What Drugs Will Be Given During an Operation?

[taurusrisen]

Hi guys. I'm thinking about getting a hair transplant. But, I got 3 questions:

 

1) What drugs would the doc give/inject me with in a hair transplant operation?

 

2) Will I be prescribed drugs after the operation?

 

3) Do any of these drugs cause sexual impotence of any kind?

 

...

Edited October 12, 2010 by taurusrisen

[Dr. Michael Beehner]

Taurusrisen,

This varies considerably from doc to doc. DURING surgery every doctor has to inject some local anesthetic ("Novocaine" being the generic word most commonly used) in the form of Lidocaine and in addition Marcaine (bupivacaine), which is a longer acting one. Those are always given in the form of a "ring block" around the scalp to numb both the donor and the recipient areas on top. Some docs use a nerve block in the area of the inside eyebrows to block the supraorbital and supratrochlear nerves, which can greatly reduce the amount of local that has to later be used.

Most doctors also give some form of a cortisone steroid medication, either mixed into the solution that is "tumesced" into the scalp before the holes/slits are made or in the form of pills. In our clinic we give 60mg of Prednisone just before surgery and 40mg daily for three more days. These are given to help reduce the chance of forehead swelling after surgery.

During surgery most clinics give some sort of a sedative to help allay anxiety and make the time go by faster. It also keeps the patient from getting antsy and moving around, which makes the placement of the grafts much more difficult. Some docs also give a narcotic along with the sedative, which helps raise the pain threshold. In our clinic we use subcutaneous Versed (midazolam) and IM Demerol for this purpose, which does a nice job of keeping the patient comfortable and also gives a nice amnesic effect.

AFTER surgery the commonest meds given out are a few days of prednisone or another steroid (Medrol Dose-pak) for swelling, some pain pills (to use if needed) and something for sleep. Some clinics routinely give antibiotics also, even though there is no proof they help, except in the case of diabetics and persons with immune problems.

No doubt the reason you bring up the impotence issue is because of the drug FINASTERIDE (Propecia or Proscar), which is probably our best medication for slowing down hair loss and actually increasing hair mass in about a third of those using it. Many men who have a HT have already been on this med for some time and simply continue taking it. If not, some in fact are started around the same time as the transplant in order to maximize or increase the contribution of the native hair to the overall cosmetic appearance. Studies show a 2.9% incidence of sexual side effects (the commonest being reduced erection or reduced libido) which is pretty darn low. The hair surgeon you go to will undoubtedly tell you of its benefits and also the small incidence of side effects and then you are free to go on it or not. I can tell you that the patients that do both (HT's AND Finasteride) often have spectacular results later on, that wouldn't have been so with only the HT's. You end up with an ADDITION of two things (HT's and increased native hair) versus a SUBTRACTION if you don't use finasteride (the transplants are a plus over time, but subtracted is the progression of male pattern baldness and the loss of the remaining native hairs.

Mike Beehner, M.D.

Edited October 12, 2010 by Mike Beehner, M.D.

[hairlossguy222]

1.) It will definitely depend on who your HT doc is - you will want to check with your surgeon

-My first HT, I was given some form of sedation to make me drouzy as well as a local anesthetic

-My procedure with Dr. Feller, I was given just a local anesthetic (combined with Epinephrine...don't ask me why as I don't know specifics)

 

2.) Again, check with your Dr., but most prescribe some pain killers (vicodin) that can be used if needed. But rather than that, nothing else

 

3.) Nope

[hairlossguy222]

Wow, my post just got owned by Dr. Beehner....the beauty of posting at the same time

[taurusrisen]

Taurusrisen,

This varies considerably from doc to doc. DURING surgery every doctor has to inject some local anesthetic ("Novocaine" being the generic word most commonly used) in the form of Lidocaine and in addition Marcaine (bupivacaine), which is a longer acting one.

 

No doubt the reason you bring up the impotence issue is because of the drug FINASTERIDE (Propecia or Proscar)

 

Yeah, before I get my hair transplantation surgery, I'm going to tell my doctor NOT to give me any heavy medication or injections like sedatives or pain killers, except for lidocaine.

 

And as far as propecia is concerned, I REFUSE to take that after the surgery. It's a known fact that it causes sexual impotence and in many cases, permanent loss of sexual desire and it definitely causes erectile dysfunction.

 

The most I want is lidocaine during surgery and nothing after surgery. If I feel pain after the surgery, thats too bad.. it'll go away in days. My sexual health comes first!

