Showing posts with label how. Show all posts
Showing posts with label how. Show all posts
A viewer asked why I'm still wearing a hat after Surgeonofnalts added 15-eyebrows worth of hair to my head... some facts about post-hair transplant growth...
Doctor Alan Bauman, who did my hair transplant, commented on my recent post about hair loss and it brings up an interesting issue:
It's true that the majority of primary-care and dermatologists aren't interested in hair loss treatment, and find it a distraction. It's not covered by insurance, and a typical PCP or dermatologist won't profit from treating hairloss. More importantly, they often lack insight into a simple fact: if the patient had the courage to ask a physician, he likely is highly concerned about his hair-loss even if he appears otherwise. So when he's dismissed or ignored, he probably loses some trust for the physician.
That trust can undermine the doctor-patient relationship in ways the doctor never sees. Kinda sad, so here are some tips:
Countless patients come through our doors each year after being shunned or even ridiculed by their dermatologist for wanting to do something about their hair loss. The most help any of them ever got from their Derm was a bottle of rogaine as they were sent out the door. Seek the advice of a trained medical professional who SPECIALIZES in hair restoration.
It's true that the majority of primary-care and dermatologists aren't interested in hair loss treatment, and find it a distraction. It's not covered by insurance, and a typical PCP or dermatologist won't profit from treating hairloss. More importantly, they often lack insight into a simple fact: if the patient had the courage to ask a physician, he likely is highly concerned about his hair-loss even if he appears otherwise. So when he's dismissed or ignored, he probably loses some trust for the physician.
That trust can undermine the doctor-patient relationship in ways the doctor never sees. Kinda sad, so here are some tips:
- See a specialist if you can. Even if you're not interested in a hair transplant, a physician who specializes in hair is ideal (if your dermatologist or PCP has hair-loss informational resources in the front office, you're probably safe).
- If you talk to your primary-care physician (or some derms), you're likely to do so at the end of an appointment discussing another medical issue... so don't wait until the doctor is reaching for the door handle.
- Educate yourself before going, and let the physician know what you've tried already. This will help him/her know you're concerned. Trust me: unless he's treating his own hairloss, he's not going to know you're concerned about yours if you're subtle.
- Ask for a recommendation and not options. Many physicians feel they're serving the patient if they list a variety of treatment approaches. While this demonstrates the physicians knowledge, the patient wants the doctor's advice.
- If all else fails, go to another doctor. It's a lot easier to find another doctor than to try to change your doctor's personality or methods.
It's hard enough to decide whether to get a hair transplant and how to afford one. Choosing the right doctor can be overwhelming. A Google search reveals countless objective and biased sources, and who has time to sort them all out?
Here are a dozen sample resources on picking a good doc, in no particular order. But I've summarized practical guidance below in 10 tips, so you don't have to go on a web safari to find the key considerations.
Whew- that's a lot of content to "comb over." Now before I give you my own top 10 approaches, I should explain my two potential biases. First, I title this blog "The Hair Insider" because I gained some inside perspective while working as Product Director of Propecia (the only prescription product proven to save and grow hair). I met many of the leading physicians -- some made me cringe, while others seemed sincere. Still, I'm more likely to have a favorable view of those larger affiliations like MHR or Bosley (mostly due to the impressive Medical Director Ken Washenik, who struck me as a well regarded leader, despite a whole anti-Bosley site).
Second, I'm obviously partial to (Bauman Medical) because I had a positive experience with Dr. Alan Bauman this week (and I didn't need to pay full price because I am helping him market via online video). But in my own due dilligence (2 years considering getting a transplant), Dr. Bauman and his team in Boca Raton, Florida came highly referenced, well credentialed on television and print, and were often identified by peers as the guy they would choose. I felt like that mattered more than anything.
1) Nothing beats a reference. True, I can't compare my Bauman experience with other doctors, but I was treated well, liked the staff, and I fully expect positive outcomes. If I hadn't heard so many positive things about Bauman, I would have wanted to speak with his patients -- both the ones who returned, and the ones that might have had a less positive experience, assuming they exist. If you get a reference, put the most stake in the one that comes from someone who had the transplant a year earlier, and can vouche for not just the experience but the ultimate outcome. And put less stake in the references you get from the practice, since those are clearly not drawn randomly.
