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Key questions to ask to avoid having a botched hair transplant


Leading hair restoration expert Dr Bessam Farjo provides guidelines to ensure successful surgery

Key questions to ask to avoid having a botched hair transplant


"In one reported instance a rapidly spreading scalp infection caused the loss of a patients eye"
Dr Bessam Farjo, Farjo Hair Institute



IF you’re thinking of following in the footsteps of the growing number of celebrities having hair transplants, these are the questions you need to ask to avoid a botched job. 

Manchester United legend Ryan Giggs, Emmerdale actor Chris Bisson and Coronation Street star Alan Halsall have all revealed in recent months they’ve been under the knife to sort out their thinning locks.

But hair restoration surgeon Dr Bessam Farjo has warned that you need to be careful about where you get it done because, if you get it wrong, it could prove fatal. 

The co-founder of the Farjo Hair Institute – which has clinics in Manchester and London – says there has been a recent rise in deaths around the world as patients opt for unlicensed and ‘unethical’ clinics. 

A good hair transplant should cost around £7,000, but both men and women are flocking abroad for cut-price deals costing as little as £700 in places such as Istanbul, Turkey. This trend is set to continue when the coronavirus travel restrictions are lifted. 

And it’s here where the dangers begin. 

Dr Farjo is past president of the International Society of Hair Restoration Surgery (ISHRS). 

He and the ISHRS say: “While this procedure has a low risk of complications when properly performed, like any procedure performed with local anaesthesia there is a risk of medication toxicity resulting in cardiac arrhythmia, neurologic symptoms such as seizures, and death. 

“Although still infrequent, reports of deaths during or after a hair transplant procedure have seen an uptick in recent years, associated with inexperience or the unlicensed practice of medicine in this field.”

One risk is from infection, as incisions are made in the scalp when moving hair from a donor site to the bald area. 

Dr Farjo and the ISHRS add: “Black market clinics with little or no medical expertise may avoid the costs of required disinfection procedures which, in regulated clinics, reduce infection risks.  

“Perhaps one of the most troubling areas of black market cost cutting is the violation of regulations forbidding surgery patients from being operated on in the same room simultaneously, in order to avoid cross contamination of blood-born infections such as HIV and Hepatitis C. 

“Reports of industrial style clinics or ‘mills' with patients lined up side by side during surgery, pose tremendous cross contamination risks that won’t be revealed for years if they occur.

“In one reported instance a rapidly spreading scalp infection caused the loss of a patient’s eye.”

You could also end up with harrowing areas of rotting flesh, as blood supply to the skin is compromised, resulting in dead tissue. 

To stay safe, these are the questions Dr Farjo says you need to ask before parting with your money: 

Is the clinic or doctor being advertised legally licensed to operate? 

“You can check this by contacting the local or regional authorities. Meanwhile the ISHRS runs a global ‘Find a Doctor’ service, listing member surgeons throughout the world. These surgeons abide by an international code of conduct. If a clinic isn’t properly licensed, it will also not be insured.”

Who will actually be performing my surgery? 

“Some clinics are ‘fronted’ by what appears to be a respectable surgeon or physician. But the actual job of performing the surgical part of the transplant is then delegated almost entirely to a ‘technician’ who does not have medical licences or any surgical training. We’ve seen cases where taxi cab drivers are moonlighting as ‘technicians’, with predictably awful results.”

Who will be designing my hairline? 

“Your actual hairline needs to be properly designed, planned and executed. There’s a huge gulf between someone trained in medicine, psychology and aesthetic appearances and an untrained technician who simply wants to finish the job and move on to the next patient.”

How experienced is my surgeon or technician? 

“A common problem is overharvesting of the donor area. Patients are left with a ‘moth eaten’ look at the back of the head, as well as extensive scarring and permanently reduced hair density, because the technician has actually taken too many grafts. Too many punch holes in the donor area - where hair follicles are extracted - and placed too close together can actually compromise blood supply to the remaining skin, resulting in necrosis.”

What does my surgeon actually look like? 

“How will you know if the person supposed to be performing your surgery is who you think it is? Usually it should be the same doctor who consulted with you previously, and they should be featured clearly in the clinic’s website and literature.”

Will there by proper after care? 

“Patients should have the psychological impact of their hair loss assessed, should be counselled on the medical management of genetic hair loss, and should take into account the implications of ongoing hair loss - factors that are often not prioritised when seeking cheaper alternatives as part of medical tourism.”

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