Dear aquanda, Thank you for posting this question. The short answer is that in most states, including California, a Neograft technician harvesting grafts is straight-up illegal, and the doctor who allows this to happen in his or her clinic could very well be putting their medical license in peril. Technicians are not permitted to pierce skin with any instrument, and skin is most definitely pierced in the course of an FUE procedure. Physicians must undergo rigorous medical training, which I think is obvious to most people. Just how much training may not be evident. After college and after medical school (4 years), doctors must choose specialty training. I spent 7 additional years after medical school receiving sub-specialty training in ear, nose and throat surgery and facial plastic surgery. There are many aspects to a surgical procedure, not merely the harvesting of follicles with an instrument. Hair restoration surgery is surgery, with all the attendant risks of any office-based surgical procedure, and that’s why only doctors may perform surgery. Not technicians. Hair restoration technicians, including the Neograft ones, have the exact same medical training requirements for their job as the guy who cuts the grass outside my office: absolutely none. Quite literally anyone who wants to be a hair restoration technician may call themselves one at any time. Finding work is not hard as most doctors who offer hair restoration do not have a full time staff of technicians, but rather rely on independent contractors, like the Neograft technicians. Problem here is how do you know how much experience a technician has? How good are they? Impossible to know if you have new ones showing up every other week, as the results of a hair restoration procedure take a full year to manifest, and often the techs are long gone. In looking for a surgeon, it’s a good idea to make sure your surgeon practices only hair restoration surgery, and hasn’t recently added hair restoration to a long list of cosmetic procedures they already offer. Look for a long track record of success in the field. Also, make sure the before and after photographs are from your surgeon, not provided to him by companies like Neograft. That happens all the time. Finally, it’s important that your surgeon offer both FUE and the linear FUT procedure. If only one or the other is offered, that’s a HUGE red flag for any hair restoration practice. If only FUT is offered, the practice is well behind the times. If only FUE is offered, they are likely very new to the field, and it’s possible that the surgeon recently acquired a Neograft machine and wants to get a return on his investment for the device, and so will start to offer hair restoration surgery despite never having performed an FUT procedure, which remains the gold standard in hair restoration today. It’s not only my opinion that FUT remains the gold standard in this industry, it’s the opinion of the International Society of Hair Restoration Surgery (ISHRS). The FUE method is a specialized method for those who want the option of wearing shorter hairstyles in the future, but due companies like Neograft selling these expensive instruments to doctors who previously did not offer nor perform hair restoration surgery, many doctors are pushing this method of hair restoration surgery. It’s just the economics of what’s happening in the field of hair restoration surgery today. I hope this information is helpful to you. Kind Regards, Ken Anderson, MD, FISHRS