I've never heard of techs making recipient sites. This would be completely unacceptable. In my opinion, it's also completely unacceptable to have techs doing extractions. They are not licensed to do surgery. In many states, I believe this is illegal (the practice of medicine by a non-physician) however the laws may vary by state. In a strip surgery, the doctor removes the strip of donor scalp and gives it to techs, who sit at workstations with microscopes* dissecting the grafts. But with FUE, some clinics have the techs harvesting the grafts directly from the patient's scalp, which is surgery, plain and simple. A medical tech certificate only requires 2 years of college, and they are not licensed to operate on patients. Techs aren't even legally licensed to inject anesthetics! Notice how the doctor is the only one administering your injections? Yet some doctors have techs making incisions into your scalp, and removing scalp tissue. This is very likely illegal.
Also, from a consumer's standpoint, there is simply no way to know how much experience a medical tech has, or how skilled they are at doing graft harvesting (experience doesn't always mean ability, but it probably helps). You choose a clinic based on the doctor's reputation, and then unskilled workers do a majority of your surgery -- it's a farce! When Dr Cole did my surgery, he had medical techs do most of the graft harvesting. Dr Cole would leave the room for 20-40 minutes at a time, leaving the techs working unsupervised. The techs did most of the harvesting and about half of the graft implantation. The only thing that Dr Cole did by himself was create the recipient sites (which he does extremely quickly, as do most doctors, from what I've seen and experienced). They don't stand there agonizing over where to put each graft, they jab your scalp rapidly with a needle, and that's how the recipient sites are made, in most cases. The only exception would be Dr Woods and Campbell, who only create a few recipient sites at a time, and only at the last moment, when they have harvested a small number of grafts (in order to avoid minimize having grafts sitting around outside the body as much as possible, and to have recipient sites as fresh as possible). As I documented in my thread here, my surgery with Dr Cole was virtually a total failure. But it was very cost-efficient for Dr Cole!
Also, the concept of "artistry" is IMO over-blown, when it comes to vast majority of doctors. They're not artists. They are following a template, coloring within the lines, so to speak. "Artistry" is marketing BS that they use to promote themselves.
*(not all clinics even use microscopes to dissect the strip! They use inferior magnifiers or jeweler's loupes instead. "Do you use microscopes?" used to be a key question to ask, and still is, in some clinics.)
