The position of the International Society of Hair Restoration Surgery is that any procedure involving a skin incision for the purpose of tissue removal from the scalp or body, or to prepare the scalp or body to receive tissue, (e.g., incising the FUE graft, excising the donor strip, creating recipient sites) by any means, including robotics, is a surgical procedure. Such procedures must be performed by a properly trained and licensed physician. All FUE harvesting tools, including robotic devices, are considered extensions of the hand of the operator, and as such, all operators of these devices must be physicians.
Physicians who perform hair restoration surgery must possess the education, training, and current competency in the field of hair restoration surgery.
The ISHRS believes the following aspects of hair restoration surgery should only be performed by a licensed physician:
- Preoperative diagnostic evaluation
- Surgery planning
- Surgery execution including: Donor hair harvesting, Hairline design, Recipient site creation, and Management of other patient medical issues and possible adverse reactions
- Post-operative care
The ISHRS recognizes the delegation of the listed aspects of hair restoration procedures as follows: in some countries, accredited health professional groups, for example, Physician Assistants (U.S.), Physician Associates (U.K.), Nurse Practitioners (U.S. and U.K), Surgical Care Practitioners (U.K.), are licensed to perform medical and surgical procedures under specific criteria. These health professionals are accountable to their licensing authority for unethical conduct. In these countries, the ISHRS recognizes that such professional groups are practicing legally, and the ISHRS approves of this as long as they are practicing within the scope of their license and under the supervision of a licensed physician who performs hair surgery and possesses the education, training, and current competency in the field of hair restoration surgery.
The ISHRS believes it is unethical for an individual to travel to a state and/or country in which he or she is not licensed and perform the surgical aspects of hair restoration.
The ISHRS also believes it is unethical for a doctor to train an individual to perform surgery who is not an accredited health professional licensed to do so.
ISHRS members are required to agree to and abide by the ISHRS Code of Ethics and ISHRS Position Statement on Qualifications for Scalp Surgery. Violators will be subject to disciplinary actions.
Adopted by the Board of Governors, 11/13/2019