- Even minimally invasive hair restoration procedures are, in fact, surgery requiring medical expertise. For example, diagnostic decisions are being made, full thickness incisions into the skin are occurring, appropriate dosing of anesthetic medication is critical to patient safety, and patients must be medically monitored. These are just a few of the reasons that all surgery must be considered the practice of medicine.
- With respect to follicular unit hair transplantation, hundreds to thousands of tiny incisions are made. This includes both hair transplant procedures using strip-FUT (follicular unit transplantation) and FUE (follicular unit extraction) methods of donor harvesting.
- Properly trained and licensed physicians — and where allowed by law in the United States, physician assistants (PAs) and nurse practitioners (NPs) who practice within the scope of their licenses — should be the only professionals performing hair restoration surgery. This includes preoperative diagnostic evaluation; surgery planning; surgery execution (including donor hair harvesting, hairline design, and recipient site creation); and management of medical issues and possible adverse reactions.
- When unlicensed personnel perform highly skilled aspects of hair restoration surgery, in addition to surgical complications, patients risk misdiagnosis or performance of unnecessary or ill-advised surgery. For example, in some cases, hair loss can be caused by disorders related to underlying systemic diseases which, if not properly diagnosed and treated, can lead to major medical problems.
According to Washenik, laws vary by country and by state regarding the specific portions of procedures that can be delegated to unlicensed personnel, but the ISHRS believes that a licensed provider knowledgeable in the field of hair restoration must perform all surgical incisions or excisions which are part of the procedure. “When doctors advertise their credentials and then delegate the surgery to unlicensed personnel, we believe patients are being misled and placed at risk,” he stated.
As a leading authority on hair loss treatment and restoration with more than 1,200 members in 70 countries, the ISHRS provides educational materials for patients considering hair restoration. Questions that consumers should ask physicians can be found at https://ishrs.org/questions-ask-your-hair-doctor. “Find a Physician” services are also available by visiting https://ishrs.org or calling the ISHRS consumer inquiry line at 1-800-444-2737 (U.S. Toll-Free) or +1-630-262-5399.