 

...

Edited October 12, 2010 by taurusrisen

[taurusrisen]

1.) It will definitely depend on who your HT doc is - you will want to check with your surgeon

-My first HT, I was given some form of sedation to make me drouzy as well as a local anesthetic

-My procedure with Dr. Feller, I was given just a local anesthetic (combined with Epinephrine...don't ask me why as I don't know specifics)

 

 

hairlossguy, how long do you think will the local anesthetic linger in the body before its evacuated from the body? Also, do you know if the local anesthetic will cause erectile dysfunction?

 

...

[hairlossguy222]

Taurus,

 

I have no idea and will not throw out an arbitrary estimation regarding the lasting effects of the anesthetic. Best bet is to ask a doctor. To my knowledge, local anesthetic (when injected in the head....on the person's neck) will not cause erectile dysfunction.

 

I saw another post of yours on another forum discussing how you will not take Propecia due to 'permanent' erectile dysfunction side effects and because you say you don't need it.

 

That statement alone makes me think that you really should educate yourself some more on hair transplants before you follow through with it....once you pull the trigger, you're in it for good.

 

I personally would never proceed with a HT without medical therapy in my arsenal. Hair loss is a progressive thing and you'll find yourself chasing it your whole life.... why not fight it with everything you got? Also, there is a lot of myth around propecia. There is no medical literature that I know of in the USA that describes 'permanent' erectile dysfunction. Perhaps someone can state otherwise.

 

I just don't want to see you worse off and regretting your decision.

[taurusrisen]

Taurus,

 

I have no idea and will not throw out an arbitrary estimation regarding the lasting effects of the anesthetic. Best bet is to ask a doctor. To my knowledge, local anesthetic (when injected in the head....on the person's neck) will not cause erectile dysfunction.

 

I saw another post of yours on another forum discussing how you will not take Propecia due to 'permanent' erectile dysfunction side effects and because you say you don't need it.

 

That statement alone makes me think that you really should educate yourself some more on hair transplants before you follow through with it....once you pull the trigger, you're in it for good.

 

I personally would never proceed with a HT without medical therapy in my arsenal. Hair loss is a progressive thing and you'll find yourself chasing it your whole life.... why not fight it with everything you got? Also, there is a lot of myth around propecia. There is no medical literature that I know of in the USA that describes 'permanent' erectile dysfunction. Perhaps someone can state otherwise.

 

I just don't want to see you worse off and regretting your decision.

 

You mentioned that I'll be chasing hair loss all my life. I must disagree with you. For one, I got good genes in terms of hair regression. The only place I need a HT is in the front and temple area, thats all. My hair from the receding point beyond is thick, theres no problem there. And if a HT means "chasing hair loss," then why didnt that stop you and thousands of others from getting a HT in the first place?

 

And, whats the point of fighting HT with "everything i got" if propecia may cause erectile dysfuntion? Wheres the fun in enjoying a HT if sexual health is put to risk? That doesnt make sense. I WILL NOT use propecia EVER.. bottom line. With all due respect, i just dont understand the problem with someone refusing to take a medication thats known to cause serious sexual side effects.

 

..

[TakingThePlunge]

taurusrisen,

 

The decision to take Propecia or not take it is a personal one. However, hairlossguy222 is right on the money. Hair loss is progressive and pursuing hair transplant surgery without stabilizing future loss medically may lead to a very unsatisfactory end.

 

I felt as you did prior to my first HT. However, after deciding to drop thousands on my hair, I realized that the most prudent thing for me to do was to use every tool at my disposal to protect my investment. Now, of course, had I experienced any severe side effects, I would have discontinued use.

 

I've been on finasteride now for almost two years and I haven't experienced a single day of erectile dysfunction nor any loss of libido. Aside from an initial bout with mild testicular pain and then months of watery semen, everything has been perfectly fine for me. I did back off my dosage in order to see how it would affect ejaculations and it has changed for the better.

 

It's a known fact that it causes sexual impotence and in many cases, permanent loss of sexual desire and it definitely causes erectile dysfunction.

 

This statement simply isn't true. Yes, some guys do experience sexual side effects but they are in the minority and, in the vast majority of those cases, the sides are completely reversible upon discontinuation.

 

I've got no vested interest in you taking meds. Everyone must decide for themselves but, I highly suggest doing a bit more research before moving forward with hair transplantation.

