I want to have a hair transplant but there is so much confusing information I have no idea what to believe. What should I know?
Yes, I agree. It is most confusing. With the advent of FUE and the explosion in the number of clinics and fly by night operators flooding the hair transplant market all of a sudden the competition in the field of hair transplant has expanded faster and more broadly than at any time in history. With this increased competition has come unique marketing requirements and even more unique selling propositions. Most clinics in India hire employees with an MBA to market themselves. These employees may not be well versed in the ethics of medical practice therefore medical scruples have no meaning. Clinics with doctors and trained staff still exist but such clinics are on a steady decline.
The only reasons for which a clinic should be judged (FUT or FUE) is whether the clinic produces good results on a consistent basis and if the clinic maintains international standards of hygiene, training and staffing. Does the doctor do the surgical part of the procedure himself or does he allow his technicians to perform the surgery without his presence? Many times companies try to distract the novice hair loss patient from doing proper research on various online discussion forums and websites by engaging in advertising for products or procedures that have little or nothing to do with their actual results. This can and does include advertisements for non-surgical treatments such as lasers, stem cells and unproven medications. There will be a lot of discussion about the caring of the staff and the experience of the clinic but there will be little to show for actual final results, which is the only thing that matter.
The most common reasons promoted by these unscrupulous operators to convince the client are very attractive as well as innovative. They may be any of the below in isolation or in combination:
- We have a modified version of FUE.
- We use “the robot”.
- We do not let the grafts remain out of the body for more than five minutes.
- We sedate you throughout the procedure so the experience is painless.
- We use Bio-FUE.
- We use stem cell transplantation.
Any form of FUE, in order to be called “FUE”, must remove individual follicular units as they grow naturally in the donor scalp. Anything else is not FUE including procedures that use large punches to remove multiple numbers of follicular units in one extraction. Some clinics will claim this type of procedure to be better than traditional FUE as it allows for follicular units to have a higher survival rate and better consistency. The problem with these types of procedures is that they are not FUE at all. They are nothing more than traditional, and severely outdated, punch graft surgery. The punch used to move these “modified” FUE grafts are well over 1cm in total surface area and the only portion of the procedure that is “modified” is that the donor wounds are closed with sutures or staples. There is absolutely no evidence to suggest that these punch grafts are better than modern state of the art FUE grafts and it is very probably that transection rates are very high for the follicular units along the periphery of the extraction point.
The robot is presently not as skilled as an FUE surgeon who does FUE daily. If you review who is using the robot it has been utilized by most successful FUT (strip) clinics but not nearly as much by those clinics used to performing manual or motorized extraction. Why do you think FUE surgeons do not care? Why do they want to do all the hard work themselves? Why do they not buy the robot themselves? Are they broke? The reason why leading FUE practices the world over have not embraced the robot is because the skill and precision of the robot is inferior to that of an FUE surgeon with established eye/hand coordination for manual or micro-motor extraction. A robot cannot harvest as skillfully as a veteran FUE surgeon and the impending placement skills of the robot are of kindergarten level.
A lot of companies and clinics in India have a brilliant way to engage a client by telling them that the grafts they harvest are simultaneously implanted so the overall growth is better due to a greatly reduced time out of body. They will also tell you that Dr. Bhatti’s out of body time for grafts is over 3 hours! To those who fall for this argument I will only say, “Please leave your grafts where they are for God’s sake and do not bother about a hair transplant if out of body time (OOBT) means more to you than an out of this world result (OOWR)”. At the very least, have the clinic show you direct evidence with comparisons that validate their claims.
A good anesthetic technique does not need the patient to be anesthetized. The anesthesia should be strong enough to numb the recipient and donor areas completely and the effect should not decline for up to ten hours. The reason most companies completely sedate the client is mostly due to the fact that technicians do the harvesting which is the most crucial phase of the FUE procedure. Most countries, including India, UK and USA do not allow any person other than a licensed doctor to make a cut in the skin whether it be with a knife or with a punch.
Last but not least are non-surgical procedures such as Laser, etc. Revenues for many clinics are dropping and competition is increasing. This means that clinics are getting more desperate to build and maintain their revenues so they are starting to offer procedures that are of much less obvious benefit. Compared to surgery the results are very difficult to justify. This can included “Bio_FUE”, Lasers, etc.
There are more ways to mislead patients than I have presented here but these are the methods that have caught my attention of late. If you have questions about any particular method or procedure you have read about please don’t hesitate to contact me. I answer each email myself and I’m happy to help you find the right solution even if it is not in my own clinic.