technicians vs surgeons

[Adamleland]

I went on a consultation and upon my continual education on the process I was told the technician (if really good) can be more important and has more skills than the doctor. One example used was a technician by the name of Michael Barge. Is this to be believed that if I go to the best technician that's as good as going to to best doctor?  

[deeznuts]

Why is a doctor inherently skilled at hair extraction? Medical school trains doctors on a lot of things but extracting grafts using a manual punch or motorized punch isn't one of those. Being a medical doctor means you have a lot of knowledge and spent years studying in school.

Some technician extracting grafts 8 hours a day for 5 year is going to be better than a doctor who in many ways becomes a jack of all trades dealing with consultations, prescriptions, checkups, managing the business, and implantations.

Extracting grafts doesn't require any insane medical knowledge. You have cab drivers in Turkey essentially extracting grafts and working in hair mills. That's not to say they're good at what they do... Just that you got guys off the street essentially able to do surgery (but very crappily). Extracting grafts requires good manual dexterity and good processes (ideally set by the doctor based on medical literature). If the doctor ensures that they are up to date with best practices (i.e. motorized FUE/manual FUE, holding solution, proper preparation of the grafts, local anesthetic), then the tech is set up to succeed. 

The one issue with techs that people have noted is that when a doctor does the entire surgery, you know what you're going to get. i.e. You know if Dr. X shows up that you're going to get Dr. X the entire way. You don't have to worry about the technician leaving for greener pastures or anything

Personally, I think the importance of the doctor (and just to emphasize, this is my opinion) is in the following

1. Establishing good and effective processes so the techs can succeed.

2. Keeping up with best practices and medical literature

3. Managing staff well (i.e. some doctors have techs working with them for a decade plus)

4. Following regulations and laws

5. They should have some involvement in the surgery. Probably during the implantation step

Of course, if there a doctor working under another doctor, then they don't need to worry about most of the stuff on that list and they can just focus on doing the actual surgery to the best of their ability

Edited April 6, 2023 by deeznuts

[duckling]

My conclusion will be that:

1) with surgeons you get stability and assurity.

2) with just techs and no surgeon all types of results are open (bad, average, good, excellent)

3) If both are performing then you need them to be in sync for a good/excellent result.

I don't have a specific order of reasoning. I will just list out all the points which came to me.

1)When you pick a plastic surgoen then the hairline they will give you will not be a basic one which is copy pasted on every patient but a hairline which complements your face. ( i know nowadays even many surgeons give a standard hairline ). But In hairmils doctors will give a basic hairline for everyone and techs will work on that.

2)Many clinics now have multiple surgeons so sometimes its a hit and miss which one you got unless you get the surgeon you wanted. (which is true for clinics where they have different packages for different doctors) 

3)If you pick a clinic which is run by one surgeon only then you can sure that what kind of result you might get by looking at past results of them. Because they will have techs working with the surgeon from long time. The sync between surgeon and techs is very important.

4)In hairmills Techs are sometimes hired if lot of surgery are planned on a single day and they are overwhelmed. In this case the techs will not have a proper sync between each other and mistakes can surely be made. Whereas if a surgeon is doing majority of important task then atleast you have a assurity but even then the surgeon also might make mistakes because they also have few bad cases but the probability of this happening is lower.

5)Techs sometimes have more experience than surgeons who just perform VIP cases. So if you get them and are lucky then you might get even better result than what a good surgeon would have given you.

6)Role of techs even in clinics run by single surgeon will exist as surgeon will do majority of work but they can never perform all the task unless the graft counts are low and surgery is expanded to 2-3 days. 

7)Donor management a surgeon will do better. Techs will not care much about your donor. They have a specific number to extract and implant.

8)Surgeon will definitely pick juicier grafts which are healthy but techs might not pick them. And even if they do they might put muti grafts in hairline.

[BaldGuy]

9 hours ago, Adamleland said:

I went on a consultation and upon my continual education on the process I was told the technician (if really good) can be more important and has more skills than the doctor. One example used was a technician by the name of Michael Barge. Is this to be believed that if I go to the best technician that's as good as going to to best doctor?  

