The main reason I might encourage eyelash transplant surgery is for people whose lashes have been damaged to trauma, medications, or other incidents, or possibly premature/permanent fall-out of the lashes. Here is why (for cosmetic reasons) I would NOT recommend it.
1 - Lashes are taken from your head hair & sewn into the lash bed. The hair of your head is programmed to continue growing, so it means routine maintenance for those lashes. Otherwise they'll end up looking like curtains. Secondly, if you have curly hair, you'll end up with elephant looking eyelashes hanging down over those peepers.
2 - Eyelash transplant surgery can't really be customized. As a spokesperson for the eyelash extension industry, I know that I personally have over 200 options in colors, lenghts, thicknesses to choose from when I design someone's eyelash set. I can use thick lashes, I can use thin lashes; I can decide how long a lash needs to be and where it needs to be placed. With lash transplants, you can't really control how they grow, their shape, nor their design. Furthermore, it's like going to your heart surgeon and asking him to style your hair for the day. From a creative standpoint, it's simply not the same.
3 - Certified, and highly skilled lash technicians are creative, they have flair, and usually apply 60, 80 to 100 lashes PER EYE. Lash transplants usually include 30-40 or 50 hair folicles removed from the back of the head for both eyes. That's only 15-25 lashes per eye. NOT WORTH IT IN MY BOOK.
4 - EXPENSE. Eyelash transplants average about $3,000 per eye.
I had a client who had the transplant surgery, and the doctor only applied about 20 lashes per eye. Not to mention she naturally has baby fine (CURLY) hair so the surgery looked nothing but ridiculous. I told her, "Gina, I do a minimum of 60 lashes per eye when I apply a set of lashes - not to mention, they are beautifully designed ranging from short lashes to longer lashes."
To sum it all up, the expense, the pain, the lack of beauty, design and flair, are all reasons I personally recommend NOT having the lash surgery done. But what do I know. I have only applied a few thousand sets of lashes in my day.