Preoperative Prep

As with all hair transplant procedures, a good surgery begins with a good night’s sleep. This applies to both patient and physician. Upon patient arrival, the plan should be reviewed and photos taken for later comparison. In our clinic the patient is given a tee shirt that can be discarded at the end of the day.

The patient is laid prone into a cushioned headrest and the donor area shaved. The amount of shaving corresponds to the amount of grafts targeted. For 300 graft cases we find that the same size and width shaved area used for strip surgery is sufficient. This of course allows the patient’s hair to cover the site at the end of the procedure. For FUE cases in excess of 300 grafts we shave correspondingly larger areas. We would shave twice the area when targeting for 600 FUE grafts, three times the area for 900 grafts, and so on.

Ask the patient to sit up at the end of the table for a moment and apply a standard gauze wrap around the head to catch drainage and irrigation fluid. We find it helpful to stick 4x4 gauze behind the ears. Then place the patient back into the prone position and clean the donor area generously with iodine followed by glucohexinol.

Even when the patient’s head is immobilized in the cushion, there is still a degree of flexion and extension at the level of the neck. Use this to position the head such that the hair stubble in the recently shaved donor area is as vertical as possible. This is usually accomplished by flexing the head down into the cusion.

Next, using a 30 gauge needle, infiltrate the donor area with 1% or 2% lidocaine containing epinephrine 1:100,000. We also like to use a “super juice” mixture of 1:20,000 epinephrine in saline, although this isn’t always needed.

After the area is sufficiently numbed, introduce several CCs of normal saline into the target area only. Do not infiltrate the entire donor area, just two to four square centimeters around the target area.

he patient is now properly prepped for the FUE procedure to begin