Dr Greg Williams talks about his passion for hair transplant surgery and patient interaction
Dr Greg Williams is one of the few plastic surgeons in the UK who has dedicated his practice to hair restoration. So, where did his interest in the field begin and what is it he enjoys most about this intricate line of ‘extremely rewarding’ work?
After graduating in 1990 from medical school in Kingston, Jamaica, where he was born and raised, Dr Williams moved to the UK in 1992 to pursue a career in surgery and qualified as a plastic surgeon from the Royal College of Surgeons of England in 2003. He undertook an Aesthetics Surgery Fellowship at The Wellington Hospital in London, a Burns Fellowship in Galveston, Texas and spent time in both Brazil and Toronto learning about hair transplant surgery before taking up his NHS burns and plastic surgery consultant post at the Chelsea and Westminster Hospital in central London. Dr Williams was one of the few doctors in the UK who performed follicular unit hair transplant surgery in the NHS, doing so as part of the reconstructive procedures offered to burn survivors.
“I moved into hair restoration surgery as part of my burns practice in the NHS, where I worked at some of the well-known burns services in the South East of England. I would work with patients who had scarring to their hair-bearing areas and would be looking to restore this through modern follicular unit transplantation,” explains Dr Williams.
Now he is a Fellow of the Royal College of Surgeons of England, a member of the British Association of Aesthetic Plastic Surgeons, president of the British Association of Hair Restoration Surgery (BAHRS) and a Fellow of the International Society of Hair Restoration Surgery (ISHRS). He also works as the lead hair restoration surgeon at Farjo Hair Institute’s Harley Street practice, and although the clinic offers non-surgical treatments, it is the surgical options available that Dr Williams enjoys carrying out the most.
Training and continued education has been a fundamental part of Dr Williams’ career and is something that still remains extremely important to him, especially in a specialty, which he says, has no specific regulation or training requirement in the UK or Europe. He emphasises, “Unfortunately, there is little training available for hair restoration in the UK and there are currently no specific qualifications required, so it is possible for any doctor to start doing this surgery and that is quite a big problem.”
Dr Williams adds, “In different European countries there are opposing laws and standards to do with hair restoration surgery and some countries have no specific guidance at all. I chair the ISHRS Sub- Committee on European Standards which advises on this.” Dr Williams suggests any practitioners looking to get into this line of work do their research, go to conferences, take time to learn the skills, be critical of their work and make sure that what they are offering is of an acceptable standard. However, in a specialism that has no set standards this can prove difficult. So, when performing hair transplant procedures Dr Williams suggests, “I think the acceptable standard is that about 90% of transplanted hairs should grow, the hair growth direction and angle should be correct, and the transplant result should look completely natural. Patients should be appropriately counselled about the risks of significant on-going hair loss and the pharmacological and non-surgical treatments available for this. The key outcome is subjective patient satisfaction, which is determined, in part, by setting realistic expectations and then delivering them.”
He adds, “A great way to learn is to shadow a hair transplant surgeon who is receptive and willing to host you so you can see what is involved. Hair restoration surgery is not difficult to learn but can be very hard to do well. For any doctors that are already practising, it is essential they are carrying out procedures in a Care Quality Commission (CQC) registered facility and that all service providers of hair restoration surgery are CQC registered; both of which are legal requirements. They should also know their limitations. If it’s too much for you, refer it to someone who can handle it.”
Reflecting on his work, Dr Williams says that although he enjoys managing all different types of hair loss concerns, he finds treating transgender patients particularly rewarding, “I find the female hairline creation in male to female transgender patients very rewarding because, as a group, these patients tend to be very happy and very satisfied with the results I can provide them.”
The philosophy that I teach my children is that life is a series of paths, there are forks in the path and you end up where you are because of the decisions you make. There is nothing I would change as I wouldn’t be where I am now.
When doing follicular unit excision I utilise a range of tools including manual punches, automated drills and robotic devices depending on the patient’s hair and scalp skin characteristics, to ensure that I extract the best quality follicular unit grafts with the least amount of damage to the hairs.
I was told by a mentor very early on in my career that one can try to have an NHS practice, a private practice and a family life and you will fail at all three; but, you can perhaps do reasonably well at two. I have found that true and although I am where I am today because of the NHS, I found it to be a natural progression to focus on my private practice and family life.
I’ll always most enjoy the clinical side of my job and having patient interaction, but I am also particularly interested in regulation of this field, promoting high standards and good ethical practice.