The Initial Consultation — How a Reputable Diagnosis Works

Why a detailed initial consultation is the most important step

A hair transplant is irreversible. Incorrectly placed hairlines remain, once-removed donor reserves are exhausted, and an operation performed too early can hardly be corrected later. That is precisely why we invest time — a lot of time — before every treatment decision. A detailed initial consultation with a complete diagnosis is mandatory for us, not optional.

What you won't get from us: a 15-minute appointment that ends with a sales pitch. What you will get: up to 90 minutes of personal time with Dr. Sophie Karg or Dr. Sussan Rosenthal, a complete medical diagnosis, and a written report to take home with you.

Before the appointment

Optional: send photos in advance

If you would like to get an early orientation, you can send us 4–6 photos of your scalp in advance (front, part, back of the head, both sides — preferably in good daylight). We will take the time for an initial assessment and can prepare the appointment accordingly.

What you should bring

• Existing findings — previous trichoscopy reports, blood values (especially thyroid, ferritin, hormone panel)
• Medication list — all current medications, including over-the-counter ones
• Family history — how did hair loss progress in father, grandfather, mother, aunts
• Photo comparison from previous years, if available — shows the progression
• Your specific questions — preferably as a list, otherwise you'll forget half of them on site

What you don't need to bring

• No previous findings? No problem — we will perform the complete diagnostic on site.
• No ready opinion — we do not expect a preliminary decision for a specific therapy.
• No special preparation of the scalp — come as you are.

During the consultation — the five phases

1. Anamnesis (15–20 minutes)

We take time for your story. When did it start? How is it progressing? What have you tried already? Are there any family indications? Which concomitant diseases or medications are relevant? What are your expectations for the result?

This phase is not routine — it is the basis of every reliable diagnosis. For diffuse or female forms of hair loss, the anamnesis often determines more than any technical examination.

2. Clinical examination

Visual examination of the scalp, assessment of the Norwood or Ludwig classification, pull test, inspection of the donor area at the back of the head, assessment of hair structure.

3. Trichoscopy with high-resolution image documentation

We use a professional trichoscope for digital microscopy of the scalp. You can watch on a large screen — we show you what we see: follicular density, degree of miniaturization, signs of inflammation, FU distribution in the donor area.

In this phase, many patients realize for the first time what is actually happening on their scalp — and why previous attempts may not have worked.

4. Donor area analysis

The donor area at the back of the head is the crucial resource for any transplant. We measure the follicular density in different zones, estimate the maximum available graft count over the entire lifetime, and assess the quality of the follicles (vellus hair proportion, miniaturization).

For some patients, this is the most difficult but most important statement: "Your donor area cannot provide what you desire." This honest answer is part of our work.

5. Standardized photo documentation

Eight standardized shots from fixed angles. These images form the baseline — if you later decide on a therapy, we will compare every progression at 3, 6, and 12 months using these images.

For women and diffuse hair loss: additional recommendation for laboratory diagnostics

For female hair loss, diffuse thinning, or an unclear diagnosis, we recommend a complete laboratory diagnosis — thyroid panel including antibodies, complete iron status, vitamin D, possibly hormone panel. If you do not yet have current values, we will write you a referral to your family doctor or can arrange the laboratory tests directly from our practice.

This additional diagnostic is crucial for many female patients — a thyroid disorder, PCOS, or iron deficiency would otherwise remain undetected, and no therapy would be effective.

After the consultation

Written report

You will receive a written medical report with:

• Complete diagnosis (Norwood/Ludwig stage, differential diagnosis, possibly co-diagnoses)
• Assessment of the donor area
• Therapy recommendation — conservative, surgical, or combined
• Long-term outlook (5, 10, 20 years)
• Estimated graft count for surgical indication
• Binding individual treatment plan

You can use this report for a second opinion — we expressly recommend this. A reputable practice encourages a second opinion instead of interpreting it as distrust.

Time for reflection — no sales pressure

We do not make surgical decisions on the day of the initial consultation. You take the report with you, take your time, talk to family or another practice. If you decide, you contact us — at your initiative, not ours.

This initially seems unusual to many of our patients. But it is part of our philosophy: A good treatment decision is made calmly, not under pressure.

What an initial consultation with us costs — and why

Our initial consultation is a fee-based medical service. We will discuss the exact amount when you book your appointment — it covers the specialist's time, the trichoscopy diagnosis, and the written report.

Why we don't offer "free consultations":

• A 90-minute specialist diagnosis is a genuine medical service — it cannot be provided "for free" if it is to be serious.
• Those who pay for advice buy the advice — not the surgery that is then "offered".
• It filters — patients who seek us out are seriously interested in a solution, not in comparing free offers.
• It protects our attention for the patients we truly treat.

In the high-end segment of medicine, a fee-based initial consultation is standard. Our patients appreciate the clarity — they pay for medical diligence, not for a disguised sales pitch.

Duration and procedure summarized

• Appointment duration: 60–90 minutes, depending on complexity
• Who advises: Dr. Sophie Karg or Dr. Sussan Rosenthal personally — no delegation to assistants
• What you take with you: written report, individual treatment plan, if applicable, photo documentation
• Follow-up contact: at your initiative, no sales call
• Waiting time: usually 2–4 weeks — we accept a limited number of patients to ensure quality

Frequently Asked Questions

Can I also have the initial consultation online?

For a complete diagnosis, a personal presentation is necessary — trichoscopy and donor area analysis cannot be performed remotely. However, we are happy to offer a preliminary video consultation in which we discuss your situation orientatively and clarify whether an on-site appointment is advisable. For international patients, this is the first step — see our International Patients page.

How long do I have to wait for an appointment?

Usually 2–4 weeks. We deliberately accept a limited number of patients to give every treatment the care we promise. For urgent matters, please contact us directly.

What if the recommendation is "no transplant currently"?

This happens to a significant portion of our initial patients — especially very young men, those with active stress-related hair loss, or those with an insufficient donor area. You will then receive an honest explanation and an alternative plan (conservative therapy, waiting period, co-treatment of the underlying disease). This recommendation is as much a part of our work as a surgical recommendation.

Will the initial consultation be covered by health insurance?

No — hair medicine in Germany is almost exclusively a self-pay service. For medically relevant co-diagnoses (e.g., thyroid disease, iron deficiency), the subsequent treatment of the underlying disease may be covered by your health insurance through your family doctor — we will discuss this individually.

Am I obliged to undergo treatment afterwards?

No, in no way. The initial consultation is a self-contained medical service — the written report is yours, you can use it as you wish, including for consultation at another practice.

Can I bring an escort?

Certainly. Many patients bring a partner or a trusted person. Four-eye discussions for important treatment decisions are demonstrably better — we welcome this.

How do I book an appointment?

Directly via our booking system (Book appointment) or by phone at the practice. For international patients or special discretion requirements: please inquire directly by email or via our International Patients page.