2) Listen to "The Bald Truth" by Spencer Kobren, an author and founder of IAHRS. Kobren charges doctors for the exhaustive work he conducts to weed out the wackos from the credible surgeons with good reputations and patient experiences. I'm not sure all of the best surgeons are part of IAHRS, but I doubt many hacks are among them. Initially I called Spencer for a reference, but then decided to go with my gut, and called the guy I had met and had been well referenced by my colleagues as somone sincere, progressive, and talented.
3) Remember what's important. If someone is pitching you hard on a specific doctor, take a step back. Don't shop by price-per-graft, or you'll get what you pay for. You want an experienced physician not a noob, but you also one who's not so late in his career that he's unlikely to keep current on the latest technology.
4) The doctor isn't the only factor. Hair transplantation involves a variety of roles: a doctor, a counseler, technicians, specialists, assistants. A good surgeon keeps his staff, and they become a well-oiled machine. Although the responsibility rests in the hands of the physicians, the tech team does a variety of critical work... from harvesting to implanting the hair. It's a team job, so ask about the entire team and don't get woed by the doctor alone. Now consider this tip when you assess the Bosley's or MHR. They've probably got good training, but ultimately the franchise name is less important than the doctor and team you get.
5) Don't worry about location. Hair transplantation can be done anywhere, but proximity isn't vital. It's convenient to have someone close, but far more important that you find the right team. The cost of a flight is trivial in the grand scheme.
6) Don't get pressured by the "consultants." These guys are important to keep doctors doing what they do best (surgery) and they can help you assess your needs. But they're often glorfied sales people, and they want to close the deal. I could not fathom approaching a chain via a consultant, because I'd feel like I was buying time share.
7) Look for passion not profit pursuit. My surgeon, who is about my age, always knew he wanted to be a hair transplant surgeon, and found his calling after dabbling briefly in cosmetic surgery. But there are other physicians that were doing general medicine, and decided they were sick of managed care and wanted the hours and money of cash-paying cosmetic patients. That's not the ideal profile for me.
8) Plunge into a community (Kobren's is called the The Bald Truth Talk forum). Here's a nice post that has some advice for the noobs. Another is the Hairloss Help Forum. These forums will help you learn from people that have, or are currently in your same boat. If you're the guy that likes Consumer Reports and ePinions, then you'll want to conduct thorough reference checks and ask loads of questions. But the references are certainly hand picked by the practice, and who has time for that? I believe in crowdsourcing, so if I see lots of posts and threads that are favorable about a doctor, I'll hope it's not someone "gaming the system" but real patients praising the best doctors (or slamming the worst).
10) It's a Buyer's Market. The transplant industry is not booming like breast augmentation or Botox, and some of the poor surgeons are fading away... while even the good ones are eager for new cases. That doesn't mean you want to haggle or shop and compare, but it means you don't need to feel rushed or pressured.
Here are a dozen sample resources on picking a good doc, in no particular order. But I've summarized practical guidance below in 10 tips, so you don't have to go on a web safari to find the key considerations.
- WebMD: Picking a Surgeon
- US Hair Restoration
- OmniMedical Search
- Hair Restoration Advice
- Skin Treatment Guide
- eHow: How to Rate Them
- International Hair Surgical Group
- International Society of Hair Restoration Surgery: a leading organization with the world's worst logo.
- Life Tips: Finding a Hair Restoration Doctor
- International Alliance of Hair Restoration Surgeons
- American Hair Loss Association
Whew- that's a lot of content to "comb over." Now before I give you my own top 10 approaches, I should explain my two potential biases. First, I title this blog "The Hair Insider" because I gained some inside perspective while working as Product Director of Propecia (the only prescription product proven to save and grow hair). I met many of the leading physicians -- some made me cringe, while others seemed sincere. Still, I'm more likely to have a favorable view of those larger affiliations like MHR or Bosley (mostly due to the impressive Medical Director Ken Washenik, who struck me as a well regarded leader, despite a whole anti-Bosley site).
