CME article Part II. Hair transplantation: Surgical technique

J Am Acad Dermatol. 2021 Oct;85(4):818-829. doi: 10.1016/j.jaad.2021.04.063. Epub 2021 Apr 27.


The second part of this hair transplantation review concentrates on the technical aspects of the surgery. First, we review the 2 main local anesthetics used in hair transplantation, lidocaine and bupivacaine, how to achieve long-lasting local anesthesia, and what techniques can be used to minimize the pain associated with anesthetic infiltrations. Second, we review the 2 donor harvesting techniques currently used: strip harvesting follicular unit transplantation and follicular unit excision. The technical aspects of each technique are described in detail, along with their advantages and disadvantages. Third, the different methods of graft implantation currently used by the majority of hair surgeons are discussed, including premade sites and stick-and-place and the use of tools such as implanters. Fourth, postoperative care, expected results, and the main complications involved in hair transplant surgery are reviewed.

Publication types

  • Review

MeSH terms

  • Alopecia / surgery
  • Anesthetics, Local
  • Hair
  • Hair Follicle*
  • Humans
  • Skin Transplantation
  • Tissue and Organ Harvesting*


  • Anesthetics, Local