There is a low barrier entry into performing hair transplants both in the UK and abroad.

Dr. Manish Mittal is a well-established London-based hair transplant surgeon. He receives more than a few patients who went abroad for their procedure and have not spoken to a doctor during the whole process. This raises a red flag.

He is seeing a growing number of bad results when people come to him for a repair.

Repair cases have grown from 10% in the past to 40% this year.

He gets frequent calls asking the difference between a £2K or £3k quote abroad versus his £7k to £10k price range.

Clients often choose based on the lower price offer, thinking what’s the worst that can happen?

He mainly sees poor use of hair follicle grafts, those that are transplanted from the back of the head to the balding area.

The donor area is finite and can only give so many grafts. It cannot be revisited, and grafts have to be carefully placed in the balding area. Repair jobs are never as good as the original.

This is why it is much safer to have your procedure in the UK in the first place.

Dr Mittal gets repair problems worldwide, not just in any one country.

The overseas model operators will work on 4 or 5 clients in a day, with the number of grafts being the target. The more grafts, the more they charge the patient, which leads to poor results.

They frequently use unskilled people they call technicians. Legal standards are far lower abroad than in the UK. Here lies the risk you take if you are attracted by those low-cost packages.

Dr Mittal will only work with 1 client per day.

Some of the £7k to £10k quotes by certain London clinics are often technicians in a clinic using the overseas model. In many cases a doctor applies the anaesthetic and leaves the technician to get on with it.

Dennis, a recent patient, had a bad hair transplant after his trip overseas.

He had had his procedure carried out by a well-known clinic there.

Not being happy with the result, he saw Dr Mani, who arranged three sessions to fix things up.

“Originally to restore the front hairline, he only needed 2,000 transplants, but the overseas clinic took 4,500 grafts from his donor area. After doing the front hairline, they randomly placed the remaining grafts to use up the 4,500, and charged accordingly,” said Dr Mittal.

The main issues in this particular case were:

1. The hairline alignment was too low. Hair transplants must not be placed below the frontalis muscle.

2. Transplants on the hairline should only be 1 follicle to achieve a natural look because they are the most visible.

Dr Mittal found transplants of several follicles on the hairline, which he needed to remove.

Dennis’s 3rd and final visit was to have removed, a final batch of 500 randomly placed plugs.

In the case where the donor area is harvested, there is a limit on how much Dr Mittal can do.

The result of this is that instead of doing an original procedure in the £7k to £10k region, patients end up needing to spend an extra £11K to £20k for a correction procedure, which is much more expensive and can never be as good.

It can be a false economy to be persuaded by those alluring ads offering 5-star accommodation with a seductive low-priced hair transplant offer.

Part of Dr Mittal’s process is to counsel patients beforehand.

He has to give an idea of what can be achieved, but wants to hear the patient’s expectations.

The result of a repair will never be as good as coming to see a UK-based and fully qualified hair transplant specialist for two reasons.

– There will be some scarring with a repair.

– The final cost is much higher when a repair is needed.

In some cases, Dr. Mittal has had to refuse to treat the patients because of such a previous treatment.

Many GPs in the UK want to carry out the procedure because of the fees involved, and currently, from a qualification standpoint, they can do this after having seen it performed a few times.

Worse than this are those technicians abroad who are not medically qualified in the fine art of hair transplantation. Some such technicians are also at work in the UK.

Dr Mittal says “always ask these questions and watch out for these red flags when you talk to a clinic”:

– Who is performing the transplant?
– What is the doctor’s name?
– What is his involvement in the procedure?

Sometimes, doctors perform the anaesthetic and then give it to a technician to do the actual job.

The technician can be anybody from a beautician to someone who works in a supermarket and has had minimal training.
Often that person is not even licensed.

Some operators in the UK also work this way.

Raising a complaint with an authority

The complaint has to come from the patient because the General Medical Council will say, “If the patient is happy, there is nothing we can do”.

Many patients are not sure of what they are getting into when they sign up for a procedure.

If you ask a GP what the outcome can be and he says he has never had a bad outcome, then he is not telling the truth.
All surgeons have occasional bad outcomes.

Dr Mittal had a patient bang his head on the taxi door, which caused an infection.

He dealt with it and fixed it up, but an experienced surgeon would not say that he had never had any bad outcomes. That is a red flag.

Dr Manish Mittal practices at the Mittal Hair Clinic, London.

W: Mittal Hair Clinic