As the hair transplant industry continues to grow out of control, it's apparent that many novice surgeons, patient consultants or sales reps, haven’t a clue of the importance of patient selection when it comes to this extremely difficult discipline of cosmetic surgery. Anyone can sell a hair transplant to a vulnerable hair loss sufferer, but that doesn’t mean its in the best interest of the patient. Spencer Kobren and TBT UK contributor Spencer (Spex) Stevenson discuss the reality of appropriate patient selection and how some people should never even consider undergoing hair transplant surgery.

Spex: So obviously I speak with a lot of patients on a daily basis and one thing that came very apparent recently was one particular patient who created a bit of a red flag situation for me. It happens from time to time whereby the patient clearly displayed characteristics and personality traits that just kind of outlined to me that it wasn't necessarily an ideal candidate for various reasons. His expectations were somewhat unrealistic. I believe he potentially had kind of a body dysmorphic kind of condition, which, as we know, is quite common with hair loss sufferers. I think it's important that we get the message out there. It is a sensitive topic.

But there are ... the reality of the situation is that some patients just aren't candidates for hair transplant surgery, emotionally.

Spencer Kobren: A lot of patients aren't. All you have to do is read the message forms and see who may not have been a great emotional candidate for hair transplantation. Now the problem is a lot of, you know, we really do ... I always talk to, especially the physicians that I work with in the IHRS, about patient selection. The importance of patient selection. It goes well beyond just the hair characteristics and the physical characteristics. You really have to take the time to assess this patient emotionally and mentally.

Sometimes a consultant can't so that. Somebody with your expertise obviously can because you've been doing this for such a long time. But, unfortunately, a lot of times what happens is when someone walks through that door, especially a younger patient, they have unrealistic expectations like you pointed out. They are told and sold something that may or may not be possible. Even if it is possible, if the slightest thing goes wrong in a patient that is a little obsessive, then it's life destroying for the patient and it's also very difficult for the practice.

Spex: Well, it is, and it can become very counterproductive for the practice. You hit on two key points there. One that this generally does happen, not always, but generally it happens in younger patients I find. Also, another key thing is consultants. In-house consultants are essentially commission-driven and they are potentially telling the patient what they want to hear as opposed to what they need to hear because they're gonna get paid. It's really, really important to listen in my opinion and I am a consultant.

However, Spence, you highlighted I've been around a long time and I generally have, you know, genuinely have the patient's best interests at heart. I've told countless people that they are not candidates for surgery. Surgery is a last resort. This combination of having a salesman and a patient who is incredibly vulnerable and desperate and in need of surgery and doesn't understand the long-term implications and wants a quick fix are going to potentially get themselves into a situation that is incredibly traumatic, emotionally, physically, if they don't choose the right surgeon potential, the right clinic to advise them accordingly. That they aren't a candidate.

This just stems over into the fact that, you know, again, a potential patient should be seeing doctors.