Pro-Bono Program Goes to Great Lengths to Give Hair Loss Patients Their Hair, Self-Esteem Back

Monday, September 8, 2018

North Carolina woman who suffered hair loss after a traumatic injury 
is one of a dozen patients who have received free hair restoration surgery

GENEVA, IL. – September 8, 2018.  Not long ago, common everyday activities like riding a bike, swimming or going to a hair salon were out of the question for 34-year-old Vonetta Chisholm of Charlotte, N.C.  That’s because Chisholm suffered extensive hair loss following a fall as a young girl that severely injured her scalp, and she spent years covering up her resulting hair loss with wigs and hair weaves that could accidentally come undone and reveal her well-kept secret.


All the years spent feeling insecure and self-conscious about her hair loss changed when she met Jerry E. Cooley, MD, a local hair restoration surgeon and volunteer physician of the International Society of Hair Restoration Surgery’s (ISHRS) Operation Restore program.


Operation Restore is the ISHRS’s pro-bono program designed to match prospective hair restoration patients suffering from hair loss as a result of an accident, trauma or disease with a physician willing to help people like Chisholm who lack the resources to obtain treatment on their own.


“Since its inception in 2004, Operation Restore has provided more than $100,000 worth of free hair restoration surgery and expenses for more than a dozen patients suffering from hair loss due to these circumstances,” said David Perez-Meza, MD, chair of the ISHRS Pro-Bono Committee, which oversees Operation Restore. “We currently have 61 ISHRS volunteer physicians worldwide who donate their services to Operation Restore, and over the years we have helped patients ranging in age from six to 50 who would not have had the opportunity to undergo a hair transplant without this program.”


At Dr. Cooley’s suggestion, Chisholm applied to Operation Restore to cover the multiple surgeries needed to restore her hair.  To her surprise, she was accepted into the program and was matched with Dr. Cooley.


“When I found out that I was accepted to receive hair restoration surgery courtesy of Operation Restore, I was speechless,” said Chisholm.  “I felt like I had won the lottery!  My family and friends were so excited for me.  I’m so grateful to the ISHRS and Dr. Cooley for making this possible.”


Despite her extensive scarring and large area of hair loss, Dr. Cooley determined during his initial consultation with Chisholm that she was a good candidate for the surgery – both medically and psychologically.


“From a medical perspective, Vonetta had plenty of good hair to begin with that would be used for the hair transplant,” said Dr. Cooley.  “Being African-American, Vonetta has coarse, curly hair that provides good coverage, so that also helped.  Psychologically, Vonetta was highly motivated and expressed realistic expectations, a key factor in any type of cosmetic surgery.”


Beginning in April 2007, Chisholm underwent four procedures with Dr. Cooley over a 10-month period to repair her injured scalp, where hair was no longer growing and to restore hair to that area.


“Vonetta had a big white linear scar on the frontal scalp area that a hair transplant alone would not have helped,” explained Dr. Cooley.  “So, the first two procedures we performed were scalp reductions, which involve cutting out a long section of skin, pulling together the sides, and sewing it up.  These scalp reduction surgeries were very successful in getting rid of the scar area.  The next step was a typical hair transplant surgery, in which the patient’s own donor hair is taken from the back of the scalp and implanted in tiny grafts in the bald area.  While Vonetta was thrilled with the results of this initial hair transplant, I recommended a second hair transplant to refine and fill in areas with more density.”


Dr. Cooley typically tells his patients that it takes a full year from the last surgery for the final results, so he expects Chisholm to continue to see improvement in her hair with increased thickness and fullness.


For Chisholm, the improvements she has seen so far have been better than she ever imagined.  “I recently went to work for the first time without my wig, which was a big milestone for me.  My boyfriend and I also went to the gym recently and went swimming – something I didn’t do before my hair transplant.  In the past, I always had to pre-plan my day and anticipate what I could or couldn’t do because of my hair loss.  Now I don’t have to shy away from doing things, and my self-esteem and overall outlook has really improved.”


Patients suffering from hair loss due to disease or trauma and cannot afford hair restoration surgery are encouraged to apply to the ISHRS’s Operation Restore program.  Applications are available through the ISHRS Web site – – and are reviewed by the Pro Bono Committee of the ISHRS.  Selected patients are matched with an ISHRS physician volunteer and every effort is made to match patients with physicians in their geographic area.  In cases where travel is necessary, the program covers these expenses for the patient.


In June 2008, the Hair Foundation – a non-profit foundation devoted to promoting “hair health” by educating the public about options for treatment and maintenance of healthy hair – formed a collaborative effort with ISHRS to help raise funds through appropriate corporate donors to support Operation Restore.
Founded in 1993, the ISHRS is a non-profit medical association dedicated to the advancement of the art and science of hair restoration.  With a membership of over 750 physicians worldwide, the ISHRS provides continuing medical education to physicians specializing in hair loss and restoration surgery and serves as a resource for the public on the latest medical and surgical hair restoration treatments for hair loss.  For more information and to locate a physician, visit
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Editor’s Note:  Before and after photos of Vonetta Chisholm and b-roll of her initial surgery, including interviews with Chisholm and Dr. Cooley, are available upon request.



