Robert M. Bernstein, M.D., New York, New York

Hair Transplant Forum International 1998; 8(5): 23.

I enjoyed reading the editorial regarding the “Merits of the Microscope” (Forum Vol. 8, No 4, 1998) and would like to offer some comments.

I do not believe that it is necessary to be an “expert microscopist” nor to have “test conditions” for the microscope to have value in our practices. I think that anyone performing hair restoration, on a regular basis, can easily learn to use the microscope in a reasonably short period of time, and become competent in its use. It is important to understand that our patients will benefit from the use of the microscopic well before the dissector’s skills are perfected (which may take 6 months to a year, or longer).

The feelings expressed in the editorial, typify the sentiment of many members of the hair restoration community, with regard to the morbid fear of embracing a new hair transplant technology – the dissecting stereo-microscope. Like many other phobias, the anxiety produced by Microscopophobia has little basis in reality and can often result in irrational thinking. Fortunately, like other phobias, Microscopophobia can be successfully treated if there is sufficient motivation to change.

Of the various forms of therapy for Microscopophobia, desensitization seems to be the most effective, and can be accomplished in a few simple steps. First, borrow a microscope from a colleague and let it sit in the far corner of the office. Then, gradually over the course of several days, bring it to the center of the main cutting surface in the O.R., and let it rest there, undisturbed, as the doctor and staff get used to its presence. When it no longer elicits any anxiety, begin the first steps at follicular unit dissection. As confidence builds, and anxiety starts to diminish, the microscope can be used for more and more of the procedure. Once the microscope has been used for the entire procedure, the borrowed microscope can be returned, and the doctor can get one (or more) of his own.

With just these few simple steps, the hair transplant doctor will become comfortable with the new instrument and begin to appreciate its value. In short order, both the doctor and staff will fall in love with this new instrument and be extolling its virtues. But, be careful not to catch Microscopophilia. This is much more difficult to treat!