Who can perform the excision of hair follicles during an FUE procedure?

If it truly was a technician (e.g. MA-medical assistant) performing the FUE (the actual punch incisions not the physical removal of the graft) than this is illegal.However,if a Physicians Assistant (PA) was performing the punches than that is legal and within the standard of care.

FUE harvesting or cutting of the skin should be performed by a licensed doctor.  It is illegal for techs to do the surgery.  Techs usually insert the grafts into the incision that the doctor made.

It is illegal for anyone other than a surgeon to perform FUE extractions or incisions for sites. It normal practice for hair technicians to place grafts into pre made sites. Unless you had the procedure performed 'on the cheap' abroad this is gross medical negligence. Unfortunately the internet is littered with clinics in certain countries who offer discounted surgical procedures with the surgeon popping in for 15 minutes and leaving a surgical procedure to someone who has no medical background to perform the procedure. Hair transplants are life changing procedures but in the wrong hands they can be life threatening. 

Only physicians should be performing surgery.  If you have a consult or schedule a procedure with a clinic that delegates the surgical extraction of tissue then this is a violation of state law, and should be reported to the state medical board.

When researching your doctor for your hair restoration procedure, it is extremely important to ask during your consultation who does the harvesting of your grafts. Does the surgeon do the FUE harvesting? Does the Physician assistant? Does a technician?At Alvi Armani Dr. Baubac personally does all the harvesting for the procedure. This is a very important aspect of the procedure and is critical to a good outcome. 

Removing the grafts can be one by a physician or, in some states, a physician assistant or nurse practitioner under supervision of a physician (who does not need to be present in the room) but not by a technician.  A physician also has to make the openings for the grafts, but it is pretty standard to have technicians do the actual placing.

It's pretty common for technicians to place grafts into the incision sites, but it is not normal (or even legal, in most cases) for technicians to extract the grafts themselves in an FUE procedure.

In Canada, many doctors have technicians performing FUE. In my opinion, and the opinion of The International Society of Hair Restoration Surgeon (ISHRS) , FUE should only be performed by qualified physicians. It is illegal in most States in the US for technicians to perform this procedure. Physicians should not delegate this task!!!!!!!!
Dr. Robert Jones

It is illegal for a non-physician to perform FUE, certainly in New York State and at least 49 of the states.  The doctor should lose his license if he delegates this function to a non-physician. The law is clear on this.