Most patients should experience no pain once their scalp is numb, but they may have pain during the healing process in the days and weeks following a procedure. Typically, pain in the healing process is confined to the donor area, from where the hair was harvested.
Returning to the degree of pain associated with the anesthesia, it is highly dependent upon the physician’s technique in administering the anesthesia. In other words, it can easily be controlled.
Many physicians give patients a sedative to help them relax before beginning the anesthesia. Then they begin numbing the donor area. If the physician works very slowly, the pain will usually be mild and not an issue. If the physician works quickly, there will certainly be pain.
Pain from anesthesia is caused not so much by the pinch of the needle, but by the rate at which the physician injects the anesthesia into the scalp. The anesthesia causes a burning sensation in the tissue. If the physician waits until the initial injection has caused the area to begin to get numb, then subsequent injections will be less noticeable. The physician can also use anesthesia that contains bicarbonate to lessen the burning sensation.
Sadly, some physicians are simply impatient and insensitive. They rush through the anesthesia to “get to the real work,” and as a result, their patients experience significant pain.
Healing pain is also highly variable and quite controllable. The pain in the donor area as it heals is greatly affected by how the physician removes the donor strip and how much tissue is removed. If the doctor makes a deep incision and takes a lot of tissue out, there will be more pain during healing. Some physicians make deep cuts severing many nerves and blood vessels. This will cause more pain. Other physicians are more careful. They make shallower incisions and take just enough tissue to get the hair out. They cause less disruption and their patients experience far less pain.
If the physician takes a very wide strip to get a large number of grafts, and if the patient’s scalp has limited flexibility, then there may be a lot of tension on the sutured area. More tension equals more pain.
Some tips to consider
A certain amount of pain is unavoidable with hair transplantation procedures, but some physicians do a far better job of making the patient’s experience a pleasant one. It is advisable to talk to patients of that particular physician to get an idea about that physician’s sensitivity to the issue. Ask them about the pain of anesthesia and the pain during healing.
Also, talk to your physician before the procedure. If he or she is dismissive and not comforting, consider finding a new physician. Ask the doctor how long it takes to administer the anesthesia. If he or she says something like, “only a couple of minutes,” be concerned. It is just not necessary to experience great pain to have a great result.
This is one of the most misunderstood areas in the field of hair transplantation. Some doctors advertise the many thousands of procedures they’ve performed. Some highlight the number of grafts transplanted or their years in practice. What does it all mean? What information is relevant and what is just marketing hype? How can you realistically judge a physician? These are all difficult, yet critical, questions.
The first step is evaluating any physician is to ignore all the advertising hype. The number of procedures performed, or grafts transplanted, or years in practice are largely irrelevant. Many of the most experienced physicians have done the most “plug” procedures, procedures that are cosmetically unacceptable. Some of those experienced doctors have evolved with the changing technology in the transplant field and some have not. For example, below is a recent hairline transplanted by one of the most experienced transplant surgeons in the US. This surgeon has a strong reputation in the industry, and superior academic background and excellent training. Yet, the transplanted hairline is obvious, unnatural and unacceptable.
This is not what one would expect from such an esteemed surgeon. However, it is representative of his work. The problem is that this surgeon lacks a strong aesthetic sensitivity. The transplant, while dramatically transformative of the person’s looks, is aesthetically lacking. It is a medical success in the sense that the hair has been successfully moved and is growing in a new location. However, it clearly is an artistic failure because it doesn’t look natural.