Periprocedural Anesthesia and Analgesia in Hair Transplantation: An Evidence-Based Review of Contemporary Clinical Practice

BACKGROUND Hair transplantation is a widely performed office-based aesthetic procedure characterized by prolonged procedural duration, cumulative local anesthetic exposure, and reliance on sustained patient cooperation. Despite extensive literature on surgical technique and aesthetic outcomes, periprocedural anesthetic and analgesic considerations remain comparatively undersynthesized. OBJECTIVE The aims of this study were to review periprocedural anesthesia and analgesia strategies in hair transplantation and highlight practical considerations related to patient safety, procedural workflow, and intraoperative management. MATERIALS AND METHODS A structured literature review was conducted using PubMed/MEDLINE and Embase from database inception through January 2026. Studies evaluating anesthetic techniques, analgesic strategies, periprocedural pain management, and anesthesia-related safety considerations in hair transplantation and comparable office-based dermatologic surgical procedures were included. Evidence was synthesized qualitatively according to predefined clinical domains. RESULTS Available evidence supports multimodal anesthetic strategies incorporating individualized local anesthetic selection, tumescence, regional nerve blocks, adjunctive analgesia, and structured intraoperative monitoring to optimize patient comfort, procedural efficiency, and safety. However, available evidence consists predominantly of observational studies, case series, and expert consensus, with limited high-quality comparative data. CONCLUSION Individualized multimodal anesthetic strategies represent the current evidence-informed approach to periprocedural management in hair transplantation. Prospective comparative studies are needed to strengthen the evidence base and inform future clinical recommendations.