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Hair Transplant Questions & Answers
 
Subject: Local anesthetic used in hair transplants
 
Question: I recently read an article you wrote about the need to reduce the amount of epinephrine in the local anesthetic used in hair transplants, because epinephrine can cause telogen effluvium and carries some health risks with it. I'm concerned about both actually (I don't have a heart condition but even with regular examinations conditions may go undetected, as you know) if I am to undergo an HT procedure. How much (you can give the concentration ratio, I do know how it is measured) can the amount of epinephrine be reduced in the local anesthesia used in hair transplantation so that these two risks will be negligible? I understand that epinephrine does have properties that make it of value, but based on your article its risks may outweigh the benefits. Please comment.
 
Answer: The concentrations of epinephrine used by most hair transplant surgeons are not dangerous in healthy patients. The main point of the article was to use other means of hemostasis in long transplant sessions since the duration of epinephrine is only 20 minutes and it is problematic to keep injecting it. Certainly high doses can be a health risk in some predisposed individuals i.e. with heart disease or who are on broad b-blocker blood pressure medications.
We use concentrations of 1:200,000 to 1:600,000.
 
Answered by: Dr. Robert Bernstein
 
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