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Comparison of post-operative pain and the harvesting method used in hair restorative surgery



Post-operative pain is one of the most common concerns for patients undergoing hair transplant surgery. As most patients are satisfied with the cosmetic improvement after transplant, post-operative pain enhancement would help the patient’s accessibility to restorative hair surgery and would greatly enhance patient satisfaction with the final cosmetic results. This study was carried out to investigate post-operative pain following a Hair Transplant.

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In total, 241 patients (202 who carried out follicular unit transplants and 39 who had a follicular unit extraction) were eligible for the study. Post-operative pain was assessed on post-operative days 1, 2, 3, 4, 5, and 7 using Wong-Baker Faces Pain Scale. Patients’ medical records were retrospectively reviewed for information on the method of harvesting, the number of transplant increases, the size of donor design, and the tendency, the elasticity, and the bias in the scalp for pain post-surgery.


Post-operative pain after a hair transplant, assessed with Wong-Baker Faces Pain Scale, appeared to have subjective results. None of the correlation variables related to post-operative pain in the FUT group. However, such pain tended to occur three days post-operative. There was much less pain on patients in a FUE group than those in the FUT group.


Post-operative pain was much less severe in patients who were harvested by the FUE method than FUT. Post-operative pain had almost expired three post-operative days 3 in the FUT group, but only minimal pain was present even on post-operative day 1 in the FUE group.


Significant effect on postoperative pain of patient recovery. An essential part of the care of post-operative patients is the correct understanding of patients’ attitudes and concerns in relation to post-operative pain as there is concern that patients with a surgical procedure have serious concerns. Many patients with alopecia who are anxious to carry out a hair transplant are also concerned about post-operative pain. The information on the internet or obtained from a person with severe pain is very important to these patients, so they may fall under surgery. Most hair surgeons have adopted various methods to try to reduce non-operational pain using intravenous anesthetic, ice packing, or vibrators. Bupivacaine can be applied or analgesics can be prescribed for post-operative pain. However, despite these efforts, the amount of post-operative pain and no pain does not appear to be unusual pain.

With the author’s knowledge, no study was carried out to investigate the relationship between post-operative pain and various factors such as the method of harvesting (extraction of follicular units vs follicular unit transplants); the number of grafts; size of surgical design; laxity, elasticity, and glidability of the scalp; and sex. In addition, the characteristics of pain and length were not studied. This study was therefore carried out to investigate these data and to report the findings with a review of the literature.


This study was approved by the Internal Review Board. In total, 241 patients who received hair transplant surgery (202 at FUT and 39 by FUE) from June 2015 to June 2016 were eligible for the study. The operations were performed for male pattern baldness (n = 129), cicatricial alopecia of the scalp (n = 8), hairline correction (n = 103), and pubic hair restoration (n = 1).

In the FUT method, a long elliptical strip is removed from the donor area, and then a wound is approximated at the edges to be closed with sounds. In FUE method, individual follicular units are removed after incubation with a diameter width of 0.8–1.0 mm wide.

Patients with hair transplant history, laser treatment before or after surgery, eyelid surgery, rhinoplasty, filler injection, or any other type of surgery or procedures; those undergoing FUT surgery and FUE together; and the study did not include those who did not take the prescribed medication (oral anti-inflammatory drugs or antibiotics) for a variety of reasons such as adverse drug effects to ensure accurate comparison.

Local anesthesia (2ocococaine 2% with 1: 100,000 epinephrine) was applied under intravenous percolation. There was informed written consent for participation in the study from all pre-operative patients for this prospective study. Post-operative pain assessment was carried out on a daily basis.

Laxity, elasticity, and glidability of the scalp were accurately measured in each patient going under FUT. Laxity was measured. Elasticity was measured using the Park method, in which glidability was calculated by subtracting the value of elasticity from the laxity value.

After surgery, anti-inflammatory oral medication (aceclofenac) was usually on the patients for 3 days.

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