THE CONSULT

Any successful hair transplant begins with a patient's first interaction with the physician's office. Whether via phone or e-mail, a well-informed, timely response to a patient's question is the first step in establishing a good doctor–patient relationship. If a patient requests information before the consult, he or she should be directed to a website or published literature that reflects the philosophy of the office.

The consult establishes candidate selection and realistic expectations. All patients should expect natural undetectable transplanted hair. No patient should EVER have a straight “pluggy” hairline. This is because over the last decade, physicians have transitioned from larger ten to twenty hair grafts to natural one- to four-hair follicular groupings. With the appropriate technique, all patients will have natural-appearing transplanted hair. Therefore, in the early twenty-first century, the key to success is to establish realistic expectations regarding the perceived density from a hair transplant. To establish this, a hair loss history must be obtained by the physician during the consult. This includes how long the hair loss has been going on, the rate of hair loss, treatments to date, and physical characteristics of the hair, including the caliber, wave, and donor density (Table 1.1). The net density from a procedure is equal to the total number of hair follicles transplanted minus the ongoing loss of existing hair.