Who inserts the grafts?

[firsttime]

Hi

I learned that in some clinics the surgeon performs FUE by extracting grafts and makes the incisions for where they need to be inserted, and then the technicians insert the grafts into the incisions.

Does anyone have experience of this way of working? Or have you had a HT where the surgeon did both the extraction and the insertion of grafts?

Many thanks!

[LaserCap]

Typically it is the doctor who will do the extracting, and make sites.  (If a site is made in a particular way, /, the graft can only go in that way as well.  It could not possibly go in \.  

There are doctors that like getting involved with placing, check out Dr. Gabel.

What you have to realize is the fact that this is not a regulated industry.  There are groups out there where the grafts are harvested by a tech.  It's also been known some techs will make sites and do the entire procedure themselves.  The question then becomes, what schooling do they have. There has to be a difference between a tech and a doc.  

The ISHRS is always promoting and supporting the participation and work of the doctor.  In the least, a PA could do the harvesting.  I think the problem arises when a company selling equipment approaches a non-graft outfit and talks them into doing grafts.  The company will not only sell the equipment - but also the staff.  (The doctor, say in a dental office - for example), is in his office making money while the "rented techs" are performing the work.

There are thousands of examples out there.  A shame.

 

[Doron Harati]

1 hour ago, firsttime said:

Hi

I learned that in some clinics the surgeon performs FUE by extracting grafts and makes the incisions for where they need to be inserted, and then the technicians insert the grafts into the incisions.

Does anyone have experience of this way of working? Or have you had a HT where the surgeon did both the extraction and the insertion of grafts?

Many thanks!

In pro level HT clinics, the MD doctor himself make the punch\extraction and the incisions, after that the PRIME technician and his assistances use microscopes to divide the hair groups and then insert the grafts.

"Nice price" black market clinics give a 20 years old technicians do the whole process, sometimes fraud and declare themselves doctors (with no MD), sometimes ask extra 100-200 Euros that the "real" doctor will make only the incisions, of course those clinics don't use microscopes and make the procedure with a naked eye.

[gillenator]

There has been a growing trend where the techs do all of the extractions and the doctor does the recipient incisions.

The techs also place all of the grafts with few exceptions when the doctor may re-position some of the grafts.

[DrTBarghouthi]

Best practice is for the doctor to do all pre surgical planning including drawing, marking the donor, extracting all grafts and making all incisions. Experienced techs will place and the doc should also supervise that closely. 

[Doron Harati]

I myself had 2 HTs

The first procedure was a horrible medical and ecstatical failure by a cheap generic Turkish technicians clinic, I actually almost lost my life in the procedure, the thing is I didn't had knowledge about HTs and took the word of the local agent that I am suing now!

Only after this horrible experience, I did a lot of research and made my repair HT by Dr. Maras at HDC in Cyprus (Greek side), Dr. Maras did the punch with manual technique to preserve my donor and also did the slits, I am post 1 year 5 months, so happy with my repair and I became HDC representative and consultant.

You read my posts and see my story on YouTube.

[Melvin- Admin]

Most clinics have technicians insert the grafts into pre made slits. The slits are done by the doctor. In some countries, like Turkey, technicians do everything. 

[king100791]

This is interesting. I have had two hair transplants from two pretty reputed clinics in Canada and it was the technicians who did both the extractions and insertions. The doctor made the slits. 

Overall I am satisfied with my results but makes me chuckle at how the doctor is advertised while its the techs who do bulk of the work 🤔

[Melvin- Admin]

Canadian laws are different, surgeons can delegate extracting FUE grafts to technicians.

[king100791]

2 minutes ago, Melvin-Moderator said:

Canadian laws are different, surgeons can delegate extracting FUE grafts to technicians.

fair enough! btw nice hair  💥

[gillenator]

On 9/3/2020 at 3:41 AM, transplantedphil said:

Really depends on how the clinic is run.

In the USA I believe its law in most (if not all states) that doctors need to perform both the extractions and incisions. Sadly its an unregulated industry and the USA has the 2nd most highest number of black market clinics to that of Turkey (as number 1). 

I dont believe there is anything necessarily wrong with techs doing the extractions ... some are actually brilliant at it like those at Hasson and Wong, Feriduni etc. Such clinics are simply amazing and always deliver results. The problem is as a patient/consumer you never quite know who exactly is performing the procedure on you, what their level of experience is, and whether you should be comfortable with it. Its tough to judge. This is NOT an easy industry to navigate.

Ive personally experienced both scenarios, and have regretted letting someone other than the doctor i had chosen operate on me. I personally believe getting a HT is a serious medical procedure with lifelong consequences, and think experience matters. 

As an aside, @Doron Harati im still overwhelmed by your experience - and the courage it took for you to get repaired. Your story is eye opening, and one that needs to be heard. Im so glad you managed to find a way out of your situation and find a worthy clinic for your repairs

You are 100% right my friend...actually it's supposed to be the law in the USA that only a licensed physician is making any incisions into a patient, and it also allows a licensed PA to do them...other than those 2, techs are not allowed to do them however the trend continues and I agree it's because the industry is unregulated.

I believe the trend manifested because overall there were far more techs experienced in making the extractions and in some clinics, the techs were showing the doctors how to do it.

[DrTBarghouthi]

I agree. The industry is generally unregulated. Even attempts to regulate it in some countries leads to even worse consequences. An example is limiting hair restoration practice to dermatologists and plastic surgeons, which I find to be completely illogical- as there is no guarantee that being part of these specialities guarantees superior results. It is a field where you need to be an MD/DO to do anything invasive to the skin (extractions and incisions). At the same time, you need to have the ethical framework of doing what you and your team do best. It usually helps when the practice is solely focused on hair restoration in my opinion. I know there are exceptions to this rule but I think if the team is fully focused on hair restoration as a practice, there will be a higher chance of delivering consistently good results. 

[gillenator]

To my knowledge, the extent of accountability in the US is that of each state establishing a board of supervision/oversight which the public can present a formal complaint.

Yet there is an obvious conflict of interest when the board is solely made up of physicians.