Have a seat at Dr. Feriduni

Consultation

During a hair consultation, a patient is provided with detailed and comprehensive information about the causes of hair loss and advised on the various treatment options. In his consultations, Dr. Feriduni also offers to perform a detailed analysis of a patient's hair structure and hair volume before discussing the best hair therapy with the patient. He will also check the success of any previous hair treatment. Such a hair consultation provides a patient with the opportunity and the right context to discuss his or her hair situation in detail with Dr. Feriduni. Before any such consultation, patients are requested to fill out a detailed questionnaire.

The choice of the right physician depends on a number of factors, three of which are experience, technique and training. Obviously such a choice is also influenced by before-and-after photos showing in detail treatment results. The internet, conversations with other patients and recommendations from other doctors are also important factors influencing any decision as to which physician to trust. But there is nothing like a personal consultation, in which any questions or uncertainties regarding the treatment and therapy options can be discussed. And last but not least, the patient has the opportunity to check whether he gets along with the physician - also an important factor influencing any choice of physician.

A personal consultation is not only to be recommended - any responsible physician will always offer one to a patient. The patient is always at the centre of any consultation, discussing with the physician objectives, wishes, options, previous treatment and possible reasons for hair loss as well as potential therapy. The family history, the assessment of hair loss in the patient's own family, hair density, hair structure, the hair loss pattern, a microscopic examination and other examination methods or the determination of possible donor patches and the transplantation area are also important elements of any consultation. On top of all this, the pros and cons of any treatment are discussed, as well as any possible side effects. A personal consultation including an exact assessment of the different factors are not just helpful for the patient. The consultation also helps the physician to find out whether a hair transplant is the right thing for a patient, and, if so, what is the most suitable form of hair transplantation. It also allows the physician to get to know the expectations, results and hopes the patient associates with the treatment. 

An in-depth competent consultation is therefore an important ingredient of any treatment carried out by Dr. Feriduni.

The basis for any relationship of trust between doctor and patient is a personal meeting in which the wishes and needs of the patient are not only taken into account, but also discussed in detail, weighing up all pros and cons. The fully informed patient together with the experience and knowledge of the physician represent the most important basis for any successful treatment, whereby it goes without saying that the focus is always on the patient.

Dr. Bijan Feriduni
  • An open discussion taking place in an atmosphere of mutual trust
  • Adequate time for questions, wishes and concerns to be voiced
  • Individual advice tailored to a patient’s needs and taking into account all factors, including possible causes and a patient's previous history (anamnesis)
  • An elaborated analysis and diagnostic of the hair loss or lack of hair
  • A purposive eludication about the treatment and realistic options
  • A macroscopic and microscopic picture documentation to examine the efficiency of a therapy thus the progress and effect can be determined about 6 months after starting a medical therapy

4 important subjects during your consultation

An assessment of the donor and recipient region

A decision in favour of a hair transplant is a long-term one, with life-long consequences. To ensure that everything is done properly, the area from where the donor hairs are to be taken is analysed in detail, checking the number of hairs and their characteristics. No two patients are the same, and the number of donor hairs can vary from 4,000 to 9,000 follicular units. The number and characteristics of the donor hairs have a major influence on what the hair looks like after the treatment - with regard to such factors as colour, curliness, growth direction or hair diameter. In addition an assessment needs to be made of how big the area affected by hair loss and to be subjected to treatment is and - as far as possible - how any future, age-related hair loss will occur. Every patient is different, whether with regard to age, current hair loss intensity, hereditary or other factors. This means that no generalisation can be used, with each patient receiving his own personal diagnosis and treatment plan. An exact determination of the donor and recipient areas is therefore an important part of any consultation, allowing the potential of a hair transplant to be assessed as accurately as possible.

Finding out a patient's objectives and expectations

No two patients are alike - this does not just apply to his or her personal circumstances, but also to the personal expectations and wishes associated with a hair transplant. There are patients who just want to have their hair loss appear less obvious, while others want to completely change their appearance. Some don't want to have a tonsure any longer, while others don't really mind having one. Whereas certain patients would like a low hairline, others prefer a receding one suiting their age. As a way of getting to know these objectives and expectations and the priority given to them as best as possible, an in-depth personal consultation is obviously of great importance.

Explaining to patients the basic principles of hair transplantation

The number of grafts needed to fulfil a patient's expectations is one issue needing to be discussed in depth. A further issue involves discussing the limited number of donor hairs available and what influence this has on hair transplant options. A further important aspect is age-related hair loss and its effects on a patient's future appearance after a hair transplant. As part of the personal consultation with Dr. Feriduni, patients are also informed about why each patient and his hair loss need to be looked at individually. For example, it is possible for hair transplantation on a patient with very good donor hairs and just small bald patches to restore full hair density to the thinning patches. On the other hand, in patients with large bald patches and few good donor hairs, thinning patches can only be partially treated.

