Dr. Harald Eberson - the path to the top is like a winding road in the mountains

 

 

 

Looks can be deceiving, they say. The looks of a young doctor can, sometimes, be a red flag for a highly demanding patient. One may think that youth equates to lack of experience, insecurity in handling difficult cases and this does not inspire reciprocal trust.
This however can be just an unfounded assumption.
Today I talk with one of the leading hair transplant surgeons in the Netherlands. His youthful look was once perceived to be an obstacle in getting the acknowledgement he deserves. However, nowadays “the looks” is no longer the problem. It’s the lack of time due to a significant increase in operation requests. We hear his story from beginning to present times. How did he overcome the lack of trust and how is the road to professional success: paved with good intentions or paved with hard work and relentless aspiration for improvement.
In our series of Portraits, we meet today with one of the youngest and most promising Dutch professionals, worthy of interviewing:
the one and only dr. Harald Eberson, from Eberson Hair Clinic, Amsterdam.

 

Q

Dr. Eberson, many young professionals consider beginning in the field of hair transplant, but few of them actually have a clear and complete picture of what this business entails. I personally think your history is both fascinating and educative for our young members.
Tell me, how did it all start for you? How old were you when you thought about getting into hair transplant and what prompted you to look into it?

A

Mark, firstly I wish to thank you for your invitation to this interview and I welcome you back to our clinic in Amsterdam.

Well, good question, I surely never dreamt or even thought about becoming a Hair restoration surgeon back in the early years when I started studying medicine. It was later on during my residency phase in general surgery where I started looking into different kind of Hair loss treatments because I was becoming a patient too. As a young medicine student, something about when I was 25-26th of age  I was looking for some kind of solution to treat my thinning hair by myself. Different kind of shampoos and lotions didn’t work much at all and my hair loss continued.
Finally I took the guts to go to a local GP to get my prescription for Finasteride.
Taking that first step back then 20 years ago and to go to a colleague physician to talk about hair loss and getting medication for it was a good start for myself. Some regular GP’s were laughing about this aesthetic issue, although one was bald too, or didn’t know much about the use of Finasteride for hair loss.
Years later when I was 30 years old, hair loss continued and I got my first hair transplant (F.U.T.) already 15 years ago. After a successful operation I didn’t think at all about hair restoration but was getting more interested into dermatology & plastic surgery and just continued my regular career and personal life. After a couple of years and different residencies I managed to enter somehow the regular cosmetic medicine field because hospital life was not really something for me.
During my experience and work in cosmetic surgery I was introduced by coincidence by another cosmetic physician to visit one the oldest hair restoration clinics in the Netherlands. There was a vacancy for an extra hair surgeon at the time and I didn’t expect that this would happen to me. But I surely remembered the positive impact my own surgery had and from that point, almost 10 years ago it really started and I choose to enter this field called hair restoration surgery.

Q

How difficult was this for you in the beginning?

A

From a surgical point of view learning to do the basics of FUT technique was not very difficult to learn and practice.
I was already doing my own surgeries in the clinic within 3 months internship. But to deliver a good quality hair transplant and in order to deliver almost complete natural results, took me much longer. I think it took me at least 1,5 - 2 years when the real good or great results started kicking in.

Q

How long did it take you to obtain your first pleasing results? I assume, like every beginning, not everything went flawlessly from the get-go.

A

As earlier stated for FUT - that is strip surgery - took me about 1,5 to 2 years to notice good results.
In the beginning not every result was great or the FUT scars were unexpected or unwanted big for example.
However for FUE it took me much longer. It was hard work to punch every graft manually, by hand. The workload was mainly on me and everyone from the team was happy to get out 200-300 FUE grafts a day in the beginning.
Those were really small procedures like eyebrows or scar corrections. But after a couple of years extraction, and sometimes a lot of back ache, speed increased and the growth/survival  rate of extracted grafts increased also.
After that point of learning to extract quick and properly becomes a habit, the real learning starts to come in. It’ s like learning to drive a car; at first you have to do so many things consciously at the same time and are overwhelmed by many impressions during the driving you easily forget about the details.

Q

Success. Depending on whose definition you’re willing to consider, one could argue having money, makes you successful. But we both know, success in the medical field – and even more in hair transplant – requires far more than just finances and marketing.
In your case, what are the three most defining elements that contributed to your personal success dr. Eberson?

