Hair Transplant Procedure: What Happens Step by Step and How Long It Takes in Thailand

Part of our hair transplant guide. Hair transplant surgery, also called hair restoration surgery, usually takes one long day, and you're awake for it. The team draws the hairline, numbs the scalp, takes grafts from the back of the head, sorts them, makes tiny cuts where hair loss has thinned the hair, places the grafts and bandages the head.

The American Academy of Dermatology (AAD) says to expect between four and eight hours. Bangkok Hair Clinic says 6-8 hours for shaven FUE. One Hairtran Clinic patient wrote that "The entire procedure took 5 hours, not 7-8 as expected." (r/HairTransplants, 5 Oct 2024)

A few terms used below:

• The donor area is the back of the head, where hair is taken.
• A graft, or follicular unit, is a small group of one to four hairs.
• Recipient sites are the small cuts in the area hair loss has thinned, where the grafts go.
• FUE (follicular unit extraction) takes grafts one at a time with a tiny punch.
• FUT (follicular unit transplantation) removes a thin strip of scalp and cuts it into grafts, as the FUE vs FUT page explains.

Which method suits you is a separate decision. This page covers the day itself.

The Procedure in Order

This is a typical order, not a rule. The International Society of Hair Restoration Surgery (ISHRS) says FUE "varies from surgeon to surgeon in terms of setup, execution, sequence, instrumentation, staffing, anesthesia, etc." and that "the fundamental components of the procedure remain the same."

Why the Order Differs Between Surgeons

The ISHRS says some surgeons make the recipient sites first, after taking a few grafts to test the fit. Others "prefer to harvest the grafts first, and then make recipient sites with the harvested number of grafts."

Hairtran Clinic lists a complimentary lunch before the implantation stage. In one Hairtran patient's account the holes for the grafts were made before lunch, and after lunch the patient went "back to the surgery room and lay looking down this time."

Arrival, Checks and Hairline Marking

Checks, Photos and Tests

Clinics and patients describe a similar opening: photos, vital signs and a blood test. Hairtran says it takes baseline photos on the day, and that an HIV test "is required before every procedure."

A DHT Clinic patient wrote in 2017 of "a standard check of the vital signs, and a quick blood test against various diseases (HIV, etc)." (Finch Sells, 3 Aug 2017)

Drawing the Hairline and Agreeing the Plan

The ISHRS says that after the goals are reviewed, the first step is "to outline the donor and recipient areas including hairline design, and then to confirm that the patient is satisfied with the proposed areas for transplant."

Bangkok Hair Clinic and Absolute describe the doctor as the person who draws, and Hairtran has the doctor review and confirm the design. Bangkok Hair Clinic's DHI step list starts with "Surgeons sketch the new hairline". Absolute's English FUE page says "The doctor draws the hairline and prepares the area." Hairtran says "Your doctor will review and confirm the hairline design with you, making any fine adjustments before proceeding."

In the 2017 DHT Clinic account, the doctor's assistant marked out the hairline design on a plastic sheet before the writer met the doctor again.

The ISHRS position statement lists hairline design among the parts of surgery that "should only be performed by a licensed physician". That's a professional society's position.

Our hairline transplant page covers design, the Norwood scale covers planning for future hair loss, and how many grafts covers numbers. Whether you're a candidate at all is on the candidate page.

Shaved, Trimmed or Long: What Happens to Your Hair First

The ISHRS says "Shaved FUE is the most common way of performing the procedure. Non-shaved FUE may be performed in select cases but requires much more labor and time and is usually charged at a higher price."

For the strip method the NHS says the head doesn't need to be shaved, and only the area where the strip comes from is trimmed. For FUE it says "The back of the head is shaved." Hairtran says shaving "helps the doctor see hair follicle direction clearly" and makes cleaning easier.

Thai clinics set their own rules for the alternatives:

• Hairtran's non-shaven technique needs hair "at least 3 centimeters in length", and it asks you to dye gray or light hair black beforehand. That's its instruction, so ask your clinic what it wants.
• Bangkok Hair Clinic's partial-shave DHI trims "only at the specific donor extraction spots down to about 1-2 millimeters" and recommends keeping the hair at the back "at least 4-5 centimeters long or more". It says this takes longer than fully shaven DHI and typically limits a session to 1,500-2,000 grafts.
• Cosmoprime Clinic says its long-hair technique often takes 8-10 hours, in one full-day session.
• MedPark Hospital shaves the donor area "leaving short hair stumps, before administering local anesthesia".

