Not so long ago, there was a certain degree of secrecy and shame involved with undergoing a hair transplant. Men who had a procedure didn’t want anyone to know – although the outcome tended to be obvious, as early techniques were crude by today’s standards. Now, hair transplants have gone mainstream, with men from all walks of life open about having had a hair restoration procedure, or actively seeking one. Improvements in technology allow results to have the appearance of natural growth, encouraging more men than ever to pursue their goal of a fuller head of hair – and the accompanying boost in self-confidence they expect.

However, the advanced state of hair transplant surgery has inadvertently led to abuse by those looking for a quick profit. Considering that hair transplants constitute a $53 billion dollar market worldwide, the incentive to do so is great. Black market Turkish hair transplant clinics and cosmetic surgery practices that utilize a robotic device operated by non-medical technicians are among the foremost bad actors. In a highly publicized case, the owner of a surgical center in Virginia Beach, VA, was arrested in 2023 for performing hair transplants without a license.

Dr. Marco Barusco Advocates for Hair Transplant Patients

Because such unethical clinics and practices continue to thrive, often causing irreparable harm to patients, Dr. Marco Barusco – Founder and Chief Medical Officer at Tempus Hair Restoration – has become a tireless advocate for educating consumers about their risks. In his three-part YouTube podcast series – “The Current State of Hair Transplant Surgery” – Dr. Barusco provides his unique perspective as a leading hair restoration surgeon on why the situation has become so hazardous, why consumers need to take it seriously, and how they can protect themselves.

“One positive factor is that hair transplants are now mainstream,” says Dr. Barusco. “On the negative side, a lot of surgeries are being performed incorrectly. Right now, we’re seeing challenges in patients that have been really hurt by inexperienced people – unlicensed people. It’s been a dangerous thing.”


Part two of the series – “Pictures and Explanations: When Hair Transplants are Not Done Well” – features Dr. Barusco discussing photos of botched transplants with podcast host Peter Roman. Patient photos were provided by the International Society of Hair Restoration Surgery (ISHRS) from its ongoing consumer education campaign, Fight the FIGHT (Fraudulent, Illicit and Global Hair Transplants). The graphic photos of disfiguring results are of black market Turkish clinic patients. Dr. Barusco is a Fellow of the ISHRS – a distinction held by fewer than 10% of ISHRS members – and is highly involved in its Fight the FIGHT effort.


In part three of the series – “Do It Right or Don’t Do It At All” – Dr. Barusco talks with Roman about how cosmetic surgery practices add hair transplantation with robotic devices operated by unlicensed technicians. Says Dr. Barusco:

“What they [the robotic device manufacturer] do is go to a plastic surgery conference and buy an exhibitor’s space and set up with the machines and some sales people. They tell the surgeons, ‘Look, you can add hair transplant surgery to your practice. It’s a 50 billion dollar industry you can get a piece of. Just buy my machine. You don’t have to do anything. I will send the staff to do the procedure for you, and do the advertising.’ So it became very popular.”

However, Florida and other states in the U.S. have passed legislation which deems that harvesting hair and making incisions on a patient are functions that only a physician, a Physician’s Assistant (not the same as a technician or nurse) or a Nurse Practitioner are allowed to perform.

“If you don’t see any of them in the room, the surgery is being done illegally,” says Dr. Barusco. “Technicians and any other such individuals are practicing medicine without a license, and the doctor who allows them to do it in their practice is also aiding and abetting the illegal practice of medicine and may lose his or her medical license and/or face felony charges.”

Of course, the patients receiving bad outcomes may have to live with the result – and Dr. Barusco has consulted with far too many such people.

“I meet with patients almost every day who have trusted doctors and practices because they had these devices, only to find out later that they would need me to fix what’s been done to them. And what is even worse, is that these patients are coming to me not only with poor results on their hairline, but also scarring and thinning of their donor hair [the limited supply of permanent hair used for transplants] caused by taking too many hairs with incisions that are too close together and/or larger than they should be.”

How the FUE Helped Pave the Way for Bad Hair Transplant Practices

The vast majority of abuses in hair transplant procedures involve the popular follicular unit excision (FUE). Why? Because of the manner in which the procedure is performed. Follicular units (hair grafts) in groupings of one, two or three hairs are individually extracted from the back of the head (donor area) using small circular punch blades instead of a scalpel. The grafts are then transplanted to the thinning or balding areas of the scalp. Once the desired number of grafts are obtained, the donor sites are left to heal without suturing. When performed properly by an experienced, licensed hair transplant surgeon, the resulting scars are not readily visible and are easily concealed even by very short hair.

In the follicular unit transplantation (FUT), a very small strip of hair and skin is harvested from the donor area, then placed under a microscope to be prepared for implantation as hair grafts. The donor area is then closed with sutures. The FUT has undergone refinements over the years so that the only evidence is a pencil-line linear scar easily concealed by hair – even at a shorter length. As the FUT can only be performed by a surgeon’s hands, this procedure cannot be performed by a robotic device or unlicensed staff member operating a punch. The deceptive ease with which the FUE can be performed has, unfortunately, opened this procedure to widespread abuse.

How to Make Sure You Choose the Right Hair Transplant Surgeon

As we hope you’ve learned, today’s state of hair transplant surgery allows those who are an appropriate candidate for a procedure to achieve outstanding results – but only if you choose a licensed surgeon who specializes in hair restoration procedures. Looking for a hair transplant at a bargain can lead to disaster, as Chris, a victim of a Turkish black market hair transplant clinic, relates:

“Before choosing a hair transplant clinic in Turkey, carefully consider the consequences of making a poor decision. The repercussions can haunt you for the rest of your life, with little opportunity for correction or repair … Believe me when I say that the losses incurred from choosing the wrong place extend far beyond hair and money.”

In beginning your search, the ISHRS website is an ideal place to start. It provides consumers with unbiased information on a wide range of issues – including how to be sure that a properly trained and licensed physician performs your hair transplant procedure, questions to ask during your consultation and many others.

We also invite you to visit Dr. Barusco’s YouTube channel, Hair Loss Medical Advice, where you can learn as he discusses such issues as the types and causes of hair loss, hair transplant procedures, and much more. And of course, our blog features informative posts, updated every month.

Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach.

Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Author: Tempus Hair Restoration