A Typical Hair Transplant Procedure
(a "walk through" tour)

About four weeks before the scheduled session, the patient is sent a list of "pre-op instructions", and also a map and a brief description of what to expect during the first week after surgery. Our front office staff also assists the patient with any other arrangements they need help with, such as motel or travel arrangements.

The day of the procedure, the patient shows up either alone or, preferably, with a driver. The patient is encouraged to take a shower with shampoo that morning and to eat a normal breakfast. When the patient arrives, he is greeted by our staff and is handed a consent form and "medical history questionnaire" to fill out. 

Carol, one of our nurses, greets patient in waiting room.

 
Patient reads over and signs consent form for the day's surgery procedure.

 
Photos are taken from seven different views to serve as a baseline to use later for comparison views.

 
Vital signs, including blood pressure are taken.

Dr. Beehner begins to draw in hair transplant pattern.

A flared front hairline is drawn in along with an area of the front temple which will be blunted with grafts.

Carol writes the day’s plan on the dry-erase board, listing the different sizes of grafts and the numbers that will be placed in each respective zone.

Dr. Beehner begins to place the painless subcutaneous sedation-anesthesia with Versed and Demerol, which makes the patient very relaxed and the whole experience virtually pain-free. The Versed is a sedative with strong amnesic qualities and the Demerol is a narcotic, which raises the pain threshold. After this is done, a nerve block is done just above the eyebrow on each side in a small area that is frozen with a small ice cube. This blocks both the supra-orbital and supra-trochlear nerves on both sides and results in the entire top of the head being numb for the next 8 hours.

The patient’s prone position for the donor harvest portion of the procedure is shown here, with the physician directly over the head, where the donor strip will be harvested from and then sewn up.

After a horizontal area about a third of the way up the back of the head is shaved down, tape is applied to hold it out of the way during the donor harvest.

Dr. Beehner uses a special magnifying “episcope” to measure the density of hairs and follicular units on the scalp, to determine how large of a strip is needed that day.

The antiseptic, Betadine, is then applied to the area.

Dr. Beehner then uses the needle-less injector device, called the Dermojet, to put some Novocaine (lidocaine, actually) under the skin to numb the area. It feels like a hard tap of the finger on the scalp, but is not sharp.

 
Only after the area is numb from the Dermojet, Dr. Beehner then adds some 8-hour Marcaine to the area so that the whole scalp is numb the rest of the way.

The scalpel is then used to begin cutting out the donor strip. 

 
(This picture is magnified) A small part of the strip arrives and will be put into a temporary home in the petri dish of saline, cooled with ice underneath.

 
A picture of the strip cut into Follicular Units.

After the wound is closed with sutures, it is totally undetectable unless one lifts up the hair above it, as seen here.

Kelsey offers our patient some refreshment before the next stage of the procedure.

 
Our other Carol is busily cutting grafts for our patient.

Carol cutting grafts on the “teaching microscope”.

Tina, a veteran of 18 years in our practice, cutting grafts with the special “back-lighting” microscope.

Patient has a few cookies in addition before finishing up his interim “picnic.”

 
A soft washcloth is placed over the patients eyes to shield him from the bright lights necessary to do the procedure. It allows him to take a nap if he so chooses.

 Dr. Beehner finishes up the numbing along the front area. 90% of this area is already numb from the nerve block and is not felt at all. The side temple area is generally the only area where any sharpness is briefly felt.

Dr. Beehner next carefully measures the length of the patient’s follicles, to determine how deep to make the incision needles and slits. This one is nearly 5mm long.

The depth-control holder, which holds the needle, is then calibrated so that the needle depth will exactly match the length of the follicle.

A custom-cut lateral slit blade is also measured to the right depth for our patient.

 
Dr. Beehner makes the side temple recipient sites with a lateral slit blade.

Patient gets a bathroom break from the action and some refreshment drink from Velvet.

Tina and Velvet get started on placing grafts. Dr. Beehner put the first 200 grafts in the hairline before they took over.

 The grafts are all cut and now Carol joins the other two in placing grafts.

Dr. Beehner finishes up with some “stick-and-place” FU grafts for extra density in the hairline area.

The patient’s final look for the day with 1700 grafts in place.

 
A side view of the temple and front hairline area with the grafts just placed.

Carol begins applying a light dressing, with first placing Bacitracin ointment smeared Telfa pads on the graft areas.

These Telfa pads are lightly taped to each other for support and to prevent sliding around.

After placing a surgeon’s cap over the Telfa, she now puts a bandana over everything.

 “Could someone go out and get my Harley for me?”

Nurse and patient finish up their business.

The patient is then checked out and arrangements are made for his suture removal visit 10 days later and he is reminded that he can come in for a hair wash in the morning if he so desires.