Hair transplant consent form

Hair Transplant Consent Form

Download Form: Request Consent for treatment 2018

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.

Procedure:
Name:
Address:
Tel No:
Signed:
Patient:
Date:
Surgeon:
Time:

Reviewed 1st May 2015

Review 1st May 2016

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What our patients say

Dr Rogers Compliment Letter 2015 – SG

When I arrived at the clinic on Harley Street I was welcomed warmly by the staff and did not have to wait long before the Surgeon (Dr Richard Rogers) came and introduced himself. I then sat down with Dr Rogers who spent time getting to know me, asking very detailed questions. He then spent some time with me penciling on different hairlines giving me plenty of time to think, whilst giving his expert opinion and advice on what would look the most realistic. When I had decided on the placement of my new hair line Dr Rogers made sure that I was happy with the outline drawn one last time walking round showing me it from different angles using a mirror.

Through Dr Rogers being so intent on making sure I was 100% happy with the procedure before going ahead really helped me feel comfortable and sure with my decision. With my hairline drawn and having been made to feel completely relaxed by Dr Rogers I was walked to the surgery. Even then Dr Rogers continued to make me feel comfortable introducing me to each of his nurses and explaining each step to me in detail of what they would be doing whilst he performed the procedure.

Having talked through the procedure with me and going over everything in extreme detail Dr Rogers asked me to place myself on the chair and then began to adjust the position making sure that I was completely comfortable. Now that I was sat comfortably and ready for the procedure to begin Dr Rogers began to guide me through each step before doing so. To begin with he explained that he would be administering general anesthetic to numb the surrounding area, and told me that it may hurt a little like a pinch. However, I did not feel a thing! In fact I didn’t even realise Dr Rogers had begun, he was so gentle and light handed I was shocked and of course extremely pleased!

With the first part out of the way and the surrounding area completely numb, Dr Rogers told me that he would now begin to remove the strip of skin. At this stage I could honestly not believe how it was possible that I could not feel my skin being cut away. Throughout the procedure I was not once in pain and Dr Rogers continually made sure that I was ok and checked that I was in no kind of pain.

Better still Dr Rogers talked to me throughout the procedure and joined in with conversations between the nurses and myself. This really made me feel at ease and at times I nearly forgot that I was having a hair transplant. With my strip of skin removed and the nurses now taking each hair follicle from the skin, Dr Rogers began to stitch my skin back together. Even now I could not feel a thing and before I knew it Dr Rogers had finished.

Whilst the nurses continued to separate the hair follicles Dr Rogers offered me some water and asked if I had any food to eat to help boost my sugar levels. Once I had eaten a snack and topped myself up with water Dr Rogers made sure that I was comfortable before the procedure continued. He then explained that he would be administering some local anesthetic to the surrounding area for the hair follicles to be placed. With the area numbed and having been told what was to happen next Dr Rogers began to make tiny pin pricks into my skin for the hair follicles to be placed in by his nurses. I cannot stress enough how I did not feel a thing and it was over with so quickly, he was a magician with his hands! It was now time for the final part of the procedure; the nurses began to delicately place my hair follicles in one by one.

With the procedure now finished and my new hairline complete, I was given plenty of time to slowly sit myself up. Dr Rogers then offered me some water and food to help boost my sugar levels. Now that I had my bearings back, Dr Rogers walked me into a quiet room and showed me to a mirror. He then said that he would leave me for a few minutes to look at the hairline. After a few minutes had passed he knocked on the door and asked if I was happy with the outcome, to which I found myself near on speechless! I told him how happy I was with it and continually thanked him for doing such an amazing job.

He then asked me to take a seat and began to explain in detail how to care for my new hair each day and gave me a detailed plan on paper. He then gave me a spray that he explained would help to clean any blood away from the surrounding area. After making sure that I was completely happy with the outcome and asking if I had any questions Dr Rogers shook my hand and wished me the best of luck with my new hairline.

SG