Our pages on no-shave and long hair transplants cover those options.

Anesthesia and Sedation: What Gets Numbed and What You Feel

The Injections

The AAD says "Most patients remain awake during the entire surgery and need only an anesthesia that makes the scalp numb. Some patients also take a mild sedative to help them relax." The ISHRS adds that some surgeons prefer sedation "orally, intramuscularly, or intravenously".

A 2004 review from the Hair Transplant Institute of Miami says "Most of the pain associated with the procedure results from injection of the local anesthetic." Warming and buffering the anesthetic, and numbing the skin first, can reduce that pain.

Bangkok Hair Clinic lists "mechanical vibration, distraction and light sedation". An Absolute Hair Clinic patient (blog post, 24 Jan 2025) wrote of a foot massage and a vibrating device, and rated the injection "Maybe 3 or 4 out of 10." The Hairtran patient wrote "for me it felt like a 3 or so."

Those are two individual ratings, not an average, and nobody can say how it'll feel for you.

Sedation Differs by Clinic

• Bangkok Hair Clinic mentions "optional light sedation" on its DHI page.
• BHI Clinic says "Patients are given pain relievers, antibiotics, and mild sedatives before the procedure starts."
• Absolute Hair Clinic's Thai page says to bring a caregiver and not drive yourself, because sleeping medication is used during surgery and can leave you drowsy afterward. Translated from Thai (our translation).
• MedPark says local anesthesia "may cause dizziness and drowsiness" and asks you not to drive yourself on the day.
• Hairtran's FAQ describes local anesthesia and says "you will likely only feel a slight tightness or numbness during the process". A Hairtran patient wrote of getting "some Valium and Antibiotics" before the hairline was designed.

The DHT patient in 2017 wrote of "a cocktail of sleeping pills and valium". Practice differs, so ask whether you'll be sedated and whether someone needs to come with you.

Top-Ups on a Long Day

The 2004 review lists "timely repetition of anesthesia" among the basics for a long case. One Hairtran patient wrote that while the holes were made "you will feel a little bit here and there and you just let them know and they inject a little more to numb it." That's one account, and the Thai clinic pages compared here don't say when they top up.

A review published online in October 2026 says the evidence on anesthesia methods "consists predominantly of observational studies, case series, and expert consensus, with limited high-quality comparative data."

Taking the Grafts

Hair is removed from the donor area in one of two ways: single grafts with a punch (FUE) or a strip (FUT).

FUE: Punches, One Graft at a Time

With FUE, the ISHRS's FUE page gives the punch size as 0.7 to 1.2 mm, manual, motorized or robotic. Its surgical treatments page says "follicular units are individually extracted from the patient's donor area using a small round micro punch." The small wounds are "left open to heal without sutures", but with thousands of small cuts it's "an invasive procedure and does constitute surgery."

Thai clinics state their own sizes: Bangkok Hair Clinic 0.6-0.8 mm, Hairtran about 0.8 mm, Absolute 0.8-1.00 mm and MedPark 0.8-1.0 mm. What FUE is and what it costs is on our FUE page.

FUT: The Strip in One Paragraph

With the strip method, the ISHRS says, the donor wound is "closed with sutures or staples" and technicians dissect the strip into grafts. The NHS says each graft holds 1 to 4 hairs.

A DHT Clinic patient (FUT, Feb 2017) wrote: "After about an hour, the donor strip had been taken, and I looked up to find 8-10 assistants slicing it up in to thousands of tiny follicular units". That's one account, from 2017.

Who Does This Step

The ISHRS says "the key is that the procedure is physician-driven and performed". The American Board of Hair Restoration Surgery (ABHRS) says creating extraction incisions is "a non-delegable act, and must be performed by the physician of record."

Elsewhere on the same page the ABHRS adds "or other licensed medical practitioner as permitted by local and state legal medical guidelines". Both are professional standards, and the ISHRS notes that in some countries other licensed health professionals may do procedures under specific criteria.

