Bernstein Medical - Center for Hair Restoration - FUE Pain

FUE Pain

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Q: Does Follicular Unit Extraction performed by a robot hurt more than regular FUE? — R.T., Greenwich, CT

A: As with manual FUE, robotic FUE hair transplantation is an outpatient procedure performed under long-acting local anesthesia – a combination of lidocaine and bupivacaine. After the initial injections, the patient does not experience any pain or discomfort.

Before starting local anesthesia, we give most patients oral valium and intra-muscular midazolam (a very fast acting sedative that is very relaxing). While some patients doze off at the beginning of the procedure, others prefer to watch TV, a film, or just chat.

Local anesthesia generally wears off after 4-5 hours, so for transplant sessions lasting longer than this, we will give more anesthesia before the first wears off. With Robotic FUE, there is no discomfort once the procedure is completed and the anesthesia wears off. This is in stark contrast to an FUT strip procedure which can be uncomfortable in the donor area for days to weeks.

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Q: I recently saw an episode of the Rachel Ray Show where her guest, Dr. Anthony Youn, said that the Neograft machine for Follicular Unit Extraction is painless and uses a vacuum rather than surgery to remove the grafts. Can this be true? — A.B., Old Greenwich, C.T.

A: Follicular Unit Extraction (FUE) using the Neograft machine is not painless and, while it does not produce a linear scar, it is surgery and there is significant scarring in the form of thousands of tiny holes that heal with round white marks.

In the video, Dr. Anthony Youn asks: “Do you wanna take a feel? It’s just a vacuum.” Rachel Ray states: “You don’t feel a thing.” Youn replies: “No [you don’t].”

This is very deceptive on the part of the doctor, since the instrument is basically a cutting instrument with the suction being used to remove and insert the grafts. Although the suction part would not be painful, the cutting part certainly is and requires the same anesthesia as a traditional hair transplant.

Our main concern is that the machine produces grafts that are sub-optimal with respect to quality and potential growth, as the Neograft’s suction apparatus tends to strip follicles away from their surrounding protective tissue and tends to dry the grafts out.

For in-depth information on this topic, read our pages on Follicular Unit Extraction (FUE) and the Neograft Machine for FUE.

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