October 2016

The ISHRS shares, from time to time, legal developments on issues potentially affecting members. One such issue is the permissibility of delegating portions of hair restoration procedures to unlicensed personnel. In the United States, a physician’s authority to delegate to unlicensed personnel varies from state to state and depends on each state’s regulatory scheme. Many states prohibit the delegation of surgery or medical tasks to unlicensed personnel.


The Florida Board of Medicine issued a Declaratory Statement in June 2016 that states that, “surgical excisions and incisions related to the transplantation of skin grafts goes well beyond the assisting of physicians.” The Florida Board of Medicine further explained Section 458.3485, Florida Statutes, did not authorize the petitioning physician:


to delegate the task of harvesting follicular units consisting of the excision of skin, subcutaneous tissue and hair follicles by use of a scalpel, micro-punch, motorized surgical extraction device or similar surgical instrument or device and incising the scalp for transplanting such grafts, to a medical assistant, or any other person who is not licensed as a health care practitioner and appropriately trained or otherwise experienced in the performance of such surgical procedures, in an office setting.


The Florida Board of Medicine’s Declaratory Statement is consistent with Resolution 16-130 adopted by the Florida Medical Association (“FMA”) in 2016. In particular, the resolution provided:


RESOLVED, [t]hat the Florida Medical Association oppose the use of unlicensed personnel and/or medical assistants to perform critical-to-quality steps of hair restoration surgery, such as re-distribution planning, donor harvesting of follicular units via FUE or strip methods, and creation of recipient sites; and be it further


RESOLVED, [t]hat the FMA oppose the use of unlicensed personnel and/or medical assistants to perform the diagnosis or treatment of hair loss conditions; and be it further


RESOLVED, [t]hat the FMA support legislative efforts to prohibit the use of unlicensed personnel and/or medical assistants to perform hair restoration evaluation, diagnosis, and/or critical-to-quality steps of hair restoration surgery, such as diagnosis of hair loss etiology, hair re-distribution, planning, donor harvesting of follicular units via FUE or strip methods, and creation of recipient site.


An earlier decision by the Virginia Board of Medicine is also consistent with the Florida Board of Medicine’s Declaratory Statement and the Florida Medical Association’s recent resolution. In 2011, the Virginia Board of Medicine instituted disciplinary proceedings against a physician who permitted unlicensed individuals to regularly incise the scalp and insert hair grafts without direct supervision, which the Virginia Board of Medicine concluded in December 2011, violated 18 VAC 85-20-29.A(1), a regulation that prohibits knowingly allowing subordinates to provide patient care outside of the subordinate’s scope of practice or area of responsibility.


The prohibition on the delegation expressed by the Florida Board of Medicine and the Virginia Board of Medicine are consistent with the ISHRS’s position on delegation announced in the ISHRS Position Statement on Qualifications for Scalp Surgery, available at These procedures should only be performed by a properly trained and licensed physician, or in countries where allowed, a licensed allied health professional within the scope of his or her license.


In addition to the foregoing examples from the United States, there are also recent international examples of charges being leveled against non-doctors performing hair restoration surgery. In September 2016, the Istanbul Attorney General’s Office charged two individuals with treating patients without a diploma following a police raid that allegedly revealed them performing hair transplant surgeries at a clinic without a doctor being present. As of this writing, the case against these two individuals is pending, and the Attorney General’s Office has requested prison sentences of 2-5 years.


The foregoing examples reinforce the importance of physicians, allied health professionals, and unlicensed persons involved in hair restoration to understand the legal restrictions on delegation in the jurisdictions in which they practice. Physicians, allied health professionals, and unlicensed persons involved in hair restoration surgery should carefully consider a number of factors in deciding whether delegation of a hair restoration surgery task is legal, ethical, consistent with the standard of care, and in the patient’s best interests, including, whether:


(i) The delegation is legally permissible, consistent with the applicable standard of care, and consistent with the codes of ethics to which the physician or allied health professional is bound;


(ii) The unlicensed personnel has adequate education, training, and experience to perform the delegated tasks;


(iii) The level of supervision a physician must provide to the individual to whom the task is delegated (e.g., direct, in the same facility, available by phone, none) is being met;.


(iv) Malpractice insurance covers the physician and unlicensed personnel;


(v) The patient provides informed consent for the procedure, including the delegated portion of the hair transplant surgery; and


(vi) Delegation of a portion of the hair transplant surgery is in the patient’s best interest.


In summary, when deciding whether the delegation of medical tasks associated with hair restoration surgery is legal, ethical, and in the patient’s best interests the physician and other individuals involved need to research and consider a number of factors. Relying on what others do or the assurances of a sales representative puts all those involved, including the patient, at risk. Accordingly, the ISHRS encourages physicians, allied health professionals, and unlicensed persons involved in hair restoration surgery to research and understand the legal restrictions on delegation in the jurisdictions in which they practice.

The International Society of Hair Restoration Surgery (“ISHRS”) is a nonprofit corporation, exempt from federal income tax pursuant to Internal Revenue Code Section 501(c)(3), whose purpose includes educating physicians and their assistants regarding hair restoration techniques, procedures, and related issues, as well as encouraging and facilitating the free exchange of ideas, knowledge, and experience among physicians and assistants providing hair restoration.