After Hair Transplants
WHAT CAN I EXPECT AFTER SURGERY?
There will be a mild to moderate amount of pain and discomfort associated with the surgery. This should be easily controlled with oral medications. Tylenol with codeine (or equivalent if allergy to codeine exists) is generally always sufficient for pain control.
The discomfort and pain should begin to decrease within 48 to 72 hours after surgery. A significant increase in pain after this period should prompt you to call the office.
Generally most of the discomfort that you will feel will arise from the tightness in your scalp. The tightness will be present both in the transplanted area as well as in the area where the donor grafts were taken. This tightness will gradually improve over several weeks.
A bulky cotton compression dressing will cover your scalp for 2 to 3 days after your surgery. Dr. Ducic will tell you whether the dressing may be removed at home or whether a visit to our office is required.
Some oozing is to be expected from the areas of transplantation for the first 2 to 3 days after the surgery.
Transplantation of the hair follicles (plugs) usually causes the hair shafts within the transplanted plugs to be shed within the first few weeks after the surgery. Don’t be alarmed. Regrowth of the hair shafts from the transplanted plugs will generally be expected to occur by 3 or 4 months after the surgery.
Multiple sessions of transplantation are generally required to obtain the best, most natural appearing results. The exact number of sessions is sometimes difficult to predict, as it will vary depending on the response (in terms of hair growth) that you have with each session. The entire process may take 1 session (for small areas of concern) or numerous sessions over several years (for large areas of balding). These sessions are optimally spaced at 3 to 4 month intervals, in order to give the most recently transplanted plugs a chance to fully grow. It is worthwhile noting that the results of each subsequent session may be initially less noticeable, as the new plugs will be hidden by hair growth from the previous plugs. However, as the recently transplanted plugs attain significant length (may take 6 to 9 months), there will usually be a gratifying increase in hair density in the area.
You should realize that there is a definite limit as to how much hair may be transplanted. Although Dr. Ducic will strive to give the balding areas as much coverage as possible, there is only a finite number of plugs that he is able harvest from the back (and occasionally sides) of your scalp. Thus, you may be asked to make a decision as to which bald areas are a priority for you to cover. Sometimes, additional procedures, such as scalp reduction, may be recommended in order to decrease the total area of baldness.
After the surgery, Dr. Ducic may prescribe minoxidil topical solution for you. Using the topical solution alone (without hair transplants) often results in poor “fuzzy” hair growth in limited areas. However, when it is used in conjunction with hair transplants, the “fuzzy” growth induced by the minoxidil, will serve to further thicken the more natural appearing transplanted hair. Even if you have had a poor previous response to minoxidil, it may still be beneficial if used after hair transplantation.
There will be small crusts or scabs on each of the transplanted plugs for the first 10 to 14 days after the surgery. These should not be disturbed (don’t pick at them or otherwise try to dislodge them, before they are ready to fall off on their own). As a result of the presence of these small scabs, the area of transplant will often be obvious to an observer (for 10 to 14 days). However, the area may be easily covered with any of a variety of hats, bandannas, scarves etc. Also, leaving the hair surrounding the bald areas longer in length, may allow it to cover the crusts during the healing phase.
Some numbness in the area around the plug donor and recipient sites is to be expected. This change in sensation is almost always temporary, and will gradually resolve over several weeks (uncommonly it may take a few months to resolve).
The only hairs that will be cut with each transplantation session are the hair shafts of the plugs being transferred. Hair that is growing in recipient areas (where plugs were previously transplanted) will be left undisturbed.
Some mild swelling of the forehead and scalp can be expected for several days after the surgery. Bruising is usually not a significant problem, but, if it does occur, it should not be a source of great concern for you. It will quickly resolve.
It is of utmost importance to tell Dr. Ducic ahead of time if you have ever been on Accutane, received radiation therapy to the head or neck, taken steroids or immunosuppressive agents.
