Red, Yellow, Green Light: Ways I Communicate About Candidates for Hair Transplant Safety
I was on the panel for the Basics course at the ISHRS annual meeting in the Bahamas and explained my algorithm for how I speak with patients in a constructive and efficient manner, and my colleague sitting next to me wrote down my algorithm saying it was a great idea. Accordingly, I thought I should write a blog about it so that you as a reader could understand how I address my patients during a hair-transplant consultation session. I divide patients into three categories: red, yellow, and green and based on that categorization I tailor my consultation in such a way as to have an individual understand what would be safe and effective for that person.
For a man who is in his early 20s and with extensive baldness, he would be more likely than not classified in my book as a “red”, meaning he would be an unsafe patient for surgery in almost in any case. During the consultation I would obviously not speak about surgery at all but dissuade him from going to a colleague who may be either unethical or unknowledgeable enough to operate on him and thereby cause lifelong misery and problems. I would spend most of the consultation time focused on medical management issues and explaining the importance of these medications in helping him slow down his hair loss problem.
The yellow category refers to an individual in whom there is some risk in having a hair transplant procedure and in whom it would be advisable to explain the importance of ongoing medical management and the inherent risks as well as benefits of having a hair transplant. For example, this may be a 32-year-old male who has moderate hair loss but poor to adequate donor density and who is contemplating taking medicine. I would spend half the time counseling him on the importance of medicine as a preventative measure for hair loss and I would spend the rest of the time counseling him on both the pros and the cons of surgery. I would emphasize the risks of having surgery and not make it sound perfectly rosy for him so that the risks are clearly spelled out.
Finally, the green-light category refers to the man say in his 40s with stellar donor density and with moderate hair loss and, of course, with realistic expectations. Although I would spend time to counsel him on medical therapy, I would focus on the benefits of surgery and not over frighten him with the downsides or risks of surgery even though I would clearly still elaborate on them. Obviously, individuals do not neatly fit into these categories of green, yellow, and red and some are yellow-red and others are green-yellow for example, and I tailor my consultation to reflect the degree of surgical candidacy for that particular individual.