WATCH THE REPLAY OF THE PATIENT EDUCATIONAL LIVE STREAM – 11.11
Panelists:
Kapil Dua, MD, MBBS
Ricardo Mejia, MD
Bradley Wolf, MD, FISHRS
Anil Garg, MBBS, MS, MCh, FISHRS
Shady El-Maghraby, MD, MSc, FISHRS
Discussion included:
-What is the ISHRS Fight the FIGHT Campaign, and why was it created?
-What is a safe hair transplant surgery?
-What points should a patient keep in mind when making a decision?
-What should be the criteria for choosing the doctor?
-What should the doctor be doing during the hair transplant surgery?
-What are the potential risks of the surgery?
-What steps are various governments taking to ensure patient safety?
Before a Hair Transplant, Find Out Who Will Operate
A hair transplant can change a person’s appearance for life. So can a poorly performed one. During an International Society of Hair Restoration Surgery (ISHRS) patient education livestream, physicians from several countries described patients who expected a doctor to perform their procedure, only to find that unlicensed technicians were doing much of the work. The consequences can include scarring, depleted donor hair, disappointing growth, and lasting emotional distress. Their message was direct: treat hair restoration as surgery, investigate the clinic, and ask exactly who will be responsible for each step.
When the doctor is absent
The ISHRS’s Fight the FIGHT campaign aims to alert patients to fraudulent and illicit hair transplant practices. Committee chair Ricardo Mejia said the campaign grew from complaints by patients who reported that no doctor had seen them, their results fell short of expectations, or they were left scarred or disfigured.
The problem is not confined to one country or one kind of clinic. Panelists described black-market clinics in the Middle East, technicians operating in India, and smaller-scale practices in the United States where doctors may hire technicians trained by equipment companies. A clinic can look polished and advertise impressive results while obscuring who actually performs the surgery.
Some patients are told that a doctor will be involved, then discover the doctor has disappeared after making a few incisions. Others may be sedated while technicians carry out most of the procedure. As the panelists stressed, a patient should not have to guess who is operating on them.
Why repair day matters
Hair Transplant Repair Day, observed on November 11, was created to connect patients harmed by poor or illegal procedures with surgeons willing to provide repair surgery pro bono. Mejia said the idea came from ISHRS member Marcelo Pichon, who wanted doctors around the world to unite in support of patients and provide reliable information about choosing a surgeon.
Repair can be difficult, and not every case can be corrected. One serious problem is an overharvested donor area. Hair removed from that area does not grow back, and once the available donor hair is depleted, a later surgeon may have little or nothing left to use. Patients can be left with a thin, uneven appearance that is difficult to conceal.
The damage also reaches beyond the scalp. Panelists described patients who hid under hats, avoided mirrors, or felt too ashamed to report what had happened. Repair Day offers a way to seek help, but the campaign’s larger goal is to prevent harm through patient education.
How to assess a surgeon and clinic
Choosing a clinic takes more than comparing prices or scrolling through attractive before-and-after images. The panelists recommended checking credentials, asking direct questions, and making sure the doctor who evaluates the patient is also involved in planning and performing the procedure.
Verify credentials and experience
Ask about the doctor’s qualifications, training, experience, and medical license in the country where they practise. Patients can check whether claimed affiliations or certifications are genuine. Mejia clarified that the American Board of Hair Restoration Surgery (ABHRS) has a separate certification process for doctors’ knowledge, education, and training in hair restoration.
The ISHRS website can also help patients look up members and see whether they attend professional meetings. Credentials do not guarantee a good outcome, but they provide information worth checking. Patients should also examine the clinic’s photographs and testimonials critically. Repeated wording, images taken immediately after surgery, or photos that appear to belong to other doctors can be warning signs.
Ask who does what
Before agreeing to surgery, ask which steps the doctor will perform and which tasks assistants will handle. The panelists emphasized that patients should not assume the doctor will be present throughout the operation simply because they met during a consultation.
Rules differ by jurisdiction, but the physicians described a shared principle: an unlicensed person should not perform surgery. They said the doctor should make the clinical assessment and surgical plan, and be responsible for decisions and incisions. The consent process should clearly explain each team member’s role. Patients can ask how the clinic supervises assistants and whether they can have an observer present.
Look for a considered treatment plan
A responsible doctor may decline surgery or recommend medical treatment first. Hair loss can have causes other than male pattern hair loss, and some patients may need treatment to stabilize it before surgery. The donor supply is limited, and planning must account for how hair loss may progress and whether grafts will be needed later.
Be wary of promises that sound certain or unlimited. Panelists cautioned against claims of 100 percent success, unlimited grafts, or very large numbers of grafts in a single session without a careful assessment. A doctor who agrees to every request may not be exercising sound judgment. Consulting at least two doctors can help patients compare recommendations and spot unrealistic promises.
Understand the medical risks
Hair transplantation is a medical procedure, not a haircut. It involves local anaesthesia, a lengthy operation, and possible complications. Panelists listed technical problems such as poor growth, unnatural hairline design, graft damage, excessive removal of donor hair, and scarring.
They also discussed medical risks, including infection, reactions to anaesthetic drugs, and scalp necrosis. In severe cases, complications can be life-threatening. Patients should tell the doctor about existing conditions, smoking, medications, and other relevant health information. The clinic should assess the patient before surgery and have a plan for emergencies.
The team’s training matters, too. Patients can ask whether staff are prepared to manage complications and whether the clinic has appropriate emergency arrangements or access to a hospital. A clinic that cannot answer plainly about emergency readiness deserves further scrutiny.
Report harm and seek support
The panelists said patients who believe they were harmed or operated on by unlicensed staff should consider reporting the experience to the relevant medical board, health authority, police, or court, depending on local rules. They noted that authorities may need patient complaints and evidence to act. Regulations and reporting routes vary between places, so patients should check the procedures that apply where they received treatment.
Reporting can feel daunting. People who have been harmed may prefer to hide the result rather than revisit a distressing experience. The panelists urged patients to seek support and, when they feel able, share their concerns. Their reports can help authorities identify unsafe practices and may help other patients avoid them. The ISHRS also provides patient education and case-study resources through its Fight the FIGHT campaign and Hair Transplant Repair Day.
Conclusion
A safer hair transplant begins before anyone enters the operating room. Patients need to know who will assess them, who will make the surgical decisions, and who will perform each step. They should verify credentials, ask direct questions, and be cautious of guarantees or promises that ignore the limits of donor hair. If something goes wrong, reporting the experience may help protect others. The central point from the panel was simple: hair restoration is surgery, and patients deserve qualified medical care and clear answers.
Frequently Asked Questions
What should I ask a clinic before booking a hair transplant?
Ask who will perform the consultation, make the surgical plan, administer anaesthesia, extract grafts, make incisions, and supervise implantation. Also ask about staff training and emergency procedures.
Can donor hair grow back after it is removed?
No. The panelists explained that once a graft is removed with its root, it does not grow back in the donor area. Overharvesting can therefore leave lasting visible thinning.
Is every person with hair loss a suitable candidate?
No. Some patients may have conditions other than pattern hair loss or may need medical treatment before surgery. A doctor should assess candidacy and discuss future hair loss.
Are claims of unlimited grafts or guaranteed success reliable?
The panelists warned patients to be cautious. Donor hair is limited, and no clinic should promise unlimited grafts or 100 percent success without a realistic medical assessment.
What should I do if I think unlicensed staff performed my surgery?
Consider contacting the relevant medical board, local health authority, police, or court, depending on the rules where the procedure took place. Keep records and seek advice about local reporting options.