A

I think this is a very important question or even a better issue to start with before someone is going to enter and continuing the hair restoration field. I see a lot of colleagues from different medical specialties entering this field today. Some have all the medical requirements and - or extreme professional titles to enter this field.
Some even have established their own successful running a clinic in another field but yet they don’t finish what they start or just won’t become a good hair restoration physician.
There are many reasons why they may not succeed.
- I think for myself that a good contributing factor was and still is that I am a patient myself. I know what impact it has on your well being so there ‘s some passion behind my work and why I do it.
- I started from scratch with not much background on how to perform a great hair transplant. There were no big funds available to get fancy trainings from renowned commercial clinics. So I had to learn a lot by myself from the beginning.
Not an easy task back then, so I studied a lot of literature, read books from colleagues and choose the right role models. Having a good drive to keep on learning new techniques from different workshops and colleagues is a must.
New insights, ideas and techniques are essential to keep it up in this evolving field.
- Finally, also an interesting factor, when I was a teenager one of my hobbies was painting and drawing and my Art teacher at school told me I should go to the Art School when I was younger. But eventually I choose medicine to help others and not just myself. Finally, in this field I have probably found both medicine as well as art.

Q

As I mentioned before, many young professionals are contemplating approaching hair transplant as main specialty. What is in your opinion an absolute must have in order to make it in this profession?

A

You need to have attitude and thrive to learn and to perfect yourself in this field. It is true what they say: practice makes perfect!
You need to have or try to have a sense of artistry, hair restoration is all about producing natural results and these you can find in the details of good quality work.

Q

Knowing what you know now, what would you tell any new doctor that wants to begin with hair transplant? What would be the top aspects to consider before even starting in this line of profession?

A

That's a tough question.
I would restate the question first that one has to ask oneself:
if you had a million dollar or more would you still perform hair transplant?
Or if you have not much earned yet would you still perform a reconstruction hair transplant for free, if someone is in need?
If you still would do it, you are probably in the right field because you care or because you like to do the job. If not than one should doubt to start with this work because doing it just for work or money won’t make you happy or a great hair transplant surgeon.
As a youngster, be prepared to dedicate yourself and work hard to perfect your skills and have patience. And don’t forget your patients because that’s where you are working and not the other way.

Q

They say we men get wiser by the decade. Looking back to your past one or two decades as professional in the field of hair transplant, would you change anything? Would you do anything differently?

A

No, I am happy where I am now and toward where I am heading. The only thing for youngsters would be not to think too much as a clinician who knows everything. Patients are depending on you. You have to step out, be present and be a little more commercial. You have to reach your patients and be "out there".

Q

In retrospective: any professional regrets?

A

No,I don’t like to look back! We can only learn from our mistakes if we accept them and move forward. It’s difficult to move forward if you keep looking back.

Q

If you of today could stand right now, side by side, with the you of 10 years ago, what would you tell the “younger you”?

A

I would tell him you have made the right choice and believe more in your own ability and intuition than being dependent too much on others. You have to do it by yourself but choose the right people to learn from, built with and trust on.

Q

On a serious note now, we all know everyone has minor or major disasters from time to time. What was your single most I-wish-I-have-never-ever-done-it-ever-period-full-stop type of disappointment?

A

There were many issues where I doubted for what I did medically or being in this field, commercially. I can’t remember the details because I have the tendency the forget what was very negative at a certain moment. Sometimes there were patients when I thought I really shouldn’t have operated on because they were demanding the unreasonable. They kept coming back and demanded much time and effort, testing your patience.
Commercially I had some moments where I doubted as a doctor if I am in the right field. You need to learn how to sell to a client as well. And being, at the same time, a good manager as well as a good practitioner, is not always easy as it takes a lot of time off from your personal life. Building up your own reputation and/or clinic from scratch wasn’t always as easy especially for me, as I started in an economic down time. I doubted many times personal as financially why I started my own business in this tough economic time, but the appreciations I sometimes got from my happy patients and the great results kept me in the business.

Q

Let’s stretch a helping hand to everyone in need of inspiration. Your worst case ever; how did it happen and what did you do about it?

A

There are a few cases and one is more difficult and demanding than the other. I don’t recall that worst particular case because it depends on the definition what do you call worst case.
I think as a physician you yourself probably have seen really worst cases/patients in hospital who were really sick or died in front of you and that is something I really call worst. Cosmetic clients can be technically challenging emotional demanding or you can feel sorry for because they are physical or emotional hurt by an accident or wrong operation. Of course, at that moment the client is at his worst moment and one needs to help and find a solution.
I had patients with scar formations after burn wounds, car accidents, patients who underwent 10 FUT/strip operations and almost no donor hair left to repair on their head or body. What do you do then? You can try to fix the problem based on your expertise but sometimes I send them to another colleague who’s more specialized or experienced in the things you don’t know so well. Know your own limits and the patients' potential for recovery. Don’t think you can solve all problems, all by yourself.

Q

How about the best case you ever had. What was the single most defining aspect that made you and the patient say “Wow”?

