If you're considering this, what I learned during my hair transplant journey may be useful. There are a variety of surgical techniques to address hair loss including different kinds and degrees of transplants and scalp reductions. Most hair loss progresses over many years until it eventually reaches a stable state. A big part of getting optimal results is identifying your kind of hair loss, where you are in the progression and correctly estimating how it will continue - then matching the proper technique or combination of techniques.

Some less-than-ideal outcomes are from mismatching the procedure(s) to the patient or doing too much too early in the loss period. If the progression occurs differently than expected after the procedure the outcome can become unbalanced. A few patients can be one-and-done but for many patients multiple steps over time can increase the odds of optimal outcomes. Generally, you should NOT push for one-and-done unless you're that rare candidate. Figuring out the pattern, progression and matching the correct plan of attack is where the experience and diligence of the practitioner matter most.

While a lot of hair loss clinics market the 'artistry' of their doctors, the reality is that performing the procedures tends to be fairly rote. My eventual outcome was great, but I totally lucked into it. It was still the late 90s when my hair loss progressed from "just some thinning" to the early stages of "have you considered a comb-over?" I went to a clinic and was told I was most likely early in a 'full loss' progression and that I'd probably need more than one scalp reduction before even starting transplants. They also advised waiting more than a year between scalp reductions for optimal results.

I was disappointed because I'd been hoping to walk in and walk out a few hours later with "Brad Pitt hair." But just having turned 30, I was feeling insecure about my hair, still dating and looking for "The One." So I signed up and insisted the surgeon "go big" on the first scalp reduction. The procedure itself was fine but the week-long recovery kicked my ass and for several months afterward my scalp felt stretched to the limit. To be fair, they did fully warn me on all this, I just hadn't taken it seriously enough. As I recovered, I decided it just wasn't worth it and gave up on the hair thing.

After it had settled for a year, the one big scalp reduction did improve things back to "just thinning" but eventually the loss progressed (as I was warned it would). But I'd already decided "it is what it is". Fortunately, it turns out when I met "The One" a couple years later she didn't care about my hair (despite being, according to my friends, waaaay out of my league) :-). Jump forward another ~20 years and my now-wife is seeing a plastic surgeon for C-section scar removal and mentions "If you still care, they do hair transplants."

Thanks to the now-ancient mega-scalp reduction, my hair never reached "full loss" but it'd stopped somewhere deep in comb-over territory. I didn't care that much but decided to do a consult anyway. Based on my unique history, the doc asked for year-by-year photos to gauge how things had progressed since the scalp reduction (photos from kid birthday parties worked well). Turns out that doing the mother-of-all scalp reductions and waiting ~20 years to reach full progression was, accidentally, the perfect plan. Now the target was clear, unmoving and reduced enough they could nail it in a one-and-done transplant by taking ALL the donor hair - which is rare. Most procedures are done on patients still in progression, but each patient only has a limited amount of donor hair, so they don't 'harvest' all of it because some will be needed later in the progression. They just don't know exactly where yet.

So I did it and ~5 years later, it still looks perfect. The procedure took most of a day but was pretty easy. The interesting part was the top-notch, deeply experienced plastic surgeon didn't do the procedure herself. It was done by two sub-contractor technicians who travel from clinic to clinic over a multi-state area doing nothing but transplants all day, every day. The doc explained its really best because they can do it very well and fast (apparently speed in parts of the procedure can improve the follicle survival rate). Of course, she checked in during the day and was on-hand in case anything went wrong. You don't need Sully Sullenberger in the cockpit on every milk run, as long as he's there on the rare flight that ends in the Hudson River.

tl;dr In my experience, once you have a skilled assessment, correctly matched procedure(s) and plan of attack, then using lower cost technicians to do the actual procedure should be fine - as long as there's an experienced back-stop available in the event of an "unscheduled water landing" (do 737s have scheduled water landings)? My only other concern would be ensuring they don't harvest too much, too early from some patients. Doing so would probably lift their 90-day customer satisfaction but at the expense of nefing 10-year C-Sat. To be fair, that could happen at pricier U.S. clinics too (my technicians had both started in those places and we got to gossiping over that long day).