Immunosuppressed patients (HIV positive, chemotherapy, AIDS etc.) and patients with certain autoimmune disorders may not be good candidates for this procedure as the risks of poor healing and infection leading to permanent scarring and poor aesthetic results may be much higher. It is mandatory that you inform Dr. Ducic if you have any of these conditions before surgery.
CALL THE OFFICE PROMPTLY IF YOU NOTICE ANY OF THE FOLLOWING:
- development of a temperature elevation exceeding 100.0 degrees.
- unusual bleeding or discharge from the scalp incision.
- a significant progressive increase in pain which is not easily relieved by taking your prescribed medication.
- the dressing is severely shifted or inadvertently removed within 24 hours of the surgery.
If any of the above should occur after regular office hours, do not hesitate to reach us through the answering service. For whatever reason, if you notice one of the above changes and cannot reach us at our office or through the answering service, present yourself to the emergency department for evaluation.
HOW DO I CARE FOR MYSELF AFTER SURGERY?
Make arrangements to have someone drive you to, and from, your surgery. If this is not possible, then no sedation may be used during the surgery. So, it is important to let us know ahead of time. Local anesthesia will, of course, still be used to ease the discomfort associated with the procedure.
Having someone stay with you on at least the first night after your surgery is often very helpful.
Be sure to fill your prescriptions before your surgery since it means one less thing for you to worry about afterwards.
Arrive for your surgery in loose, comfortable clothing. Your top should button or zip rather than pull over your head.
Take the antibiotics and pain medication only as prescribed by the office.
Do not take any aspirin or any anti-inflammatory compounds for 2 weeks before and 2 weeks after your surgery unless you first discuss it with your surgeon.
If you are a smoker, you should not smoke for at least 2 weeks prior to surgery and 2 weeks after surgery. Smoking and chewing tobacco inhibit your circulation and can significantly compromise your surgical outcome.
Sleep with the head elevated for the first week after surgery to minimize any swelling of the surgical area.
It is important that the dressing, placed at the time of surgery, stay in place for at least the first 24 hours. The dressing should be removed after 2 to 3 days. It will either be removed in the office, or, you may be asked to remove it at home.
After the dressing is removed, place a soft, clean washcloth over the area of the transplants, and take a luke warm shower. The shower water should be allowed to gently wash over the washcloth, thus, cleansing the wound but avoiding any direct injury to the surgical site. The rest of the scalp (without transplants) may be gently shampooed, keeping the washcloth over the transplants as protection. You should wash your hair in this manner daily for the first 3 weeks after your surgery. After this time, you may wash your hair without the need for a washcloth.
Be careful when combing your hair that you do not inadvertently catch the sutures in the donor area. Doing so is unlikely to cause any great harm, but it may be uncomfortable.
Your scalp may be somewhat less sensitive to touch for some weeks or, occasionally, months, after surgery. For this reason, be very careful when using a hairdryer, or curling iron, as excess heat from the device may injure your scalp without you being aware of it.
The donor area of the scalp is closed with either surgical staples or sutures. In either case, they need to be removed between 10 to 14 days after your surgery.
You should do no vigorous exercise and should avoid any significant physical exertion, lifting or straining for a minimum of 3 weeks after your surgery, as this activity could disrupt your wound healing. Plan on taking it easy.
Approximate recovery after hair transplantation is as follows:
DAY 1 Return home. Keep dressing undisturbed.
DAY 2-3 Day 2-3 maximum aching and throbbing. Dressing removed. Start washing hair by covering the transplants with a washcloth to provide some protection.Crusts and scabs are present over transplanted plugs.
DAYS 10-14 Stitches or surgical staples removed. Crusts and scabs mostly gone.
WEEKS 1-4 Hairs in transplanted plugs will shed. Don’t worry. This is expected.
3-4 MONTHS Hair shafts should be regrowing in the transplanted plugs. Usually need to consider a new round of transplants at this time.
REMEMBER: If you have any concerns or questions, please contact our office any time. Our office should be a source of information and reassurance throughout this entire experience, from the time of your first consultation and continuing after your surgery.