A

The best cases are the ones where both the patient and myself didn’t expect the result would be that great, but in the end it turned out to be great. I had once a Norwood 6 patient with very thin hair on his donor area and no body hair available. He was just 30 years old end felt terrible. We talked for hours personal and medically how hair loss has impact on your self esteem and live. Talked about medical strategies possible and hair transplant options possible. After several months he decided to do a FUE operation with different medical therapies to strengthen his existing hair and it did work out great. His newly implanted grafts grew well as his thin hair changed for the better within 9 months. Everything changed for him, to the better, as he shortly after the operation got a new job and a new relation within this period and it changed his life completely. I received some pictures and a nice 'Thank You' card and presents for my technicians.
It changed his personal life completely and I think when you have such a impact on one's life, that ’s a worthy reward all by itself.

Q

So, with this in mind, at what point (ie. Nr. Of grafts/sq cm) would you say the density is… “less than desirable”, to put it kindly?

A

For the thirsty one in the desert with no water or food, 25 drops of water is already something. It all depends on what you've still got already on top and what you expect. Youngsters always desire density and older men many times lesser amounts and a more natural look.  
Technically, we try to reach about 50% of your original amount of grafts normally present to get some coverage. But many factors play part in reaching a good pleasing result not just numbers of grafts.
On average, less than 20-25 grafts/cm2 looks very "plug like" on a bald scalp. I personally prefer to put in at least 30-35 grafts on average but not everyone balding client has this luxury from the donor site viewed.

Q

Shaved FUE versus long hair FUE. Some colleagues argue that long hair FUE does not bring any concrete benefits to the patient, simply because transplanted grafts shed the strands within the first 3 weeks after transplant. I personally happen to agree with this point of view, although other colleagues promote the method as the new hot thing. Your thoughts on the topic.

A

Long hair FUE looks promising and interesting as long hair FUT once did in the past! It’ s just more workload for the medical team. Shedding will happen anyway. You can see instant result but also instant baldness after a couple of weeks and you probably need to hide it anyway than from the outside world.
What I think is going to be more hot in the future would be shaven versus unshaven FUE. But this another topic.

Q

How would you recommend dealing with unsuitable candidates for hair transplant? Options, suggestions, tips?

A

Unsuitable clients can be the young male or female clients, the ones with a hair disease or the ones for example with very less donor hair left over. Just give them true advise at least and don’t make promises you can’t deliver by yourself.
Many options. Send them to your fellow colleague dermatologist for examination or therapy. Prescribe other hair loss medications or possible known medical therapies. Sometimes hair micro pigmentation can be a very good option for clients with no donor areas left over.

Q

Do you recommend patients a combined pre- & post-op approach of maintenance of hair density aka. DHT stabilizing medication or alternatives or anything else?

A

Yes, I always tell my patients during a consultation about other extra possibilities to manage hair loss. This can be regular medicine against hair loss like Propecia or minoxidil, but also with natural remedies against hair loss.
Hair transplant alone is not the solution on the long run, especially when you are quite young.

Q

True or false statement: best start learning pure manual FUE before anything else, let motorized FUE  be for a later stage in your career?

A

Would you consider being completely depended a good thing? Today more specialized motorized machines are coming on the market and they have become better. These days even a hair robot is there to do the basic job but what would you do if it suddenly broke? Can you still continue doing proper FUE?
About 9 years when I started doing FUE the first time, I followed the normal manual way of extracting grafts by myself for years and learned it the hard way. But it gave me a lot of feedback how the skin and grafts are anatomically connected. I have tried many motorized versions but back then, nothing was really sufficient. After learning to do it manually, one can get a lot of insight. For example, learning about depth and growth angle of each graft and many other factors. It gave me extra sensory insight what a good machine needs to do.
In the end I know that every machine is only as good as the operator who stands behind it is.

Q

True or false: dense packing is one of the most desired result by any patient.

A

False, first of all it should look natural. Dense packing is something extra desired by younger patients with lots of existing hair but if you are 45 or 50+ years of age, dense packing the frontal hair line is not always suitable.
Of course there are some exceptions to the rule because beauty is in the eye of the beholder.

Q

True or false:  22 years old guy - just tell them they’re too young.

A

True. This is certainly too young especially when hair loss is progressing fast in the patients live. I think 26+ years is a more suitable age when we have a better perspective how hair loss is going to progress.

Q

Ok, fine but how about 65? Any chances?

A

You are lucky when you reached 65 are still very healthy and are only thinking about your hair?
Hmm to old for what? My oldest patient was 76 who wanted to fill in his small bald crown.

 

With this in mind dr. Eberson I thank you for our time together, I appreciate it and I hope our readers learned something new from us.

 

 

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