Its all about experience. Doctors do not study how to do hair trasplants at unversity. They just learn how to do hair transplants by getting trained in a hair transplant clinic...the same applies for a technician. A technician with more experince can give a better result than a less experienced doctor.

Edited April 6, 2023 by BaldGuy

[deeznuts]

8 hours ago, duckling said:

My conclusion will be that:

1) with surgeons you get stability and assurity.

2) with just techs and no surgeon all types of results are open (bad, average, good, excellent)

3) If both are performing then you need them to be in sync for a good/excellent result.

I don't have a specific order of reasoning. I will just list out all the points which came to me.

1)When you pick a plastic surgoen then the hairline they will give you will not be a basic one which is copy pasted on every patient but a hairline which complements your face. ( i know nowadays even many surgeons give a standard hairline ). But In hairmils doctors will give a basic hairline for everyone and techs will work on that.

2)Many clinics now have multiple surgeons so sometimes its a hit and miss which one you got unless you get the surgeon you wanted. (which is true for clinics where they have different packages for different doctors) 

3)If you pick a clinic which is run by one surgeon only then you can sure that what kind of result you might get by looking at past results of them. Because they will have techs working with the surgeon from long time. The sync between surgeon and techs is very important.

4)In hairmills Techs are sometimes hired if lot of surgery are planned on a single day and they are overwhelmed. In this case the techs will not have a proper sync between each other and mistakes can surely be made. Whereas if a surgeon is doing majority of important task then atleast you have a assurity but even then the surgeon also might make mistakes because they also have few bad cases but the probability of this happening is lower.

5)Techs sometimes have more experience than surgeons who just perform VIP cases. So if you get them and are lucky then you might get even better result than what a good surgeon would have given you.

6)Role of techs even in clinics run by single surgeon will exist as surgeon will do majority of work but they can never perform all the task unless the graft counts are low and surgery is expanded to 2-3 days. 

7)Donor management a surgeon will do better. Techs will not care much about your donor. They have a specific number to extract and implant.

8)Surgeon will definitely pick juicier grafts which are healthy but techs might not pick them. And even if they do they might put muti grafts in hairline.

I agree with most of this but nothing stops a surgeon from training a tech to pick juicier grafts or manage donor better.

[duckling]

12 hours ago, deeznuts said:

I agree with most of this but nothing stops a surgeon from training a tech to pick juicier grafts or manage donor better.

That is true, they can definitely teach them. The tech assisting the surgeon during extraction can definitely learn it easily. Because surgeons get involved in two parts of whole surgery (in ones where both surgeon and techs are involved ) apart from the hairline design during consultation : 

1) crucial extraction, where they pick singles for the hairline and also pick the juicier grafts 

2) hairline slit making to not give a pluggy look

So, I think they might not love the idea much of giving away these parts due to which they make most money. (from VIP patients)

[Melvin- Admin]

There are some technicians that are better than doctors at extracting. Extracting grafts is a motor skill, anyone can learn. Designing hairlines, creating density, and creating natural hair that grows at proper angles is much more difficult. That requires anatomical knowledge. 
 

Here’s a complicated double whorl case from Dr. Bisanga, to recreate these sites at the proper angles and density requires a lot of skill. Each hair follicle is transitioning into each other. You want a skilled surgeon to do this. 

 

Ultimately, its all about the consistency of the clinics results. Some surgeons do everything, but they’re not very good. Some clinics delegate extractions to technicians, and their results are excellent. It all depends on the clinics track record. 

[BaldingEye]

9 hours ago, Melvin- Moderator said:

Designing hairlines, creating density, and creating natural hair that grows at proper angles is much more difficult. That requires anatomical knowledge. 
 

This is it! And to become a great technician you need to be train by a great doctor that masters hair transplants. If it was easy all techs and doctos would be doing this with great results and... how many amazing Hair Clinics do we really have? A bunch.