How Hair Is Inserted in Hair Transplant Surgery Hair transplant surgery begins, after anesthesia is applied, with removing donor tissue. Follicular units are then extracted from the tissue using a stereomicroscope. This is all done by skilled nurses and technicians. The insertion of the hair into the receptor sites comes later. Planning for the procedure is necessary before you even make the final decision to have it done. Once that step is completed, you will be ready to start the preparations for your surgery. Before you are approved for a hair transplant procedure, the doctor will have to sign off on you. You must be deemed appropriate for the surgery. This does not seem like a description of something that is pain-free. It certainly does not seem like a relaxing experience. Yet some feel that there is that degree of pain involved. The injections of the local anesthetic into the scalp before hair transplant procedures are definitely painful to some degree. Improvements were made in hair transplant surgery in the 1980s. Mini-grafts were better, but they still had the appearance of plugs, albeit smaller plugs. These were made up of 5-8 hairs each. This size of plugs is still being used by some surgeons even today. As time has gone by, the graft used by most surgeons has gone down. However, there are some minor complications or side effects that sometimes come with the surgery. 1. Thinning. If you have hair transplant surgery, you might be alarmed if you notice that the hair you already did have is getting thinner. This is a normal post-operative condition. The thickness comes back within a few months after surgery. It is difficult to know the difference between a good hair transplant surgeon and an inexperienced one. If you know someone who has had hair transplant surgery, you have at least one person to whom you can go for advice. You will know from looking at their hair whether the job was done well. You can ask the person whether you were treated professionally.