This is a video about unethical surgeons in South Korea, but there is a part (18 minutes in) that is relevant to this thread:
The point she makes is that popular private surgeons don't make their big money in the OR doing actual surgery, they make it in the
consultation rooms, signing up patients. The experience they provide during the free consults is what hooks the patients and gets the surgeon their fees. So that's what surgeons prioritize (in some cases in Korea, to the extent that they often delegate the procedures to "ghost surgeons" so they can spend more time doing profitable consultations).
The rotdog butchers seem to have a similar MO. They don't put much time and effort into improving surgery techniques, because that's not what makes them money. What makes them money is giving false hope to the vulnerable young women who come to their clinics wanting to be told they can change sex.
And they are very good at that part! Look how many of the girls follow them around like lost ducklings even when their fake dicks are decaying and they are in the hospital with sepsis. "My phallus fell off in the shower and there are maggots in my skin graft site, but Dr. Dickmulcher's office has been
soooo nice and helpful and we are going to do a repair surgery next week!!

" It's a target-rich environment for sociopaths.