Q: I have read that a lot of doctors today administer Midazolam (Versed) to sedate the patient. I have two questions in reference to this drug: 1) How does the doctor determine how much of a dose to administer to the patient and 2) is the drug administered all at once, or intermittently throughout the procedure?

A: Each doctor has a different protocol, so it is hard to generalize. At Bernstein Medical we usually use Versed 2 to 4 mg IM one time 10 minutes prior to giving the local anesthesia. The dose is not repeated.

We also use Valium 5-15mg by mouth. I determine the dose of each based on body weight and history of sensitivity to sedatives.

Q: Dr. Bernstein, is a follicular unit hair transplant, the way you perform it, very painful? A: We perform our hair transplant procedures using long-acting, local anesthesia, so after the initial injections, the patient doesn’t experience any pain or discomfort. The local anesthesia (a combination of Lidocaine and Marcaine) lasts about 4-5 hours. For long [...]

Q: I have read about something called “tumescent anesthesia” but didn’t understand what it is. What exactly is it? A: Tumescent techniques were first popularized in liposuction surgery where large quantities of fluid containing adrenalin were injected into the person’s fat layer to decrease bleeding before the fat was literally sucked out of the body. [...]

Q: Will I be unconscious during the hair transplant procedure and do you use general anesthesia? A: All of the surgical hair restoration procedures at Bernstein Medical are performed under local anesthesia. The fact that general anesthesia is not needed is what makes hair transplant procedures – even though they are long – very safe. [...]

“Over the past 10 years we’ve developed a new procedure called follicular unit transplantation, where hair is transplanted exactly the way it grows,” said Dr. Robert Bernstein [...] This new technique replaces the plugs — groups of hairs inserted into round holes in the scalp — used in the early days of hair transplant procedures. It is now known that hair grows in groups of one to four hairs.