It is normal for patients suffering from baldness, to spend hours on the internet watching videos covering the surgical procedure they will probably undergo. These videos provide a lot of information, but certain questions remain unanswered. One of the most frequently asked among patients about undergoing a hair transplant is the following: “Is the surgery painful?”
In order to answer this issue, we first need to explain the basics of the hair transplant procedure.
For a couple of years now the FUE technique for hair transplantation has become the most popular among specialists and patients, due to its ability to reduce perceived pain and increase comfort levels. Apart from this technique, there are many others we will see later.
By retaining the FUE hair transplants technique and adding to it the use of a Choi implanter pen, another technique called DHI or Direct Hair Transplantation was invented. This procedure has revolutionized the way of implanting follicular units, eliminating the problem of pain, because only the anaesthesia needle is perceived slightly. Furthermore, in this case the time needed for the surgery increases, and more personnel will be needed. Other techniques such as Sapphire-based, robotized, micro motor e U-Graft FUEs, hair transplant with percutaneous technique and many other non-technical examples concerning the way of working include hair transplants without shaving, pain, needle and much more. Basically, it could be said that each technique is different, but they are all based on the FUE technique.
The main objective of improving them more and more is to reduce the discomfort and pain perceived by the patient during the surgical procedure. There are basically two important phases in the FUE technique, where anaesthesia is essentially used to avoid causing pain to the patient:
The extraction of hair follicles from the donor area: this phase is carried out with the help of micro motors and micropunch tips. Together with these devices there are blades or scalpels (of surgical steel or sapphire) which are responsible for extraction in the donor region. The scalp is penetrated by blades, so administrating local anesthetics is a must. Besides using anesthesia, minimizing the scalpels’s rotation speed and using sharp blades can increase the patient’s ease during surgery.
The incision processing and the receiving area implantation phases: taking the DHI technique as example, the implant phase is preceded by the elaboration of the incisions where the hair follicles will be implanted in the receiving area. In the DHI technique, these two movements occur at the same time using a Choi implanter pen, which creates the incision and inserts the follicle into the scalp. The quality of the needles used will be proportional to that of the final result. Another case is that of sapphire blades, which are used to create the incisions before implanting the follicles, creating the conditions for a better postoperative process. This happens because the sapphire blades have a smoother surface, thus decreasing the risk of capillary complications.
The use of anaesthesia before these two basic phases is a must, for both specialist and patient. Since anaesthesia occurs locally, the area to “put to sleep” in order to decrease sensitivity will be very small. This signals the green light for the proper micro-surgery to begin. Obviously, the level of comfort will depend on the type of anaesthesia and the technique used to apply it.
The administration techniques for anaesthetic agents associated with a painless hair transplant are:
For painless hair transplantation we mean the surgical procedure taking place without the patient perceiving pain. You will only feel a slight annoyance at the time of injection (in case of needles) of the local anaesthetic, during the extraction and implantation of hair follicles. Additionally, tablets are given to patients in order to aid relax at least 30 minutes before surgery.
In the phases of extraction and opening of the micro-channels, local anaesthesia is commonly administered through needles. They are extremely thin and the procedure is really fast; in a few minutes, quickly and painlessly, the anaesthetic is placed parallel to the skin surface, so that it is absorbed by the scalp.
This new local anesthesia administration technique guarantees a painless surgery, through the use of jet injections. Instead of using needles, the anesthetic is administered using mechanical energy to create a positive pressure, capable of opening very small channels from which the anaesthetic enters. These special injectors can be in plastic, which generate less pressure with slower anesthesia, or steel, which generate greater pressure and a faster anesthesia.
These needle-less injections are effectively comparable to classic ones: this way the procedure is slightly longer and is always perfected through the classic syringe.
One of the various anaesthesia methods currently available for hair transplants is to sedate before applying the local anesthetic, using a steel needleless injector. Sedation should be administered intravenously, minutes before beginning surgery.
Administering sedation, however, is not very advisable as it is more expensive compared to other methods, which are equally if not more effective.