 

All the best,

[hairlossguy222]

You mentioned that I'll be chasing hair loss all my life. I must disagree with you. For one, I got good genes in terms of hair regression. The only place I need a HT is in the front and temple area, thats all. My hair from the receding point beyond is thick, theres no problem there. And if a HT means "chasing hair loss," then why didnt that stop you and thousands of others from getting a HT in the first place?

 

And, whats the point of fighting HT with "everything i got" if propecia may cause erectile dysfuntion? Wheres the fun in enjoying a HT if sexual health is put to risk? That doesnt make sense. I WILL NOT use propecia EVER.. bottom line. With all due respect, i just dont understand the problem with someone refusing to take a medication thats known to cause serious sexual side effects.

 

..

 

 

Taurus,

 

How old are you?

What Norwood level are you?

How long have you been losing your hair?

What is your family history of hair loss?

 

Please be aware that as much as we try to predict hair loss, the fact of the matter is, its so damn unpredictable. Both your grandfathers and great grandfathers could have NW1's, and you could unfortunately end up bald.

 

That's why I am a bit nervous with your view on Propecia. If you go into this battle with that mentality on it, I would seriously re-evaluate your game plan. You need to at least be open to the fact that you may want to take it if you see your hair loss progress. Again, just my two cents..

[RCWest]

Finasteride didn't hurt my sexual performance AT ALL. Side effects from Finasteride are few and far between. I've even tried Avodart before with no problems. A lot of people's are in their head from what they've read on the net. You should at least try it. If worse came to worse you could take half a mg. and get about 80% of the effects of 1 mg.

 

I'm just trying to help you out! The final decision is all yours

[taurusrisen]

Finasteride didn't hurt my sexual performance AT ALL. Side effects from Finasteride are few and far between. I've even tried Avodart before with no problems. A lot of people's are in their head from what they've read on the net. You should at least try it. If worse came to worse you could take half a mg. and get about 80% of the effects of 1 mg.

 

I'm just trying to help you out! The final decision is all yours

 

hi, rcwest. i appreciate the response. and its good that the drug didnt affect you negatively. but for me, i want to ride on the safe side and decide to not take finasteride. i've read enough horror stories about it. thanks.

[Tom60]

how common do you think it is for people to take 0 drugs for this?

[Thehairupthere]

Taking propecia for hair loss is a personal choice. Just know that it has been around for decades and is considered by most doctors in this field to be the best option for stopping hair loss and is very safe. If you are completely against the idea, that is your right, just know that those side effects are extremely rare and as stated before that they are reversible upon discontinuation. The next best option would be to use rogaine or rogaine foam daily which does not carry the same side effects as propecia, the only thing that may occur is slight irritation to your skin.

[taurusrisen]

Taking propecia for hair loss is a personal choice. Just know that it has been around for decades and is considered by most doctors in this field to be the best option for stopping hair loss and is very safe. If you are completely against the idea, that is your right, just know that those side effects are extremely rare and as stated before that they are reversible upon discontinuation. The next best option would be to use rogaine or rogaine foam daily which does not carry the same side effects as propecia, the only thing that may occur is slight irritation to your skin.

 

Thehairupthere;, I hugely appreciate your concern and reply. But, again, I seriously dont want to risk any degree of erectile dysfunction. My sexual health comes first before my hair any time. This is my absolute law in life which will not and cannot be broken. Thank you.

 

..

 

.

[mattj]

We've spoken about this before, but I don't think you need to worry about any of the transplant-related drugs causing that sort of problem. Finasteride is an anti-androgen; that's it's purpose and that's why it can effect some users in that way. It would be a mistake to associate all medications with this side effect, especially those administered during the relatively brief period of the surgery, or those that can make things more comfortable for you for a period post-op.

[taurusrisen]

We've spoken about this before, but I don't think you need to worry about any of the transplant-related drugs causing that sort of problem. Finasteride is an anti-androgen; that's it's purpose and that's why it can effect some users in that way. It would be a mistake to associate all medications with this side effect, especially those administered during the relatively brief period of the surgery, or those that can make things more comfortable for you for a period post-op.

 

Well, that may be the case for some. but as for me, i'm staying well clear of the stuff. My penis is my best friend and I'm not going to risk it just for a couple of more hairs on my head.

[EpilepticSceptic]

Well, that may be the case for some. but as for me, i'm staying well clear of the stuff. My penis is my best friend and I'm not going to risk it just for a couple of more hairs on my head.

 

 

Good for you!