Clinic pages are less consistent. Absolute's English FUE page says in one line that "the grafts are extracted by a technician" and in another that the graft is "extracted by himself/herself and his/her assistant." Hairtran's home page says "the doctor extracts hair follicles" in one place and credits "our skilled team" in its five-step list.

Those pages don't settle who extracts at any of these clinics. The ISHRS urges patients to "be sure your doctor is actually going to be performing your surgery, and not delegating it to an unlicensed technician." So ask which steps the surgeon will do and which staff will do. Our who performs page goes through the roles.

Sorting and Storing Grafts: Why the Clock Matters

Between harvesting and implantation, the team checks and sorts the grafts. Hairtran says each graft is inspected under a microscope, and Absolute describes an aluminum dish with 30 small channels that separates single-hair, 2-hair and 3-hair grafts.

Time out of the body matters. A review by Parsley and Perez-Meza says harvested grafts "take approximately 3 days before starting to regain their blood supply". It says "the hair restoration surgeons" should start with "hydration, temperature, time out of body and gentle handling."

The review quotes an older study by Limmer that held grafts in chilled saline. Survival was 95% at 2 hours out of the body, 90% at 4, 86% at 6, 88% at 8, 79% at 24 and 54% at 48.

Limmer's rule of thumb was that "the loss was roughly 1%/hour". The 8-hour figure is higher than the 6-hour one in the source, so read the numbers as a rough shape.

Clinics describe their own handling. Bangkok Hair Clinic uses a "first out, first in" technique "so that the first grafts harvested are the first to be re-implanted" and keeps grafts at 2-4 degrees C. Absolute says an insulated bowl with ice gel holds about 4-8 degrees for 4-6 hours, and puts out-of-body time at 2-5 hours.

Those are the clinics' own descriptions. The Limmer figures measure storage time, and they don't show that any clinic's method improves survival.

Making the Recipient Sites

The ISHRS describes recipient sites as "the slits into which the grafts will ultimately be placed". Planting can start once all the sites are cut, or after each cut, a method its surgical treatments page calls "stick and place".

Bangkok Hair Clinic says it makes "pre-incisions in the recipient area" to set angle, direction and density. Absolute's English page says the doctor "makes all pre-made incisions to control density, direction and angle."

The ISHRS position statement lists "Recipient site creation" among the acts for a licensed physician, and the ABHRS says "the creation of incisions for placement of grafts is also non-delegable, and must be performed by the physician of record."

Placing the Grafts

Forceps and Implanters

The ISHRS says there are "two techniques for implanting the follicular unit grafts - forceps and implanters." With forceps each graft is "held gently and inserted into a pre-made incision". An implanter loads grafts "into a channel and then a plunger is deployed to insert the graft into the skin", and the ISHRS says the bulb is "potentially subject to less trauma than when handled with forceps."

Thai clinics name their tools. Bangkok Hair Clinic says it uses Lion Implanters from South Korea, Hairtran an implanter pen, and Absolute "implanters for graft placement".

Who Places Them

The ISHRS says grafts are placed "most often by the trained staff" and that the step "requires a lot of experience and precision." The AAD says "two to three members of the hair transplant team may help place the healthy hairs", depending on the number.

The Absolute patient, on a 6,715-graft day, described "a conveyer belt with 2 technicians implanting the grafts" where grafts were "loaded, passed onto the technician, implanted and passed back". That's one patient's view of an unusually large day. The useful question is still which steps the surgeon does and which staff do.

Where the DHI Name Fits

The name DHI gets used for different things. The ISHRS says some use it for immediate implantation after extraction and some for placing with sharp implanters, and that "DHI is not a hair transplant method and should not be marketed as such." If a quote says DHI, ask which extraction method and which placement tool it means. Our FUE vs DHI page goes through it.

The Long Middle: Lunch, Breaks and What the Hours Feel Like

Plan for a full day. Bangkok Hair Clinic says "We provide a 15-30 minute break for lunch", and that clearing your schedule "will help reduce anxiety and allow the medical team to work without interruption." Hairtran serves a complimentary lunch before implantation, and Thai Hair Clinic lists a light lunch in its package price.

Position matters over that many hours. A 2022 review notes that "both the patient and the doctor must maintain certain postures for long periods". Three patients describe their days, each one a single account.