Second, I'm obviously partial to (Bauman Medical) because I had a positive experience with Dr. Alan Bauman this week (and I didn't need to pay full price because I am helping him market via online video). But in my own due dilligence (2 years considering getting a transplant), Dr. Bauman and his team in Boca Raton, Florida came highly referenced, well credentialed on television and print, and were often identified by peers as the guy they would choose. I felt like that mattered more than anything.
Biases disclaimed, I'm a former journalist who is sincerely trying to give fellow male-pattern hairloss folks thorough and objective advice to picking the right doctor or practice. Here is "the least you need to know":
1) Nothing beats a reference. True, I can't compare my Bauman experience with other doctors, but I was treated well, liked the staff, and I fully expect positive outcomes. If I hadn't heard so many positive things about Bauman, I would have wanted to speak with his patients -- both the ones who returned, and the ones that might have had a less positive experience, assuming they exist. If you get a reference, put the most stake in the one that comes from someone who had the transplant a year earlier, and can vouche for not just the experience but the ultimate outcome. And put less stake in the references you get from the practice, since those are clearly not drawn randomly.
2) Listen to "The Bald Truth" by Spencer Kobren, an author and founder of IAHRS. Kobren charges doctors for the exhaustive work he conducts to weed out the wackos from the credible surgeons with good reputations and patient experiences. I'm not sure all of the best surgeons are part of IAHRS, but I doubt many hacks are among them. Initially I called Spencer for a reference, but then decided to go with my gut, and called the guy I had met and had been well referenced by my colleagues as somone sincere, progressive, and talented.
3) Remember what's important. If someone is pitching you hard on a specific doctor, take a step back. Don't shop by price-per-graft, or you'll get what you pay for. You want an experienced physician not a noob, but you also one who's not so late in his career that he's unlikely to keep current on the latest technology.
4) The doctor isn't the only factor. Hair transplantation involves a variety of roles: a doctor, a counseler, technicians, specialists, assistants. A good surgeon keeps his staff, and they become a well-oiled machine. Although the responsibility rests in the hands of the physicians, the tech team does a variety of critical work... from harvesting to implanting the hair. It's a team job, so ask about the entire team and don't get woed by the doctor alone. Now consider this tip when you assess the Bosley's or MHR. They've probably got good training, but ultimately the franchise name is less important than the doctor and team you get.
5) Don't worry about location. Hair transplantation can be done anywhere, but proximity isn't vital. It's convenient to have someone close, but far more important that you find the right team. The cost of a flight is trivial in the grand scheme.
6) Don't get pressured by the "consultants." These guys are important to keep doctors doing what they do best (surgery) and they can help you assess your needs. But they're often glorfied sales people, and they want to close the deal. I could not fathom approaching a chain via a consultant, because I'd feel like I was buying time share.
7) Look for passion not profit pursuit. My surgeon, who is about my age, always knew he wanted to be a hair transplant surgeon, and found his calling after dabbling briefly in cosmetic surgery. But there are other physicians that were doing general medicine, and decided they were sick of managed care and wanted the hours and money of cash-paying cosmetic patients. That's not the ideal profile for me.
8) Plunge into a community (Kobren's is called the The Bald Truth Talk forum). Here's a nice post that has some advice for the noobs. Another is the Hairloss Help Forum. These forums will help you learn from people that have, or are currently in your same boat. If you're the guy that likes Consumer Reports and ePinions, then you'll want to conduct thorough reference checks and ask loads of questions. But the references are certainly hand picked by the practice, and who has time for that? I believe in crowdsourcing, so if I see lots of posts and threads that are favorable about a doctor, I'll hope it's not someone "gaming the system" but real patients praising the best doctors (or slamming the worst).
10) It's a Buyer's Market. The transplant industry is not booming like breast augmentation or Botox, and some of the poor surgeons are fading away... while even the good ones are eager for new cases. That doesn't mean you want to haggle or shop and compare, but it means you don't need to feel rushed or pressured.