 

I would suggest avoiding any type of HT at all costs. If you have already scheduled a surgery date you would be VERY wise to cancel it immediately. Otherwise there is a high chance that in the not too distant future it will be the biggest regret of your life. Look around on the various forums for the "repair" patients and see what they have to say about it.

 

Indeed, one of the best things about hairloss forums like this one is that posts like this are saved and preserved; that way you can come back in 3,5,10 years from now and see that posters with WAY more knowledge and experience about HTs than you were kind enough to warn you in advance about making a very stupid mistake.

[taurusrisen]

Good for you!

 

I would suggest avoiding any type of HT at all costs. If you have already scheduled a surgery date you would be VERY wise to cancel it immediately. Otherwise there is a high chance that in the not too distant future it will be the biggest regret of your life. Look around on the various forums for the "repair" patients and see what they have to say about it.

 

Indeed, one of the best things about hairloss forums like this one is that posts like this are saved and preserved; that way you can come back in 3,5,10 years from now and see that posters with WAY more knowledge and experience about1 HTs than you were kind enough to warn you in advance about making a very stupid mistake.

 

I dont get your post. On the one hand, you warn me about getting a HT. Then, in the second paragraph, you sounded a bit sarcastic. Anyway, if your post is an honest and serious one, it sounds like you had a VERY VERY bad HT procedure. Did this involve Finasteride?

 

I searched for complaints on Dr. Rahal. This is the doctor I want to see. One patient of his complained that hes a butcher. But then again, I only found one complaint about him. Nevertheless, now I'm a bit apprehansive about seeing him for a HT procedure.

 

...

[mattj]

 

I searched for complaints on Dr. Rahal. This is the doctor I want to see. One patient of his complained that hes a butcher. But then again, I only found one complaint about him. Nevertheless, now I'm a bit apprehansive about seeing him for a HT procedure.

 

...

Was this complaint on one of those 'consumer advice' websites? Some years back an anonymous person made complaints about Dr Rahal and at least one other doctor to a website, all written in the same style by the same person. From time to time people find it and take it seriously, which is frustrating as anyone with an agenda can use that website and there is no fact-checking or verification involved. We do suspect that we know who was responsible, and it wasn't a patient.

Forums like this one are open to anyone to post, and if a patient has a complaint there's nothing stopping them airing their grievance here. I would advise anyone researching a doctor to base their opinion on the reputation a doctor has in online communities and speak to genuine patients, and forget the anonymous attacks.

[Tom60]

this forum is pretty honest. There are tons of resources that you can use to make the best decision for you. I am sure that you can find that someone was in the same position as you.

 

keep us updated on what you decide to do!

[taurusrisen]

We do suspect that we know who was responsible, and it wasn't a patient.

 

Forums like this one are open to anyone to post, and if a patient has a complaint there's nothing stopping them airing their grievance here. I would advise anyone researching a doctor to base their opinion on the reputation a doctor has in online communities and speak to genuine patients, and forget the anonymous attacks.

 

And, how do you know who exactly was responsible for this? How do you know he wasnt a patient? And why would such a person waste his time posting complaints on a forum just for a gag?

 

...

[taurusrisen]

this forum is pretty honest. There are tons of resources that you can use to make the best decision for you. I am sure that you can find that someone was in the same position as you.

 

keep us updated on what you decide to do!

 

Thanks, man.

[mattj]

And, how do you know who exactly was responsible for this? How do you know he wasnt a patient? And why would such a person waste his time posting complaints on a forum just for a gag?

 

...

 

Assuming we're talking about the same thing, it was a very transparent hit job. As I said, at least one other doctor was also attacked at the time by what appeared to be the same individual. They also attacked forums and the owners of those forums, evidently having some sort of issue with them too. Within that context, back at the time it first happened, I don't think anyone with good judgement took it seriously after the subject was dissected. It was suspected to be a smear by a rival whose own reputation had taken a nosedive on the transplant message boards.

 

By all means post a link to what you're talking about. I'm typing this in defence of Dr Rahal, but to honest, I think a read of the report itself would settle most peoples' minds on the matter.

[Dr. William Lindsey]

Local anesthesia is eliminated in just a few hours. Sometimes its too quick and the patient needs to be re-numbed frequently, others it lasts the entire procedure; but on average the medicines noted above will last up to 6 hours or so.

 

They will not contribute to sexual side effects if placed in the scalp.

 

Dr. Lindsey McLean VA