wrong decision are simply too high.
Anyone considering a hair transplant should also never plan with a budget that does not allow for travel or journey costs.
The priority must be who performs your hair transplant. And not how cheap it is or how close a clinic is to your home.
Clinics that offer hair transplants without a specialist background should generally be avoided.
The price paid by those affected in the worst case is financially incalculable.