Two Different Hair Transplant Surgeons: Differing Balding Assessments and Treatment Plans?

This question comes from a member of our Hair Restoration Discussion Forums and Social Community:

I recently underwent two separate consultations with different, recommended hair transplant surgeons and each one provided me with unique and differing assessments. Each hair restoration physician said I was a different level on the Norwood balding scale, and then suggested an unrelated number of grafts (one doctor suggested more and the other suggested less). Is one surgeon right and the other wrong? What should I do?

Differing hair transplantation assessments is most likely a fairly common occurrence, and it’s difficult to state that one surgeon is “right” while the other is “wrong.” There are several variables which could cause this issue and lead to a bit of post-consultation confusion:

First, remember that hair transplant surgery, and medicine in general, is comprised of 50% science and 50% art. Knowing this, it’s easy to understand how two, highly trained surgeons can evaluate your scalp scientifically and still devise two separate restoration plans based on their own experience and preference. It doesn’t mean one is valid or invalid, simply that these two practitioners understand the data, but view the “plan of attack” differently.

Second, the Norwood scale is not necessarily the final decider of your balding pattern and future progression. The scale, while very helpful, is simply a set of guidelines, created to help physicians diagnose and explain the hair loss process to their patients. It’s a generalization, and there is no guarantee that you will perfectly fit a pre-determined mold (especially when it comes to different physician’s interpretations and something as unpredictable as hair loss).

Third, each hair restoration physician may have differing graft placement preferences. For example, two surgeons can look at the same area of balding scalp and set number of follicular units and one could decided to distribute the grafts to the frontal hairline, temple region, and vertex, while the other concentrates all the grafts at a higher density in the frontal hairline. It’s most likely a preference, and the best thing you can do is explain your goals and expectations to your doctor and help create a collaborative treatment plan together.

With regard to what you should do from here: keep researching, consulting with quality surgeons, and don’t commit to a procedure until you are comfortable, informed, and ready to move forward.
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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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