Hair transplantation is a surgical modality used for the correction of androgenic alopecia, scarring alopecia, and other causes of permanent alopecia. Since hair transplantation is a surgical procedure, all patients must be in good health. Many surgeons perform preoperative laboratory studies that include complete blood count, platelet count, serum chemistries, prothrombin time, pre–prothrombin time, and bleeding time. Some surgeons also check for human immunodeficiency antibodies, hepatitis B surface antibodies, and hepatitis C antibodies.
As with any cosmetic surgical procedure, the patient must have reasonable expectations. In fact, dissatisfaction after hair transplantation often arises from changed or unreasonable expectations rather than from complications or poor results. During initial consultation, the physician must learn the patient’s goals and the circumstances that brought the patient to the decision to consider hair transplantation.
In addition, the physician must examine the patient, recognize the underlying cause of the patient’s hair loss, and estimate the effect that time will have on the hair loss process. The patient must be provided with ample time to ask questions and arrive at a complete understanding of the procedure, expected outcome, and the changes that can be expected over time (eg, how results will change with future hair loss). Together with the patient, create a logical plan that will impart a natural-looking result both now and in the future.
Provide patients with both written and oral preoperative instructions. They need to be instructed to discontinue blood-thinning agents well before surgery to normalize bleeding time. Most surgeons require patients to discontinue aspirin or aspirin-containing products a minimum of 7-10 days before surgery. Nonsteroidal anti-inflammatory medications (eg, Advil, Motrin, Aleve) must be discontinued depending on the half-life of the agent. Consumption of alcoholic beverages has been shown to increase bleeding tendency and should be stopped a minimum of 7 days before surgery. Excessive vitamin E consumption is believed to increase bleeding tendency, and most surgeons advise patients to discontinue vitamin E supplements a minimum of 1 week before surgery. Consider inquiring about dietary and nonprescription alternative medications, since the list of herbal supplements that affect bleeding is growing.
Link to this page