A Hairtran Clinic Patient, Post Dated 5 Oct 2024

The patient had lunch after the recipient holes, then lay face down. "I was listening to podcasts all the time which was super calming. You will not feel much on your back head, just a little bit like someone would poke you with a finger all the time."

An Absolute Hair Clinic Patient, Blog Post Dated 24 Jan 2025

This was a 6,715-graft FUT and FUE day that the doctor said was the most she had done in one day. The writer arrived at 8 AM, called the neck the worst part of extraction, "really sore from laying head down", and had "a quick snack around 2 PM". The writer added that "it was midnight by the time we finished everything."

A DHT Clinic Patient, Blog Post Dated 3 Aug 2017

The FUT was in Feb 2017, in "a reclined chair lined with pillows", with "a large hole in the front to rest my face". The assistants "would take turns giving me foot massages", and in the writer's words "at around 6:30pm, the procedure came to an end."

How Long Each Stage Takes at Thai Clinics

This table lists the lengths Thai clinics publish about their own procedures, with figures from medical bodies underneath. We compared what the clinics publish and haven't visited them. None of these is a promise for your day.

Absolute's Thai-language figure is translated from Thai (our translation).

Hairtran publishes three ranges for similar work, so one clinic's figure is a range. BHI Clinic is the only clinic compared here that splits the day into two stage lengths.

No page compared gives a time for hairline marking, anesthesia, sorting, site making or dressing, and none gives a usual start or finish time. MedPark and Hairsmith give no length at all, so a clock-by-clock schedule for a Thai clinic would be a guess.

Patient totals vary as much as the ranges do. The Hairtran patient put the whole procedure at 5 hours, the Absolute patient's day ran from 8 AM to midnight, and the DHT patient's from a planned 9 AM start to about 6:30 PM. Graft counts, which drive the length, are on our how many grafts page.

Dressing, First Wash and Leaving the Clinic

At the end of hair transplant surgery the team cleans the area and dresses it. The AAD says "your scalp will be bandaged and you will be given instructions for at-home care." Bangkok Hair Clinic's DHI page says saline removes debris and "a bandage is placed on the donor zone", and its FUE page asks you to wear the headband it gives you for 4-7 days against facial swelling.

The first wash differs a lot by source:

• Bangkok Hair Clinic's partial-shave page says "You can wash your hair the next morning".
• Hairtran schedules a day-one visit for wound cleaning and a check-up by medical assistants under doctor supervision. A Hairtran patient wrote that the next day "they will remove the bandage to clean the wound".
• BHI Clinic books wound cleaning or hair washing for the next day. It recommends staying in Bangkok "at least 48 hours", and on the same page "3-7 days".
• MedPark says the first wash is done at the hospital, and Thai Hair Clinic's package lists "a hair wash and checkup daily till your departure date".
• Absolute's Thai page says to leave the bandage on for 24 hours, and that clinic staff wash your hair for the first 4 days and teach you how. Translated from Thai (our translation).
• The NHS says bandages can usually come off after 2 to 5 days and a gentle hand wash is possible from day 6.

The NHS also says "You need to be very careful with your transplanted hair for the first 2 weeks after your operation." The ISHRS says dressing, exercise and water policies "vary among surgeons, so it is important to follow the instructions given by the surgeon you choose rather than any information found on other websites". UK guidance and Thai clinic instructions differ, so follow the clinic you book.

The Absolute patient called "sleeping upright with a travel pillow" the toughest part of recovery. Aftercare, week-by-week recovery and shedding have their own pages: aftercare, recovery timeline, shock loss and infection.

What to Bring, Wear and Avoid on the Day

Where clinics agree:

• A button-up or front-opening shirt, so nothing is pulled over your head afterward. Hairtran, Bangkok Hair Clinic, Hairsmith and Absolute's Thai page all say it.
• No tea or coffee on the day. Hairtran says to have a light breakfast but avoid tea or coffee, "which can increase bleeding risk".
• Wash your hair that morning, with no gel or spray. Absolute's Thai page asks for a scrub the clinic gives you, the night before and that morning.
• A good night's rest before. Bangkok Hair Clinic's list says "Ensure plenty of rest the night before".

