Hair transplant consent form - request for treatment

Hair Transplant Consent Form

Download Form: Consent Form

Hair transplants by micro incision slit grafting is a surgical technique that redistributes permanent donor hair to a thinning or bald area. It can give excellent results but the prospective patient must understand the principles and limitations first. This hair transplant consent form is here to help you with this. It also applies to female pattern hair loss.

The Principle

When a man starts to lose hair, he normally loses it in one of the forms of male pattern baldness (MPB). This means that he has inherited this tendency and the hair on the forehead and crown has been programmed to gradually stop growing. This eventually leads to baldness. Currently only Minoxidil, Finasteride and Dutasteride have been shown to help slow this down.

However, even in a man who has experienced severe hair loss, he will still have a horseshoe pattern of remaining hair at the back of the head and just above the ears. This is the donor (permanent) hair growing area. This area is limited in size and density of hair and varies between individuals but will normally contain around 4000-8000 grafts.

These hairs can be transplanted over a number of sessions to the areas that need them, usually the forehead (forelock) and temporal areas. The crown can also be transplanted but this is a large area so you should expect a lower density than normally achieved frontally.

The actual pattern and speed of loss in any particular person is hard to predict. It is important to bear in mind that further hair loss is likely and so transplanting too much too soon will use up the limited donor area before your final pattern is established.

It is also important to realise that there is a limit to how closely together each hair transplant may be placed per session. Further sessions can place more transplants between the original ones and build up the density. There will also be a maximum density possible by surgery.

Most people will want 2 sessions or possibly more to achieve reasonable density, particularly for the frontal hairline, depending on individual hair loss patterns and hair type. This means that you are making a commitment to restoring your hair. There is also a limit to the number of sessions, usually no more than four per area. All results are individual depending on your personal hair characteristics and only the surgeon can say what he feels are possible. We cannot achieve the same results as Nature but the aim is to cosmetically improve your appearance. No conversations with personnel from this clinic or any other clinic nor pictures demonstrating previous patient results implies a guarantee that your result will be the same or similar.

The Procedure

Hair transplantation is a minor surgical procedure carried out under local anaesthetic. You will be perfectly awake and can chat to the surgeon during it. We do recommend that you eat and drink before the operation i.e. have breakfast or lunch.
We will discuss your planned surgery with you, bearing in mind the current knowledge of hair restoration surgery, the accepted best practice guidelines and your own, personal requirements. Pre and post-operative photos are normally taken of your scalp above the eyebrow level to retain anonymity. These may be shown to prospective patients to demonstrate potential results but your confidentiality is assured.

Local anaesthetic is injected into the donor area of the scalp and then a strip of skin is removed. The anaesthetic does sting a little but is quite bearable and goes numb very quickly.

There are two methods utilised to remove the hair. In the majority of patients, the Strip (FUT) method is used. The donor strip is given to the nurse and technicians to cut into individual hair grafts whilst the surgeon stitches the incision. This should then leave a fine pale scar easily covered by your own hair so long as it isn’t too short. We recommend removal of the sutures between 8 and 12 days after surgery even though we usually use absorbable sutures.

The alternative method which has been recently developed is Follicular Unit Extraction (FUE). This is essentially removing hair by hair. It is best suited currently for smaller hair transplant procedures.
The balding area is then anaesthetised and the graft incisions are made using a specially shaped micro needle. The grafts are then placed into these slits.

After the anaesthetic wears off after 4 hours the scalp will feel a bit tight and sore but this soon goes. Simple paracetamol will help. You will also get some forehead swelling and bruising, which lasts a few days and is perfectly normal.
You will also have crusting around the grafts. These must not be scratched as the grafts may be pulled out too. These crusts will quickly dissolve once you start getting your hair wet on day 2 after the operation. The grafted area of scalp will appear slightly pinker than usual for a few days but this soon passes.

The tiny hair that is transplanted in the grafts normally falls out within a week. This is normal and due to “thermal shock”. The hair will then grow normally from the hair root and will be noticeable by approximately 3 months and carry on growing as fast and as long as your normal hair.

If the surgeon is transplanting into a thinning area, then this can occasionally cause temporary shedding (shock loss)of some existing nearby hair shafts. They then regrow. Unfortunately, any other hair loss is due to continuing male pattern baldness. It is important to realise that surgery does not stop further loss of non-transplanted hair and it will take a number of sessions to replace all your thinning hair with grafts. You may also find that different hair styling may be beneficial.

Any surgery, however minor, can have complications such as infection, bleeding, scarring or scalp numbness. These are uncommon in hair transplantation but may occur in up to 1% of patients.

You should also be aware that there are alternative methods of addressing hair loss such as hair pieces, drugs or doing nothing and that hair transplantation involves artistry and personal opinion as well as the medical variability of patient characteristics. You are therefore paying for the costs of treatment, not a specific, guaranteed result. No doctor or surgeon is able to guarantee the results of individual procedures of grafts due to patient differences.

However, we want our patients to be pleased with their grafts. We therefore require a 12 month post-operative review to check growth compared to pre and post-operative photos for quality control purposes. It is important to realise that you should not expect any regrowth before three months at the earliest and the hair will start off like fine wispy hairs between 3-4 months before growing to normal length.

After reading this and discussing any questions with your surgeon, then please fill in the form and sign below:

I understand the procedure of hair restoration surgery as outlined above and as discussed with the surgeon. I am happy that I have asked for the information I need and I have disclosed any information the surgeon may need.

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Reviewed 1st May 2015

Review 1st May 2016

Very professional team and painless hair transplant. Recommending without a doubt!

EC