Consumer Advocacy

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Seeking Hair Restoration Surgery?

Be sure that a properly trained and licensed physician is responsible for your treatment.

The International Society of Hair Restoration Surgery (ISHRS) is concerned about the growing risk to patients of unlicensed technicians performing substantial aspects of hair restoration surgery. The use of unlicensed technicians to perform aspects of hair restoration surgery, which should only be performed by a properly trained and licensed physician*, places patients at risk of: (i) misdiagnosis; (ii) failure to diagnose hair disorders and related systemic diseases; and (iii) performance of unnecessary or ill-advised surgery all of which jeopardizes patient safety and outcomes. There may also be a risk that unlicensed technicians may not be covered by malpractice insurance.

The ISHRS believes the following aspects of hair restoration surgery should only be performed by a licensed physician*:

  • Preoperative diagnostic evaluation and consultation
  • Surgery planning
  • Surgery execution including:
  • Donor hair harvesting
  • Hairline design
  • Recipient site creation
  • Management of other patient medical issues and possible adverse reactions
  • Post-operative care

To help insure patients have information needed to make informed decisions about who performs their hair restoration surgery, the ISHRS urges potential patients to ask the following questions as well as questions regarding costs, risks, and short and long-term benefits and planning:

Patients Should Ask These Questions:

  • Who will evaluate my hair loss and recommend a course of treatment? What is their education, training, licensure, and experience in treating hair loss?
  • Who will be involved in performing my surgery, what role will they play, and what is their education, training, licensure, and experience performing hair restoration surgery?
  • Will anyone not licensed by the state be making incisions or harvesting grafts during my surgery? If so, please identify this person, explain their specific role and why they are legally permitted to perform it.
  • Is everyone involved in my surgery covered by malpractice insurance?

Relevant Issues Regarding the Unlicensed Practice of Medicine, Scope of Practice, and Inappropriate Delegation

ISHRS Position Statement on Qualifications for Scalp Surgery

Legal Update: Delegation of Surgery in Hair Transplantation, Oct. 2016

Consumer Alert, Nov. 15, 2014

Physician Practice Alert, Aug. 27, 2012

Beware of the Hair Transplant Black Market

Filing an Ethical Complaint About a Member

If you have firsthand knowledge of alleged unethical conduct, or having good faith objective evidence of an ISHRS member’s violation of the Code of Ethics, you may submit a complaint against an ISHRS member using the ISHRS Complaint Form. The ISHRS Ethics Committee investigates ethical complaints against ISHRS members. For instructions and to download the form, visit this page.


There is no such thing as “scarless surgery” in hair transplantation.

The ISHRS is concerned about false and exaggerated advertising claims related to hair restoration surgery such as “scarless surgery” or the claim that the surgery can be completely performed by a machine.

The fact is that any incision, whether by machine or by hand, that enters the skin beyond the most superficial of depths causes a scar to form, and there is currently no machine capable or automatically performing all the aspects of the hair restoration surgery. Available technology can only assist trained surgeons performing hair restoration surgery.

Misleading and Improper Messaging


Consumers face potential of serious risk when unlicensed personnel perform hair restoration surgery   The…

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