The physician's assessment of your hair loss, and need for hair restoration, may be different from your original assessment.

In the most simple case, when you look in the mirror you see yourself on a flat plane—essentially in two dimensions. The physician conducts a global scalp examination in three dimensions. The physician sees more than you see in the mirror.

In the course of a global examination, including your medical and family history, the physician determines the probable cause of your hair loss. While androgenetic alopecia (male and female pattern hair loss) is the most common cause, other causes must be considered. If a disease is found to be the cause, effective treatment of the disease is the first priority. The physician will also determine the relative ratio of your scalp hairs that are in growing, resting or shedding phase—a determination that can influence a recommendation for hair restoration. The physician's recommendation can also be influenced by your age and your degree of hair loss—for example, the physician's recommendation for hair transplantation in a young man with rapidly progressive hair loss may be influenced by the need for a progressive program of hair transplantation to replace future loss of hair.

The physician may raise issues you had not previously considered. Hair color, scalp color, hair texture, and the condition of scalp skin may be important factors in the physician's recommendation for a surgical hair restoration program. These are considerations that may influence the choice of hair transplantation, scalp reduction or scalp flap as the procedure most likely to produce the best outcome.

Timing may be a consideration you need to discuss with the physician. Some patients express a wish for an optimal result as quickly as possible—for example, a one-step surgical procedure rather than multiple sessions required for a successful transplantation program. The physician may understand this wish for a "quick" result, but may or may not recommend such a procedure as the one most likely to achieve an optimal outcome. Issues such as timing should be thoroughly discussed, and agreed upon by both you and the physician before hair restoration is undertaken.

The physician may recommend that the optimal approach is a combination of surgical hair restoration and topical or oral hair restoration pharmaceutical agents.

The Bottom Line

The optimal outcome of a hair restoration program is most likely to result from decisions based upon your unique, individual needs, arrived at by joint decision-making with the physician and hair restoration specialist.