Hair restoration surgery today is a $4 billion global industry—the enormity of that number underscores a compelling motivation for the development of a black market where unlicensed, unregulated technicians (and those who hire them), profit by acting as hair restoration surgeons. While globally regulation of medical licensure and the legal practice of medicine has required that only properly trained, licensed and regulated medical practitioners are allowed to perform surgery. The medical paradigm, designed to protect patients, has seen a break down for hair loss patients seeking hair restoration surgery. Furthermore, some patients searching for low cost surgery mistakenly believe they are merely bargain hunting, unaware they could be losing long standing patient protections when they either choose or are inadvertently drawn into the Black Market. In the most dangerous circumstance for patients, a black market clinic may have no licensed medical practitioners present at all. Black Market clinics sometimes lure patients with predatory pricing—offering as many grafts as they can excise at one low price. The complication section of this article can illustrate how this seemingly attractive offer may lead to a moth eaten appearing, irreversibly over harvested donor area.
Globally, surgery fees vary based on local economies and costs of living. It must be pointed out, therefore, that lower prices offered by some clinics or doctors in a particular region do not necessarily establish them as promoting Black Market surgery. However, it is important for patients to be aware that what appears to be a “great deal” must be scrutinized for the telltale signs of the hair restoration surgery Black Market with its associated risks. For risk details read on to see how Black Market clinics can come with hidden costs of irreparable damage, serious adverse outcomes and even life-threatening dangers.
The Black Market marketeers have in recent years built an entire industry to mislead hair loss consumers with false and fraudulent advertising. For example, Black Market marketeers often promote the presence of an experienced doctor when there is none; show before and after photos of excellent patient results– that may not be their doctors’ actual patients. Black Market marketeers may attack patients online who try to report their adverse experiences. Advertisers for the Black Market are willing to advertise for anyone who will pay them whether a legitimate or Black Market clinic. In the worst reported Black Market operations several patients are operated on in the same room, at the same time—like an assembly line or “hair mill”. For patients operated on within the Black Market, when adverse outcomes occur, and by the time affected patients realize they were victimized, they are often too far away and too embarrassed by their results to make their stories public.
Another type of Black Market clinic where technicians are allowed and encouraged to act as surgeons are those staffed by a “token” doctor who may know little about hair restoration surgery, or may actually be well credentialed but chooses to delegate surgery to unlicensed, unregulated technicians who are cheap labor, rather than perform the surgery himself or herself, or delegate to licensed medical professionals where allowed by law. Unlicensed technicians have no regulatory oversight. It has been reported that in some hair restoration facilities there is one doctor who roams the hallways saying hello to patients while dozens of surgery cases are being performed at the same time! Patients must be aware that these “token doctors” may fraudulently advertise their credentials to attract patients and may even meet with them to discuss the procedure, but are minimally involved, if at all, with performing any part of the hair transplant surgery. In some instances, patients have complained that the doctor who they expected to perform the surgery, waved from the door then walked away while technicians went on to perform the hair transplant surgery—from start to finish. In fact, this is a common occurrence in many cosmetic surgery offices in the United States, where a surgeon will buy a heavily marketed device to assist with donor harvesting, then advertise their own credentials to attract patients, and in a ‘bait and switch’ type operation, bring in technicians to perform most if not the entire procedure.
Complicit with this type of Black Market operation is the Black Market doctor who, depending on the laws of the jurisdiction, may be violating medical delegation regulations—which require them to be proficient in any task they delegate. These laws typically require that a delegated task be in the hands of an appropriately licensed medical professional practicing within the scope of their license. This type of delegation also violates a patient’s right to informed consent if the doctor fails to obtain a patient’s permission before delegating the surgery to someone else. More importantly, patient safety may be compromised when receiving surgery at a clinic that is operating outside the standard acceptable medical regulatory and ethical guidelines.