I long for a day when physicians can be rated by patients on such key attributes as "bedside manner" and "technical excellence." Indeed, perhaps there's a Trip Advisor for hair surgeons that isn't really a disguised pitch for one group or practice. Let me know, and good luck!
It's really hard to tell the difference in this photo, but it's one I just took from my laptop as an interim update (I'm editing the footage from the hair transplant currently). I ended up with nearly 2,000 grafts transplanted on Monday, but many follicles contained 2-4 hairs each (so we're talking about maybe 5,000 new hairs). In fact, the challenge was to find single-hair units for a tapered front line.
Here's more detail than you may want, but this describes the innovative new type of transplant I had (versus the traditional strip-harvest where they gotta take a chunk of your scalp off).
- Notice how Dr. Alan Bauman gave me a circular recession, rather than a flat front (which looks abnormal).
- You'll see I volunteered to shave my head (optional) because I knew it would make things easier, and all of my camera hijinx and live web casts interfered with the otherwise efficient process of a hair transplant. Maybe half of people prefer not to shave the head, presumably because they don't want people knowing they had a transplant.
- I had an FUE (follicular unit extraction), which means I had no surgical incision that's known as a "strip harvest." That means I'll have no visible scar on the back of the head, I experienced less pain, and benefited from a variety of different transplanted hairs (a range of densities) that aren't found in one strip. And nobody has to dissect the harvest strip into individual follicles.
Hair transplants are basically moving "donor" hair to the forehead or crown from the back of the guy's head, where the hairs are higher density and not prone to harm by DHT, the nasty little substance that kills off hair.
- In an FUE, which is relatively new, they randomly grab follicles (containing 1-4 hairs each) with a tiny, sharp rotating knife tube (like a circular cookie-cutter). No pain. Then they quickly pluck 'em (or use suction) and place 'em in dishes until they're counted and sorted. Wanna see some photos of the FUE? It's not something I'd look at over breakfast, but trust me it's better than looking at a harvest (see gross picture).
- Those little individual rice-sized hair follicles are later inserted into the tiny slits that Dr. Bauman carefully decorated on my forehead to resemble the natural pattern and angles of a normal hairline (in one of my videos, you'll learn this is the real art that separates the good transplant doctors from the ones that give you a Frankenstein or pencil-troll look).
- Candidly, I'm glad I didn't do the normal "strip harvest" incision because it's an older and more invasive approach. Although strip harvest has advantages (you can do 3000-5000 follicles at one time, it's faster and less expensive), it's kinda freaky to think of a chunk of my scalp getting chopped off and dissected. FUE was once dismissed by transplant physicians because it's time consuming and (if they're not trained well) some of the hairs get chopped and don't grow. But if you're skilled at using an FUE tool, and have an auto rotating machine (Bauman used a "cutting edge" and expensive NeoGraft machine), then the process is quick and the success rate is high.
- My sense is that FUE will become the standard of care, especially for touch ups and folks that lack good donor hair along the back of the scalp. The trick is that surgeons need to be trained to do it quickly, but there's almost nothing but upside (besides cost) for the patient getting FUE. And FUE is easier to learn and do, so newer physicians and dermatologists are more likely to use them than fussing with incisions and strips (which have risks if you cut too deep, and fail if you cut too shallow).
- I have a significantly lower hairline now, and it's going to be much more dense than before. I'll need to wait for the hair to grow out, and the maximum benefits won't be realized until 9-12 months or longer. Most of the new grafts will grow soon, then drop (maybe 30 percent will hang). Eventually, they'll get back into the normal hair growth pattern.
- I can't wait to share the "behind the scenes" footage, because it's informative and really fun. I had a blast, and experienced very little discomfort (mild and short pain with the first anesthesia shots, and while some of the hairs being slid into the mini incisions toward the end of the day). Lots of post-operative treatments helped-- oxygen foam, bruise-reducing herbals, prednisone, pain medication, and even a pressurized oxygen tank -- where I watched a whole movie inside a 7-foot tube enjoying medical-grade pure oxygen (this heals, and has loads of other benefits). Harvest patients usually complain about the pain from the donor scar, but I can lay comfortably on a pillow because the only tender area is on my forehead.
More coming via the magic of video!
