(THE STATE OF MODERN DAY HAIR TRANSPLANT IN INDIA, TURKEY & THE WEST)
“You do not have to be a hair transplant surgeon to make money! Buy a gun and rob a wagon!”
Honest advice by a patient on a famous forum to a clinic in East Europe that is almost solely run by technicians under the supervision of a dentist.
This conveys the condition of the hair transplant industry today without mincing words. I have never before come across a more disgruntled patient who ever received a hair transplant. He was listed for surgery with me and at the last minute when he was packing his bags to be here in Chandigarh for a hair transplant, received an alluring call from a lady counsellor in East Europe giving him 50% off the package and including 3 nights’ stay in a nearby hotel.
Of course he fell for the red herring and paid a price by grudgingly footing a bill of over of Euros 7500 as hospital bill when his hospital treatment ordeal was over. He had developed profuse bleeding from the scalp donor which started at around midnight the same day of the procedure. The Clinic phone was switched off. A doctor was called by the hotel and he was shifted a nearby hospital emergency. A few bleeders were cauterised and his condition was stabilised. He then stayed in the hospital for one more day under observation.
Six months later he has a wispy area where fine hair have grown in patches; and the donor area looks so ugly he does not like turning his back to anyone. He says for the first few months he was so shattered, he would reach the office first and leave last so his workmates do not get to see his scarred donor!
This is what impulsive behaviour in seeking irrational discounts can do to you.
A bad hair transplant ordeal can sap you emotionally. It can destroy your life and relationships than nothing else we have seen. Though cosmetic surgeries are controlled by the State under strict regulations since they are done in a hospital setting, nfortunately, no one is setting any rules for hair transplant. Salons, Spas, and Hotels are offering hair transplants without any fear.
A holiday company in India offers a free hair transplant with a 7 day sojourn on a Sea Cruise. Matters have come to such a pass that fantastic advertisements are all over social media.
With so many freebies thrown in, it is getting to sound suspicious how these clinics can ever meet their bottom lines.
So a team of doctors from my region, visited a few clinics in India that offered huge discounts like INR One for a hair transplant!
The first clinic we visited was run in a shanty structure the reception of which smelt like a dung-heap. The doctor came out of a cabin with bare chapped, dirty smelly feet as if he was emerging from an underground dungeon in the Great London Plague! Without seeing the donor area, he began to discuss how he will take 6000+ scalp grafts and 1200 body grafts to cover the whole head. My friend asked him for his degree and registration which the doctor evaded. He was hesitant to show us the operation room. It really put us off. The price he quoted for a full hair transplant was a mere INR 35000 (USD 500) for a ‘head full of hair’. He showed us a tattered album with before and after pictures. Very familiar pictures that one sees daily on searching the term ‘hair transplant’ on Google adorned his album and he showed them to us with overtly misplaced pride.
The next clinic we visited was in a posh locality in South India. There was no doctor in attendance when we visited though 3 surgeries were simultaneously going on. We were told the doctor remained on call and turned up on the morning of the procedure for 2 hours just to ‘supervise’ the procedure. We were offered to speak with him on the phone. The assessment was done by an unkempt technician of doubtful pedigree and demeanor with long nails with trapped dirt.
So much for sterility during the procedure!
The cost of hair transplant offered was INR 40,000 for ‘unlimited number of grafts’. What this number was when translated into specific graft numbers, no one could answer.
THE NADIR: HAIR TRANSPLANT INDUSTRY IN DISGRACE
The downfall of hair transplant services the world over started as early as 2012 when the international body ISHRS, contemptuously derided FUE hair transplant.
By design, very few discussions or talks were assigned to this budding speciality in those formative years of FUE hair transplant. Junior doctors wanting to add hair transplant to their repertoire went home with the impression that FUE was a cheesy speciality to be in. It was made out to be unfashionable and a disasterous undertaking for any beginner wanting to invest in the future. This constant debridement assumed the ogerous dimensions everyone loved to hate.
