Solutions to Solving the Public’s Perception of Hair Restoration
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* Susan Kingsley

1.  Susan Kingsley, MBA, PhD

## Abstract

Based on E. Antonio Mangubat’s “Advances in Hair Restoration: Changing the Public’s Image,” presented August 12, 2004, and John Ohanesian’s “ISHRS in a Changing Market,” presented August 14, at the 12th Annual Meeting of the ISHRS in Vancouver, British Columbia.

The 12th Annual Meeting of the ISHRS, held in Vancouver, BC, in August 2004, offered Dr. Antonio Mangubat, MD, an ideal opportunity to suggest solutions to improving the poor public image of hair restoration surgeons. Despite significant improvements in hair restoration techniques over the past 30 years, the public still seems focused on the poor-quality transplants of the 1960s–1980s. Furthermore, neither the public nor many physicians working in other medical specialties respect the skills required for hair restoration and related surgeries. In fact, even hair restoration surgeons themselves tend to have negative views of their fellow practitioners! Why should such attitudes persist in this day and age of skilled medical professionals?

Within the hair restoration community, a major issue is the erroneous belief that fellow surgeons are “the competition.”

Dr. Mangubat, an officer of the ISHRS practicing in Seattle, Washington, suggested that one of the problems is that transplants now “look so natural that the public can’t see them.” Laypersons and other physicians also tend to view hair transplantation as merely cosmetic, with no understanding of the enormous contribution the procedure can make to a patient’s self-esteem and quality of life. Within the hair restoration community, a major issue is the erroneous belief that fellow surgeons are “the competition.”

Dr. Mangubat emphasized that the key to changing these negative perceptions is education: education of the public, education of medical peers outside the hair restoration community, and education of hair restoration practitioners. By changing the attitudes of the latter, we should be well placed to change the beliefs of the other two groups.

Within the hair restoration community, cooperation and high ethical standards are essential. Secret techniques and an unwillingness to share knowledge and experiences should be things of the past, as should overt hype and denigration of colleagues. Running a practice purely as a commercial endeavor, without consciously thinking of ethics, should also be consigned to history, along with biased advertising and selective information. Such unprofessional, unethical behavior just scares the public and reinforces the negative impressions of our medical colleagues. There is no reason for hair restoration surgeons to be secretive—there are more than enough potential patients worldwide for each qualified surgeon to have 200,000 patients! Dr. Mangubat stressed that, by working together, we could easily double the percentage of people with hair loss who currently seek any type of treatment from 3% to 6%. Furthermore, we can ensure that all surgery uses the most up-to-date techniques to best serve the needs of individual patients.

An important way to change the attitudes of non–hair restoration physicians is to promote our surgical field as a skilled specialty, perhaps by registering it as a specialty with the American Medical Association. Furthermore, non–hair restoration physicians need to be educated about our accomplishments and expertise. Dr. Mangubat exhorted the audience to remember that “hair restoration is a true specialty and if we don’t think it is, then no one else will.” He questioned why the discipline’s major professional society, the ISHRS, had only 600 of the many thousands of hair restoration surgeons as members. Perhaps the Society needed to run more training programs and general meetings to make membership more worthwhile. He also wondered why so few hair restoration surgeons take the Board certification exam. Are they still affected by the controversies of the past? Do they think it is too difficult, or do they feel it to be unnecessary? How can we persuade our non–hair restoration peers of our professionalism if we have such beliefs? Dr. Mangubat emphasized that “we need to prove to our colleagues that we are just as serious about our specialty as they are about theirs.”

The ISHRS is doing its best to improve public perception that hair restoration lacks any benefit other than a purely cosmetic one. Its jewel is the “Operation Restore” *pro bono* program that provides hair restoration services to people who have suffered hair loss as a result of trauma or illness and are unable to pay for hair restoration. In fact, the most heartfelt part of Dr. Mangubat’s presentation was a speech from the mother of an 11-year-old boy who had survived major burns and painful skin grafting procedures. She put a human face to the significant benefits of hair restoration surgery, describing how “Operation Restore” is changing her son’s life by restoring hair to the bald, burned side of his head. As Dr. Mangubat stated, if all hair restoration surgeons treated just one *pro bono* case a year, the public perception of the discipline could be positively changed forever.

## Additional Strategies

Following Dr. Mangubat’s recommendations for public and physician education, John R. Ohanesian, President and CEO of Bosley in Beverly Hills, California, suggested additional strategies for improving the public perception of hair restoration surgery. He lamented the fact that the public viewed hair restoration as a joke and that the media still focused on the poor quality “plugs” of 30 years ago. He believed that this was due to a lack of focused public communication.

The ISHRS’s only public communications outlet at the present time is its Website. People may perceive this site as biased as it only discusses the merits of surgical and medical options for the management of hair loss. On the other hand, it is unlikely that many members of the public even access the site, as a Google search of the Internet brings up over 4 million hits for “hair loss,” with the ISHRS Website absent from the first 100 references listed. Mr. Ohanesian identified this initial public resource as a major area for improvement for the ISHRS.

Mr. Ohanesian also described how the *Wall Street Journal* and the *New York Times* had recently published stories on hair restoration and had contacted the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons, respectively, for informed comment, not the ISHRS. As a result, the conclusions in both articles were erroneous. “And why were these other societies contacted?” he asked. Because major media outlets are unaware that the ISHRS exists. The only relevant links on the American Medical Association’s list of National Medical Specialty Society Websites is the American Academy of Cosmetic Surgery, the American Society for Aesthetic Plastic Surgery, and both the American Association and American Society of Plastic Surgeons. The ISHRS is nowhere to be seen.

The solution to the ISHRS’s lack of visibility, according to Mr. Ohanesian, is for the Society to recognize the importance of communications in today’s changing market. To this end, he recommended that the ISHRS establish a major communications capability. The Society’s communications strategy could include the commissioning of market research with consumers to identify issues relevant to hair loss and hair restoration, the appointment of a public relations (PR) company to get the message out, and partnering with a well-regarded industry organization for legitimacy. He contended that “technology alone is no longer enough in today’s marketplace” and that appropriate communications are key to shaping public opinion.

In terms of market research, Mr. Ohanesian described how Proctor and Gamble keeps its hair products on the public’s radar screen. The company spends millions of dollars on market research each year to determine public understanding of its hair products and to identify areas for targeted communication. Mr. Ohanesian suggested that the ISHRS could do something similar: conduct its own market research and then develop targeted information campaigns to remedy the identified misconceptions. He believed that the most successful way to disseminate these messages is through the use of a PR agency. “PR is a positive and powerful tool” and should be harnessed by the ISHRS, he stated.

The solution to the ISHRS’s lack of visibility is for the Society to recognize the importance of communications in today’s changing market.

Mr. Ohanesian also recommended that the ISHRS partner with a respected industry organization to get its message out into the wider community. He identified the *National Hair Hour* radio program, sponsored by the *National Hair Journal*, as an appropriate unbiased partner with a wide public following. With such third-party partnering, the ISHRS should become a trusted source of information for the public.

By utilizing a multiplicity of communication strategies, including Website improvement, conducting market research, and working with PR agencies and respected third parties, Mr. Ohanesian concluded that the ISHRS should be able to widely publicize its expertise and services, and change public perceptions of hair restoration.

## Footnotes

*   *(Susan Kingsley, a professional medical writer and President of BioPharma Solutions in Vancouver, BC, Canada, is an independent consultant to the ISHRS and assisted the Forum in covering several keynote talks at the ISHRS Annual Meeting in Vancouver.)*

*   Copyright © 2005 by The International Society of Hair Restoration Surgery