Follicular unit extraction is safe and effective without bupivacaine and nerve blocks when using lignocaine with adrenaline.
August 2018 in “Dermatologic Surgery” 
3 citations
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May 2016 in “Journal of Cutaneous Medicine and Surgery” The document suggests using small syringes, distraction techniques, topical anesthetics, and specific drugs to ensure a pain-free experience during hair restoration surgery.
March 2026 in “Critical Care Medicine” Hair restoration can cause severe seizures due to combined drug toxicity.
April 2017 in “Australasian Journal of Dermatology” Most patients with Lichen planopilaris improved with acitretin, but treatments often didn't work well; preventing infection in skin surgery is important, and bupivacaine might be a better anesthetic.