Expert guide: Cosmetic & Plastic Surgery 2015 12 June 2015 June 2015 13 H air transplant surgery is be-coming increasingly popular in the UK, not only amongst men with male pattern hair loss but also amongst women with female pattern hair loss and patients of both gen-ders seeking eyebrow augmentation and – to a lesser extent – eyelash, beard and moustache transplants. The procedure is also suitable for other conditions with hair loss (alo-pecia) such as congenital temporal triangular alopecia and cutis aplasia, traction alopecia from tight braids or weaves, and scarring alopecia from burns, surgery and accidents. Some causes of hair loss from dermato-logical conditions can also be treat-ed with a hair transplant and, as the public become more aware of the surgical options available to them, the numbers of hair transplants car-ried out annually will continue to grow.When performed by a skilled and suitably trained hair transplant sur-geon, the results should be entirely natural looking, with only an expert able to differentiate transplanted hairs from naturally occurring ones. However, a poorly executed hair transplant can, at best, have limited or no hair growth and, at worst, have significant numbers of hairs growing at the wrong angle or direction – with an inappropriate transplant de-sign leaving the patient aesthetically disfigured.Picture Caption #1: Traditional Strip Follicular Unit Transplant (Strip FUT) donor hair harvesting from the back of the head with the patient sitting.Traditional referral routes were by word of mouth from patients who had surgery with a particular doctor, or by GPs who knew of the doctor by reputation. With the advent of the internet, website advertising has be-come the standard and viewers of-ten make an initial judgement on a doctor or clinic based on the quality and appearance of their website. It may be surprising for many to find that there is no formal training in Hair Restoration Surgery in the UK and very few, if any, follicular unit hair Greg Williams FRCS (Plast)dr.greg@farjo.com +44 (0) 845 313 2131 The Importance of Knowing Who Is Doing Your Hair Transplant Procedure By Greg Williams MBBS, FRCS (Plast) President, British Association of Hair Restoration Surgery united kingdom transplants offered in the NHS. Most doctors wishing to learn the proce-dure do so by attending education-al meetings, observing established practitioners in the private sector, going on short ‘hands on’ courses, or engaging in apprenticeships that do not result in a recognised qualifi-cation. There are only a handful of fellowships on offer in the world and the majority of these are in the USA.It might also be surprising to find that the only qualifications required to perform a hair transplant in the UK are a medical degree and active registration with the General Medi-cal Council. Following the PIP breast implant scandal, the Department of Health is looking to increase the regulation of the entire cosmetic surgery industry, while Health Edu-cation England is overseeing the pro-posed future training requirements for Hair Restoration Surgery ¹ . So how should a prospective pa-tient currently choose a doctor to perform their hair transplant?Picture Caption #2: Follicular Unit Ex-traction (FUE) donor hair harvesting with the patient lying face down Research Most established hair transplant surgeons in the UK will be members of the International Society of Hair Restoration Surgery (ISHRS)² but the entry criteria does not require any proof of skill or number of cases un-dertaken annually. Senior members are recognised by the status of ‘Fel-low’³ , but this demonstrates duration of membership, attendance at scien-tific meetings and a commitment to education, journal publication and contribution to national and regional hair transplant societies, rather than clinical ability.The British Association of Hair Resto-ration Surgery (BAHRS)4 is modelled after the ISHRS; In addition, mem-bership is categorised according to activity with Full Medical Members performing hair transplants regu-larly5. However, there is still no re-quirement to demonstrate any out-