The maths nobody does before booking.

Quick answer: A hair transplant takes most of a day, so one surgeon can do one or two. Look up how many a clinic says it performs, divide by the number of surgeons, and you will know roughly how much of your procedure a doctor will personally carry out. This is not a scandal. It is how most large clinics work. The problem is that almost nobody tells you.

Before I had my first hair transplant I watched a lot of videos, read a lot of pages and compared a lot of prices. I never once worked out how many hours were in the day.

Start with how long it actually takes

A hair transplant is not a quick procedure. Between the consultation, the hairline design, the anaesthetic, the extraction of every individual graft, the creation of the recipient sites and the placement of those grafts one at a time, you are looking at most of a working day. Larger cases run longer.

So a single surgeon, working properly and without cutting anything short, can perform one, perhaps two procedures in a day. That is not a controversial figure. It is just what the work takes.

Now do the sum

Take any clinic you are considering. Find the number they publish: procedures per year, patients treated, operations completed. It is usually on the homepage, because it is meant to reassure you.

Then find how many surgeons they have. Also usually published, often with photographs.

When you run that sum on a real clinic, you are not uncovering a scandal. You are working out something the clinic already knows and simply has not told you: how much of your procedure a doctor will personally perform.

Two different jobs, one photograph

The confusion is usually not a lie. It is a job title doing double duty.

Both are real roles and a clinic needs both. But when a doctor's face appears on every page of a website, most patients assume the second and are shown the first. Nobody has to say anything untrue for that to happen.

Where technicians come in, and where the real risk is

In most hair transplant clinics, in Turkey and elsewhere, a good deal of the physical work is performed by technicians rather than by the doctor. That is normal and it is not, by itself, a problem. An experienced technician who has placed grafts every day for years may well do it better than a surgeon who does it occasionally.

So the useful question is not are technicians involved. They almost certainly are. The useful questions are these.

• Which parts do they do? Placing grafts into sites a surgeon has already created is a different matter from creating those sites in the first place. The incisions determine the angle, the direction, the density and the hairline. That is where your result is decided.
• Who trained them, and how long have they done it? "Highly experienced team" is not an answer. A number of years is.
• Is the surgeon in the room? Not in the building. In the room, for the parts that decide the outcome.
• How many patients are being treated at once? A doctor overseeing three simultaneous procedures is doing something different from a doctor overseeing one.

What to ask, and what a straight answer sounds like

Three questions. Ask them in writing, before you pay a deposit.

• Who performs my consultation, hairline design, extraction and implantation? By name where possible, by role where not.
• Will the surgeon be present for the incisions?
• How many procedures does the clinic perform in a day?

A good answer is specific and unembarrassed. Something like: the doctor performs the consultation, the hairline design and the incisions, and a team of technicians with a stated number of years of experience carries out the extraction and placement under supervision. That clinic has told you exactly what happens and has nothing to hide.

A bad answer is not a confession, it is a deflection. "Our medical team." "All our staff are trained professionals." "Dr X oversees every procedure." Those sentences are constructed to be true regardless of what actually happens in the room.

And a clinic that will not answer at all has given you the clearest answer available.

Why I did not do this myself

I am a registered nurse. I had spent years in this industry before I ever booked my own procedure. I still chose my first clinic from a website and a price, because the results looked good and everyone I spoke to was pleasant.

It did not occur to me to ask who would be holding the punch. Not because I was careless, but because the question is not one the industry invites, and once you have decided you like a clinic you stop looking for reasons not to.

That procedure failed. The extraction left permanent scarring across my donor area, which meant the surgeon who eventually fixed it had less to work with than the one who caused it.

The second time I asked all three questions, in writing, before I paid anything. That is the entire difference between the two.

Applying it to my own network

It would be easy to publish this and quietly not apply it. So, plainly: every clinic I work with has to answer these questions in writing before a patient books, and I ask them myself before the clinic is listed at all.

If I ever tell you a clinic meets that standard, ask me to show you what they said. If I cannot, do not take my word for it either.

Frequently asked questions

This is general information, not medical advice. Every case is different and a qualified clinician should assess yours.