Where they differ:

• Caffeine: MedPark asks you to avoid it for at least 2 days before, while Hairtran and Hairsmith say the day itself.
• Medicines and supplements that slow blood clotting: clinics set different windows. Tell the clinic everything you take, and never stop a prescribed medicine without asking the doctor who prescribed it.
• Alcohol and smoking: windows differ too. Our alcohol and food page covers it.
• Coming alone: Hairsmith says "you can come alone and leave alone on the day of the transplant". MedPark says to "bring along relatives to drive you home", and Absolute's Thai page says to bring a caregiver. Ask yours.
• What the package supplies: Thai Hair Clinic's lists a gel-pad pillowcase, a u-shaped neck pillow, a headband, and a bandana or hat. The Hairtran patient bought a neck pillow and a dark towel.

Questions to Ask the Clinic About the Day

These five tie to the places where clinics disagree:

• In what order will the steps happen, and are the recipient sites made before or after the grafts are taken?
• Will I be sedated, and do I need someone to drive me or stay with me?
• When are the breaks, and what's included: lunch, a pillow, a headband?
• Which steps will the surgeon do, and which will staff do?
• How long should I expect the day to run for my graft count, and when do I need to be back for the first wash?

Add them to the consultation questions you already plan to ask.

About the Figures on This Page

Clinic figures are the clinics' own statements from their own pages, read on 9 and 10 October 2026, and they can change. Figures from medical bodies are credited to them where they appear. Patient accounts are single cases, quoted as the patients wrote them, and they aren't a guide to your day.

Nobody at AsiaPatient has visited these clinics. Our editorial policy and how we evaluate clinics pages explain how we work.

Frequently Asked Questions

How long does a hair transplant procedure take?

The AAD says four to eight hours, and the Better Health Channel says a session can last two to eight hours depending on how many hairs are moved. Bangkok Hair Clinic gives 6-8 hours, Hairtran 4-8 hours in the FAQ on its home page, and BHI Clinic 2-4 hours of extraction plus 2-4 hours of implantation. Cosmoprime says long-hair work often takes 8-10 hours.

Are you awake during a hair transplant?

Usually. The AAD says most patients stay awake with a numbed scalp, and some take a mild sedative. Thai clinics differ: BHI Clinic says mild sedatives are given and Absolute's Thai page says sleeping medication is used, so ask yours whether you'll be sedated.

Does the procedure hurt while it is happening?

A 2004 review says most of the pain comes from the anesthetic injection. Two patients rated those injections about 3 or 4 out of 10, which are two individual reports, not an average. Bangkok Hair Clinic describes vibration and distraction, patients describe foot massages, and nobody can promise how it'll feel for you.

What do you do during the hours?

Patients describe lying reclined or face down while the team works, with a break for lunch. Bangkok Hair Clinic gives a 15-30 minute lunch break, and Hairtran serves a complimentary lunch. Patients mention podcasts, music and foot massages, so ask what you can bring and use in the room.

Do I have to shave my head?

Often, but not always. The ISHRS says shaved FUE is the most common, and non-shaved FUE takes more labor and time and usually costs more. Hairtran's non-shaven technique needs hair at least 3 centimeters long, and Bangkok Hair Clinic's partial-shave DHI recommends 4-5 centimeters at the back (more on our no-shave page).

Can I go home the same day, and do I need someone with me?

The NHS says you shouldn't need to stay overnight, and Hairtran says most patients go home the same day. Companion advice differs: Hairsmith says you can come alone, while MedPark says to bring relatives to drive you home. BHI Clinic recommends staying in Bangkok for the post-operative wash, "at least 48 hours" on one line and "3-7 days" on another.

Is it done in one day, or do I need more than one session?

The NHS says a large area may need 2 or more sessions on different days, and the AAD says a large case may need a few hours the next day. Bangkok Hair Clinic says most patients need one session, while Thai Hair Clinic's maximum is 3,500 grafts in one session, with larger needs split in two. See how many grafts and second hair transplant.

Who actually does each step, the doctor or the assistants?

The ISHRS says harvesting should be physician-driven and that grafts are placed most often by trained staff, and the AAD says two to three team members may help place them. Clinic pages describe their own roles in different ways, so ask which steps the surgeon will do and which staff will do (see our who performs page).

Next Step

If you want quotes from Bangkok clinics, tell us your hair loss stage and your goals and get a free quote from the clinics that fit your case. Take the questions above to every consultation.