BILEVEL TUMESCENT ANESTHETIC INFILTRATION FOR HAIR TRANSPLANTATION

BACKGROUND. A dual level of tumescent anesthetic infiltration has been found to expedite hair graft or strip harvesting for hair transplanta tion, reducing bleeding, and increasing the exit angle of the hairs, t hereby promoting increased survivorship of hair shafts and bulbs. OBJE CTIVE. To acquaint the readership with this variation of anesthetic tu mescent technique in hair transplantation. METHODS. Patients were util ized for this study during international teaching exchanges. Larger mu ltiport infiltrators were used for the deep infiltration; smaller and more narrow infiltrators were used for the more superficial anesthetic administration. RESULTS. Subcutaneous compression and a bilevel vasoc onstriction in both donor and recipient sites resulted in an increased upwardly angled exit angle of the hairs to be harvested, an increased separation of individual hair shafts, and reduced bleeding. Placement of the correct incisional angle of instruments inserted into the dono r site was facilitated. CONCLUSION. Utilization of a bilevel tumescent anesthetic infiltration technique is a superior method of anesthesia for hail transplant harvesting and transplanting. Bleeding at both occ ipital donor and frontal recipient sites was negligible. (C) 1997 by t he American Society for Dermatologic Surgery, Inc.