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When Saying Yes Comes Before Patient Care - Robbie Williams' Unnecessary Hair Transplant

Robbie Williams has become one of Hollywood's latest to succumb to the lures of unnecessary surgery.

However, rather than the LA staples of a facelift, liposuction or extensive dental work, he's opted for a hair transplant. Not unusual in itself - in fact, it is the most popular cosmetic surgery for men - but one that made me sit up and take note purely because, in his own admittance, he didn't need the surgery.

Robbie has never been a man who I've looked at and believed he could do with thicker tresses, yet it seems that not all surgeons agree.

The clinic where his transplant was performed hasn't been named, except to say that it is in LA, but I find it hard to believe that an ethical and reputable surgeon would carry out a procedure on someone with no need for the surgery or where the surgery is of no benefit.

While I commend whatever clinic performed Williams' treatment for not using him as a promotional tool, I still find it a worry that a surgeon has agreed to perform a hair transplant on someone who does not need it. Whether that person is a celebrity or not, it is an ethically murky area for surgeons in any field.

Sadly, the temptation of garnering celebrity names to add to your CV - even if not widely promoted - can sometimes prove to be enough of a compromise for surgeons or anyone else for that matter. So, too, can the lure of financial gain, or even the inability to say 'no' to a famous face.

It's a dilemma that most medical professionals, regardless of their field, will have come across during their years of practice: how to deal with a potential patient who wants treatment but does not need it.

Essentially, there are two choices - either treat them, or don't. However, things aren't always that black and white for everyone. Don't treat the patient, and you run the risk that they will keep trying different professionals until they find someone who will - and that person may not be as thorough or capable as you are, leaving the patient open to risk. If you do treat them, you need to be sure that you are acting in their best interest by balancing their desire for the treatment with the potential risks they face by having it or not having it done.

In my opinion, the best option is to have an open and honest conversation about the risks of any surgery or procedure, as well as delving deeper into the reasons for the patient's desire for it. Hair transplant surgery is not an invasive procedure, but that doesn't mean that it is without risk, so it should never be undertaken without proper consideration. Like many surgical procedures it involves anaesthesia - albeit a local one - as well as multiple incisions. While the risk of infection is low due to the nature of surgery and the level of aftercare, that's not to say that there is no risk whatsoever, so any surgeon needs to be sure that the potential benefits will outweigh the chances that things could go wrong.

I have been a hair transplant surgeon for many years and have worked hard to put firm guidelines into place at my practice, the Farjo Hair Institute. If prospective patients don't fit into our criteria, then the team takes each on a case-by-case basis and tries and find out exactly what is driving them to have the surgery.

What I would like to see is a universal code of practice that all hair restoration surgeons agree to be bound by. Of course, versions of these exist within industry bodies such as the International Society of Hair Restoration Surgery and the British Association of Hair Restoration Surgery, but practitioners are not required to join any of these kinds of industry bodies. In that respect, hair transplant surgery is an unregulated field.

For me, the ideal future of hair transplant surgery will involve firm regulation. Rather like traditional doctors taking the Hippocratic Oath, hair restoration surgeons and their assistants should be required to commit to acting in their patients' best interests, being reviewed at regular intervals and they should know that they will be called to account if their skills or ethics come into question.

It doesn't matter whether it's a celebrity or Joe Bloggs - the patient's needs must always come first.