What followed was the undoing of FUE as we saw it in 2012 when it was still a respected field in the eyes of its practitioners. The period 2012-2015 was crucial in the learning phase of FUE aspirants. But they were missing! The very politicians of the field of hair transplant that opposed FUE, formed a Research Committee and sought to teach what they hated the most. During this interregnum, the demand for the ‘scarless’ technique skyrocketed and there not being enough doctors available to meet this huge demand. They were not interested in the field since most beginners were brainwashed into believing that FUT was there to stay. For they had been convinced it was the Holy Grail for the community.
One year is a long time in the field of hair transplant.
A lot of clinics trying to keep pace with the soaring demand started to train their technicians in harvesting techniques. Their techs were already well versed with plantation. It was just a matter of time when they realised that they could be independent operators and did not at all need to be working full-time in a doctor’s clinic. Many started freelancing or moon-shining from clinic to clinic. Doctors would rent out their ORs to them at a fee and patients would feel safe under the umbrella of a doctor in the establishment. As far as hair transplants went, these doctors were completely wet behind their ears. They rarely visited the ORs since they had their own running practice to take care of. A mere signboard promoting their new department at the reception would get patients by the loads. As time went by, these technicians became largely well to do and prospered; and in 2016 a technician from Ludhiana invested in and opened his own clinic. This was the first such clinic in India. Ever since it has served as a model and many such have been cloned all over the country and in South Asia as a region. These techies simply hired a doctor under whose name and overall responsibility hair transplant operations were done. More technicians were hired and in crowded premises of one or 2 rooms, 10-20 cases of hair transplant were done in day/night shifts. The hired ‘umbrella’ doctor was paid INR 2 per graft, the same fee per graft the technician had charged the doctors for whom he worked, a mere 2 years ago!
This brought in a bad name to the industry. Money became the sole motive for such clinics. Many such clinics opened later and today the number of such clinics in India outweigh specialised hair transplant only doctor clinics by a ratio 8:1. Not good tidings for the health of an industry which was already reeling under intense competition amongst doctors.
Today it is estimated that 3450 hair transplants are done in India every day of which 98.5% are FUE. Of these 82.2% are performed in doctor supervised clinics. The number of doctors devoting themselves solely to hair transplant is fast dwindling.
The industry’s scarred face can be seen every other month when one or the other mishap is reported from one corner of the world or another. The story of the Mumbai businessman who died getting an off-hour cheap hair transplant in a spa, the Pakistani actor who got a hole in his head when the scalp necrosed after a hair transplant and the much-maligned surgical center in West Europe where a patient died on the table are not very encouraging episodes when a patient is doing research on hair transplant. Google loves to bring these events on the first page of a search for the term ‘hair transplant’.
Today, patients are so scared that the first thing after you draw the hairline is their question – “Doctor, tell me what are the Side-Effects of Hair Transplant?”
The number of repair patients clinics receive are mind boggling. They comprise over 35% of my practice today. There is not much we can do in most cases with denuded, overharvested scalp donors. Mostly these hapless patients are in their 20s and quite a pathetic sight. One can only sympathise with them after hearing their horror stories during the procedure and the recovery period. Not a good sign for a medical field usurped by unlicensed, unethical and often desperate operators.
The space which was hither-to-fore maintained by ethical surgeons who devoted their entire lives refining and furthering the procedure of hair transplant in a scientific manner has been trespassed.
“Personally, I feel it’s extremely important that patients, both young and old, have the opportunity to know which clinics are safe, and the ones that have no clue what they are doing. It’s a minefield out there and the buyer needs to be aware.” Honest words by Spencer Stevenson, a Top Hair Loss Mentor, but in vain.
The patient today is blinded by the neon lights of excessive advertisement. He is being sold a dream. A dream that comes crashing down the moment money changes hands! Patients are hopeful and they are gullible. Both a cocktail for Disaster. You can only research once. And since your first hair transplant is often your last in this industry and you can never return, the hair mills continue to churn away.
Every time a new advertisement attracts hordes of patients like insects to a porch light.
The Question that looms large in the horizon as the sun sets on ethical hair transplants is: “ In this era when white collar crime is rampant in this industry, who can the patient trust?!”