Hair Transplant | Hair Transplant Duration, Cost and Type of Anesthesia

Hair Transplant Duration, Cost and Type of Anesthesia

How long does it take to have a hair transplant done? Are you under general or local anesthesia? Also, what is the cost for one procedure?
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Hair transplantation is done under local anesthesia using the same local anesthetics that dentists use, lidocaine and marcaine. Lidocaine is also known as xylocaine. Novacaine is no longer used due to the incidence of allergic reactions. Marcaine is a long acting local anesthetic. The pain associated with a hair transplant procedure is none to minimal but there is discomfort from injection of the local anesthetics. Most patients comment that the pain associated with the procedure is less than a visit to the dentist’s office. There is discomfort in the donor area if strip excision is performed, after the procedure. There is little to no discomfort after a FUE (Follicular Unit Extraction) procedure.

Most physicians use some type of anxiolytic, or medication to reduce anxiety, the most common being valium. Some physicians administer the valium by mouth; some use an injection or the intravenous route. Some physicians start an IV and administer “twilight anesthesia” which is a combination of medications which make the patient unaware anything is going on but awake and breathing. Twilight anesthesia is generally used for the local anesthetic or numbing part of the procedure because this part hurts. The most common form of anesthesia is local anesthesia with a pill given my mouth to reduce anxiety.

I can’t be as specific in answering your questions about length of time needed for the procedure and costs. Both vary greatly from physician to physician. The average number of grafts being performed in a session is 1500-2000. It can take from 6-12 hours to complete the surgery. Variations are due to size of the physician’s staff, speed of the physician, and variability in the degree of difficulty. Some patients have skin which is flexible, grafts which are very firm, a low amount of bleeding, and very visible contrast between hair and skin color. These are variables which would decrease the degree of difficulty and shorten the time of surgery. Patients who have mushy grafts, tight skin, greater than normal bleeding, no contrast between hair and skin color, and scarring from prior procedures, will take longer to perform the surgery. For a procedure of 2000 grafts or more plan to spend the majority of the day in the doctor’s office.

Price varies from physician to physician and geographical area to area. While prices do vary greatly, this is not a situation where a patient should go bargain hunting. As in other situations (in general) you get what you pay for. That is not to say the most expensive price hair transplant will be the best. One needs to do a lot of research to find a physician whose philosophy matches his or hers. Use the internet to do your research. Don’t be limited to physicians in your geographical area. Hair transplantation is a specific specialty practiced exclusively by few physicians so it may be necessary to travel if an experienced expert is not in your area. Some physicians charge by the grafts, some charge by the session. It is more common to charge per graft as a more exact number can be given, proportional to the number of hairs moved. Charging by the session is more of a time charge and not based as much on the number of grafts moved. A rough guide is $5/graft for 1000-1500 grafts. Fewer grafts will cost more per graft and more grafts will be less per graft. FUE (Follicular Unit Extraction) takes longer, is more labor intensive for the physician, and in general fewer grafts are moved in a day so cost per grafts is greater than with strip excision. Some physician list their fees on their website while others need to be contacted by phone. Again, the key to finding the surgeon who is right for you is doing your research and contacting a number of different surgeons.

Bradley R. Wolf M.D.
Member, International Alliance of Hair Restoration Surgeons