Keys to a Natural Looking Hair Transplant

We deal with men and women daily, who want more hair, are often realistic in their expectations…yet still struggle to “pull the trigger” and commit to surgery. Why? Because there are so many AWFUL examples of hair transplants walking around that scare potential patients into either doing nothing OR jumping on some new-fangled ship that offers a solution too good to be true.

Why are there so many poor hair results walking around? Several reasons….first….there is no real residency training for hair. Even in my facial plastic surgery fellowship, I was taught an antiquated procedure. So its difficult for the novice to really learn excellent technique. It takes work and practice and being willing to learn from one of the few people who are already good at hair (and there simply aren’t that many, and most aren’t willing to really show a newbie how to do the procedure right). Next, it takes a staff of TRAINED technicians to do a good hair case. So if you are starting out, how do you get staff? Well most people simply “rent staff”, travelling cutters and placers who have NO loyalty to the doctor or patient they are working for that particular day. And the doctor has no real idea of IF the rental folks are good or not…after all HE/SHE is just starting! Plus, the techs will be in another state tomorrow…what do they care if they do a bad job. Heck, as slow as hair grows…it’ll be MONTHS til anyone knows anyhow! And thirdly, it does take MONTHS to get an idea of how things are turning out. If you are just starting, and you do great work..It’s going to be a year until you have your first “grown out” patient to show new patients! Until then, how are you supposed to build a practice?

So it’s HARD to get started in hair and to do it properly. MOST doctors are simply not willing to wait. After all, it’s not brain surgery…its hair….what could go wrong????

Actually only a few things are common to go wrong, but hair is a job of attention to detail by several people..not just the doctor. The three most common problems I see, and that 95% of people afraid of committing to a hair transplant are:

• Bad scar
  Now I’ve blogged, posted on forums, and done several videos on this topic. There are essentially 2 types of scar problems. First is the old style plug scarring and zillions of patients who had hair work in the 80s and 90s…have a depleted donor area FULL of white scars. It’s possible to improve these and get more hair with good technique, but this type of scarring, by and large, doesn’t happen now days. Second, large, wide linear scars from ear to ear…often contributed to by poor surgical technique and overzealous harvesting of precious donor hair. Proper technique and experience USUALLY yield scars that are difficult to detect, even with short hair. Having done 3900 facelifts myself…poor scars are not a common problem at our office and we do roughly 25 scar repairs on patients from other doctors each year.
• Hairline too low and too straight
  There are almost NO STRAIGHT LINES in nature. So why do so many hair patients have a very straight hairline, sometimes with a funny looking curve into the temples? Why? Because it’s the line shown in the old textbooks, that I believe a lot of these new doctors use as their template. A hairline needs to be a a reasonable location, usually that point on the forehead where the scalp goes from vertical to more horizontal. Next it needs to have irregularities…little protuberances of hair that make the design look natural, like the border of a forest. Lastly, the first few hairs at the edge, need to be individual hairs…not groups of hairs. Again just like a forest, random alignment of trees at the edge followed by a forest of denser hair, as donor supply and goals allow.
• Too little hair sprinkled over too much bald scalp
  This is the biggie! We see a man a week who has had surgery in the past, where a procedure was designed NOT for the best outcome, but rather for the maximal chance of making a sale…by a consultant…not a doctor. They often say the procedure was crafted to fit their budget, financing, and since they were “just filling in” thin areas, NO DOWN TIME! What a bunch of hooey. All that really occurred is a smaller case was done, hair was sprinkled (maybe successfully, maybe not) in and amongst existing hairs that are on their last leg. And when those hairs go…the little bit of hair transplant the person actually received….looks like a sparse and ill-kempt vine. And the sales person got a commission. That definitely happened. When we do a hair case, we treat an area as if it has no hair….stragglers on their last leg are assumed to be gone, and we pack the area. Although it takes more hair, and certainly attention to detail, it’s cheaper in the long run by avoiding both donor hair waste, and multiple surgeries in the same area.

So how are YOU to avoid this? You can minimize the chances of a poor outcome with just a little homework BEFORE you sign up.

• Meet with the doctor doing the case. See his/her office…are they actually doing hair or does it look like an occasional “profit center” in a doctor’s diversely focused practice?
• Look at some examples the doctor has actually done. We regularly post examples on consumer oriented websites for all to see, AND our gallery shows numerous examples, AND we can show lots more at an in office consultation.
• Get a sense of if the practice “feels” right to you. You are likely a reasonable judge of issues, and once you know to separate out sales tactics, you can probably tell if a story sounds too good to be true. Follow your instincts and do some research on the practice. Nobody can make everyone happy, nobody, but if your research finds only poor results and examples…maybe do a bit more looking.
• And don’t get talked into a last minute deal. There is never an emergency hair transplant, or facelift for that matter. Proceed when you are ready.

I could go on for pages on this, and on our video area I have one entitled: 10 questions to ask before your hair transplant. Look at it. Ask those questions to whomever you are meeting with. It’s not a guarantee of excellence, but it will weed out a lot of less experienced practices.

Good luck.

Dr. Lindsey