IAHRS accepted member, Arika Bansal, M.D. discusses the importance of having realistic expectations when considering hair transplant surgery. Proper patient education is vital, and if you are not fully educated on the entire scope, possible pitfalls and limitations of hair transplant surgery, then surgery might not be right for you.

Arika Bansal, MD: Yeah, I would like to touch on the topic of managing patient's expectations.

Spencer Kobren: Yeah.

Arika Bansal, MD: Despite doing hair transplant for so long, despite the patients being aware, the public being aware of the procedure, still people have some unrealistic expectations when they come to us.

Spencer Kobren: Yeah.

Arika Bansal, MD: The most uncommon thing, the most ... I would say the most common area where I have to say no for a hair transplant is when I have a young, or even a middle aged guy, who comes for a hair transplant thinking that it would repair ... It will arrest the process of hair loss. So they have to be told that hair transplant is not a solution for ongoing hair loss. Hair transplant should be done early, and only when they have lost significant amount of hair in one particular area of the scalp, and then only hair transplant will give them satisfactory, long-lasting results.

Arika Bansal, MD: And at the same time, they need to be told, again and again, that even after transplant they may still continue to lose hair in the new areas of the scalp which are not bald as of now. So they may need a procedure later on and if they want to avoid that procedure, they need to stick with medications, and the medications need to be taken regularly, and they have to be in the [inaudible] of the physician for a long period of time.

Spencer Kobren: Let me ask you a question. I don't mean to interrupt you, but in your part of the world, how do consumers and patients feel about taking medication? Because that's changed a lot here. I have been on Proscar, and as a matter of fact, I have to take it tonight, I just reminded myself, for ... It's gonna be ... 25 years. Okay? I have been fortunate enough not to have any side effects that I'm aware of. I don't know what it's gonna do for the long term, but now with all of the fearmongering and stuff that's online, people are really frightened to take the drug and I think that in many cases patients are doing themselves a disservice because a lot of guys can be helped. And especially if you're considering a transplant, the financial investment, the emotional investment, you want to save every hair that you have, how do patients in India feel about taking the drugs?

Arika Bansal, MD: So, in India, in last 10 years I have seen a lot of transition in the acceptance for medications. Earlier, the patients thought that transplant is an alternative of not taking the medication. Medication is some cheaper alternative and transplant is a permanent and expensive alternative. So they used to think that once transplant is done, they can get away with the medication thing. But now, luckily, last five to 10 years, I have seen that the patient awareness is changing and it takes a lot of effort on our part as physicians to educate them. To educate them that, "See, right now you are grade two or three, but eventually you would be landing in grade seven."

Arika Bansal, MD: So, we have to show the worst case scenario to each and every patient and it requires a lot of effort, counseling, and we have to spend a lot of time with the patients to convince them. Even after a lot of those efforts, 80% of people only get converted and they get convinced to take the medications. The rest who are not ready to take their medications, they have to be told before the procedure itself that they may require a procedure later on, when the new areas become empty. So that is one thing, very important, and I have improved in my practice in convincing my patients for taking the medications, and in patients who have come with early stage of thinning.