ARTAS robotic hair transplants use local anesthesia to completely numb the scalp, making the 4 to 8 hour procedure pain-free after the initial injections. Most patients describe the discomfort as a 2 out of 10 during the anesthetic administration and 0 out of 10 during the actual extraction and placement.
This guide covers exactly what to expect for pain and comfort at every stage of the ARTAS experience.
Before the Procedure: Pre-Operative Preparation
Medications to Avoid
Your surgeon will provide a list of medications and supplements to stop before surgery. These typically include:
- Blood thinners: Aspirin, ibuprofen (Advil/Motrin), and naproxen for 7 to 10 days before
- Supplements: Fish oil, vitamin E, ginkgo biloba, and garlic supplements for 7 days before
- Alcohol: No alcohol for 48 hours before the procedure
- Caffeine: Some surgeons recommend limiting caffeine on the day of surgery
These substances increase bleeding, which can affect graft visibility during placement and slow the procedure.
Pre-Operative Sedation Options
While local anesthesia is standard, many clinics offer additional comfort options:
| Option | Effect | Availability |
|---|---|---|
| Oral anti-anxiety (diazepam/lorazepam) | Reduces anxiety, light relaxation | Most clinics |
| Oral sedation | Drowsiness, reduced awareness | Some clinics |
| Nitrous oxide (laughing gas) | Mild euphoria, relaxation | Select clinics |
| IV sedation | Deep relaxation, may not remember procedure | Rarely used, not typically needed |
Most patients do well with local anesthesia alone or with a mild oral anti-anxiety medication taken 30 to 60 minutes before the procedure begins.
During the Procedure: What You Will Feel
The Anesthetic Injections (The Hardest Part)
The local anesthetic (typically lidocaine with epinephrine) is administered through a series of small injections along the donor area and recipient area. This is the most uncomfortable part of the entire experience.
What it feels like: A series of small pinches and brief stinging sensations as the needle enters the scalp. Each injection site stings for 2 to 5 seconds before the area goes numb. The entire injection process takes 10 to 15 minutes.
Pain reduction techniques clinics use:
- Vibration devices: A vibrating tool placed near the injection site confuses nerve receptors and reduces the sensation of the needle
- Slow injection technique: Administering the anesthetic slowly reduces the burning sensation
- Buffer solutions: Adding sodium bicarbonate to the lidocaine reduces the acidity that causes stinging
- Ice or cooling: Some clinics apply ice before injections to pre-numb the skin
After the injections take effect (within 5 to 10 minutes), the scalp is completely numb. You will feel pressure and movement but zero pain.
During Extraction (2-4 Hours)
Once the donor area is numb, you will feel nothing during the ARTAS extraction phase. You may sense:
- Slight pressure as the robotic arm contacts your scalp
- Vibration from the extraction punch
- The surgical team touching and positioning your head
You will not feel the punch entering the skin or the graft being removed. If any sensation begins to return during a long procedure, the surgeon administers additional anesthetic immediately.
During Placement (2-4 Hours)
The recipient area is equally numb during graft placement. The surgeon creates tiny incisions and places each graft individually. You will feel nothing except occasional pressure.
During the full 4 to 8 hour procedure, most patients:
- Watch movies or shows on a provided screen or personal device
- Listen to music, podcasts, or audiobooks
- Talk with the surgical team
- Doze off periodically
- Take bathroom and stretch breaks as needed
After the Procedure: Post-Operative Pain
The First 24 Hours
As the local anesthesia wears off (typically 4 to 6 hours after the last injection), you will begin to feel sensations in the treated areas:
- Donor area: Mild soreness, tightness, and tenderness. Similar to the feeling after bumping your head
- Recipient area: More numbness than pain initially. Some patients describe a "tingling" sensation
- Forehead: Possible tightness from swelling that develops over the first 24 to 48 hours
Pain Management Timeline
| Timeframe | Typical Pain Level (1-10) | Recommended Management |
|---|---|---|
| Hours 1-6 (anesthesia active) | 0-1 | None needed |
| Hours 6-24 | 2-4 | Acetaminophen (Tylenol) per surgeon instructions |
| Days 1-3 | 2-3 | Acetaminophen, ice packs on forehead for swelling |
| Days 3-5 | 1-2 | Usually no medication needed |
| Days 5-7 | 0-1 | Discomfort resolved for most patients |
| Week 2+ | 0 | Fully comfortable |
Medications Typically Prescribed
Your surgeon will provide specific post-operative prescriptions. Common medications include:
- Acetaminophen (Tylenol): Primary pain reliever. Preferred over ibuprofen because it does not increase bleeding
- Prescription pain medication: Rarely prescribed, reserved for patients with low pain tolerance. Usually a mild opioid for 1 to 2 days
- Anti-inflammatory medication: Some surgeons prescribe a short course of methylprednisolone to reduce swelling
- Antibiotics: Preventive course to avoid infection (not for pain, but part of the post-op regimen)
For a complete breakdown of post-operative medications, see our ARTAS recovery guide.
Tips for Maximizing Comfort
Before Surgery
- Get a full night of sleep the night before
- Eat a normal breakfast the morning of the procedure
- Wear a button-down or zip-up shirt (nothing that pulls over your head)
- Bring headphones and download entertainment for the day
During Surgery
- Communicate openly with the surgical team about any discomfort
- Request additional anesthetic immediately if you feel any sharp sensation
- Change positions slowly when taking breaks
- Stay hydrated throughout the procedure
After Surgery
- Take pain medication on schedule for the first 48 hours (do not wait for pain to build)
- Sleep elevated at 45 degrees for the first 5 to 7 nights
- Apply ice packs to the forehead (not the transplanted area) to reduce swelling
- Avoid bending over, straining, or any activity that increases blood pressure to the head
Get Your Personalized Assessment
Upload a photo at myhairline.ai to start your hair restoration journey with an AI-powered analysis. Understanding your current stage of hair loss through our ARTAS overview guide helps you prepare for what to expect from the procedure, including the anesthesia and comfort experience described here.
FAQ
How painful is an ARTAS robotic hair transplant?
The ARTAS procedure itself is not painful once local anesthesia takes effect. The only discomfort most patients report is the initial anesthetic injections, which feel like a series of small pinches along the donor and recipient areas. These injections last about 10 to 15 minutes. After that, the 4 to 8 hour procedure is pain-free. Most patients watch movies, listen to podcasts, or nap during extraction and placement.
Are you awake during ARTAS hair transplant surgery?
Yes, you are fully awake during an ARTAS procedure. General anesthesia is not used. Local anesthesia numbs the scalp so you feel no pain, but you remain conscious and alert throughout. Some clinics offer oral sedation or anti-anxiety medication to help patients relax during the 4 to 8 hour session. You can talk to the surgical team, use your phone, and take bathroom breaks.
How long does pain last after ARTAS hair transplant?
Most patients report mild soreness and tightness in the donor area for 2 to 3 days after the procedure. The recipient area typically feels numb rather than painful for the first 24 to 48 hours as the anesthesia wears off. Over-the-counter pain relievers like acetaminophen are usually sufficient to manage post-operative discomfort. Prescription pain medication is rarely needed. By day 5 to 7, most patients report zero pain.