Discussing realistic objectives with the patient

In this part of the consultation the feasibility of a patient's expectations and objectives regarding hair transplantation are gone through, well knowing that not all wishes and hopes can be fulfilled. As a way of matching a patient's objectives and expectations with the feasibility of a hair transplant, Dr. Feriduni presents the feasible treatment options available. Unfortunately, treatment is not always suitable for a patient, with Dr. Feriduni then having the responsibility of explaining the reasons why. When the patient's expectations are not feasible or realistic, treatment should not be conducted - at least not immediately. A later examination might nevertheless come up with better factors for successful treatment, meaning that, even when a patient is advised against treatment, a new consultation with a renewed examination at a later date should be considered. With hair transplantation technology and techniques subject to permanent progress, one option is for a patient to change his objectives and expectations to such an extent that a transplant at a later date becomes a viable option.

Generally speaking, all patients should be aware that treatment is long-term, with results applying life-long.

Specific examinations by Dr. Feriduni

The trichogram
> hair roots under the microscope

A trichogram is a diagnosis method for ascertaining how far hair loss has progressed and the chances of successful treatment. A trichogram is often performed, as it throws light on the state of a patient's hair roots.
To determine the number of hair roots, the state of hair sheaths and which percentage of hairs are in each of the three phases of the hair growth cycle, hair samples are generally taken from two different places on the scalp. For best results, more than 50 hairs should be removed with their roots, and examined and counted under the microscope. By doing so, it is often possible to draw conclusions on the type of hair loss and how far advanced it is. Sensitive patients often find a trichogram painful. A less painful method providing even better results is the so-called TrichoScan.
TrichoScan & microDERM®Hair
Non-invasive, accurate diagnosis

A TrichoScan, also known as a photo-trichogram, combines a microscope with software, using IT to determine the state of a patient's hair. Whereas a trichogram requires hairs to be physically extracted, all that a TrichoScan requires is for the area to be examined (ca. 16 - 20 mm) to be shaven. This shaven part of the scalp is then coloured, dermatoscopically photographed and analysed. The digital photo creates a video image which is then assessed by the software, determining hair density. When doing a TrichoScan to determine the state of a patient's hair roots, the shaven patch of the scalp is again coloured and photographed three days later. If the hairs are in their resting or falling-out phase, they will not grow during this period, thereby providing the doctor with important indications of the type of hair loss. Clear advantages of a TrichoScan: a TrichoScan is painless and the result can be archived, allowing changes to be tracked. In addition, Dr. Feriduni and his patient can both view the state of the latter's hair on the computer monitor, exactly tracking the results of the therapy.

microDERM®Hair - digitally tracking hair growth and hair loss

The microDERM®Hair hair diagnosis method, like a TrichoScan, offers the possibility of digitally tracking changes to a patient's hair. The number of hairs, hair length and hair density are calculated automatically and displayed graphically, providing optimal support for a qualified analysis and diagnosis of hair loss. Therapy results and changes made during the course of the treatment can be displayed, stored (or printed out) and objectively checked. The use of microDERM®Hair is quick and painless. It entails shaving a 10 x 10 mm patch of the scalp to a length of 1 mm and then taking photographs of it. These are then displayed on the monitor and stored in a database. Some 2 - 4 days after the first photos are taken, a second set of digital photos of the same shaven patch is taken.

microDERM®Hair automatically processes the photos, analysing all relevant factors and displaying the results in graphical form. This analysis and the resulting findings are then used by Dr. Feriduni as a basis for discussing / recommending possible treatment methods and tracking treatment results.
Lab tests
Ruling out possible causes of hair loss

There are various possible causes of hair loss, often not apparent at first glance. In particular when hair loss is patchy, the cause can be medication, certain illnesses or deficiencies. To gain an exact picture whether for example a thyroid problem or iron deficiency is causing the hair loss, lab tests are recommended. As a way of pinpointing illnesses or deficiencies and treating them accordingly, the following lab tests are available:

Blood tests
With blood containing a great amount of information, a blood test is therefore a good way of pinpointing any illness. Some 10 ml of blood are sufficient to perform a range of different tests.

Checking a patient's hormone status
Growth, development and aging, but also a body's defence mechanisms, are processed by hormones, as are nutrients. In women in particular, a blood test can provide an insight into the most important hormones, giving indications of developments and changes, including those affecting our hair. Hormone status should be checked in the early follicle phase or at the end of a woman's monthly cycle.

A hair and mineral analysis
Chemical elements (e.g. heavy metals) and organic compounds deposited in the body over recent months and a potential cause of hair loss can be detected by the hair and mineral analysis. A hair and mineral analysis cannot replace any other analysis method and only has limited informational value. Even so, it can still be useful as a way of making further diagnostic observations and thereby gaining greater insight.
Scalp biopsy
Focusing on the scalp

Deep wounds, radiotherapy and scarring can be just as damaging to the scalp as fungal, bacterial or viral infections and autoimmune diseases - and similarly cause hair to fall out. Should there be any suspicion of a disease of the scalp or should the hair disease diagnosis not be 100 % certain, in most cases it is a good idea to perform a scalp biopsy. A scalp biopsy is carried out by removing a small piece of the scalp (a strip 0.8 - 1.0 mm long and no wider than 3 mm) with a scalpel under local anaesthesia. This is then examined microscopically and histologically.

A scalp biopsy consists of a histological examination, looking for instance at the number and structure of hair follicles, and checking whether there are any inflammatory or other processes that may be causing the destruction of hair follicles leading to hair loss.