Post Operative Care
Post Operative Instructions After A Hair Transplant
Recovery and Healing After Surgery
This area will be discussed at your consultation, on the day of hair transplant surgery and also provided on comprehensive information sheets. We also provide you with a helpline phone number if you have any queries.
You will tart taking your medication as prescribed on the evening of your surgery.
- Antibiotic – Your Doctor may prescribe antibiotics. If so, take one tablet twice daily with food for five days. Complete the full antibiotic course as directed.
- Prednisolone - This is an anti-swelling medication. NEVER take Prednisolone on an empty stomach, it can cause extreme nausea and upset stomach.
- Pain medication – Should you experience any discomfort, you may take the pain medication that has been provided for you as directed: Co-codamol 1-2 tablets every 4-6 hours. Do not take the pain medication if you will be working, driving, or operating any machinery due to possible drowsiness. DO NOT take any medication that contains ASPIRIN for ONE WEEK following your procedure. No alcohol consumption for one week. You may also take an aspirin-free medication such as regular or extra strength paracetamol. You may also apply ice to stitches/sutures for 10 minutes every hour
- Hair Medication – Propecia, Dutasteride and Viviscal may be taken as usual.
Slight bleeding or oozing may occur from the donor area where the sutures are placed. We recommend placing a towel on your pillow while sleeping for the first several nights in case of oozing so that your pillow case will not be stained. If bleeding occurs, apply firm pressure with a clean cloth or gauze to the area for 10 -15 minutes. If bleeding persists after 15 minutes of pressure, contact us for further advice.
This is a surgical procedure and swelling does occur. It is part of the healing process. The degree of swelling varies with each patient from mild to pronounced. To minimize the swelling you should do the following:
- Sleep with your head elevated at a 45 degree angle for 3 nights following surgery. This can be done by sleeping in a recliner or using at least 3 pillows supporting your back and neck in bed.
- Apply crushed ice packs wrapped in a clean cloth as frequently as possible to your forehead and temples (20 mins every 2 hours while awake). Never apply ice directly to the grafted area.
- Perform forehead massage with firm pressure moving the fluid out toward the ears. Begin this activity the night of surgery. Perform after each ice pack for 3-4 minutes. Expect swelling to peak on or around the third day.
- If significant swelling persists after three days, discontinue the ice and change to warm compresses on forehead and temples, and repeat massage as described above.
For ten days after your procedure, refrain from any strenuous activities that would increase your blood pressure, e.g. jogging, weightlifting, sexual activity. When picking up items from the floor, bend at the knees while keeping your back straight to avoid your head going below the level of your heart.
Post Operative Hair Care After Hair Transplant Surgery
This area will be discussed at your consultation, on the day of hair transplant surgery and also provided on comprehensive information sheets.
Style your hair as desired after shampooing but remember:
- Using a blow dryer is not harmful to the hair, but it should be on a cool setting.
- Comb hair with light to moderate strokes (without touching scalp). Never use force.
- Only use styling products that do NOT contain alcohol.
- Wait 5-6 weeks after surgery before colouring or cutting hair.
Direct any scalp problems to our Medical Staff (i.e. itching, in-growing, and flaking) so that proper treatment can be provided.
Crusts or scabs will naturally begin to fall off within the first week following your procedure. DO NOT SCRATCH OR PICK at these crusts because you may accidentally remove a graft or cause an infection. If all the crusts have not fallen off after 2 weeks, call our office. After the fifth day, conditioner may be applied to the transplanted area for 15 minutes before shampooing. This will cause the crusts to soften and then fall off.
Allow the grafted area to be exposed to as much air as possible. Hats and hairpieces should only be worn if necessary. Hats, if worn, should not be so tight or constricting that they rub on the transplanted grafts. If you will be in the sunlight for more than 10 minutes, you should protect the grafts by wearing a non-constricting hat for three months. Five days after surgery, you may use sunscreen with SPF 30 or higher. Avoid tanning for 3 months after the surgery.
If a graft is accidentally knocked or combed out, immediately place the graft in a solution of salt and water and refrigerate, then call our office.
Fine nerve endings may be cut during each procedure. This will result in decreased sensitivity or numbness to both the donor and recipient areas. This usually subsides over a period of 6 to 8 months, but can persist for greater than 12 months.
You may start taking Vitamin C 24 hours after your surgery. Avoid vitamin E or multivitamins for 1 week.
You should make arrangements to have your sutures removed between 10 and 14 days after your surgery. For optimal healing please return to one of our clinics. Alternatively see your GP. We enclose a suture removal form.
Alcohol is not to be taken at all during the first week following your procedure. Alcohol can cause bleeding due to the thinning effect it has on you blood as well as elevate blood pressure.
Sometimes there is shedding of existing hair 2-4 weeks after the transplant. It will re-grow.
Please remember that it is normal not to see any growth at all before three months and it takes 12 months before most growth comes through.
Post Operative Hair Care – Salt Water Soaks
Maximising Healing After Surgery
Dr. Ziering has developed the following post-operative instructions. Please read and follow them carefully, they are intended to help you maximize the results of your hair transplant surgery.
Making Salt Water Soak
You will need gauze, table salt, 1 gallon distilled water, spray bottle.
Mix a gallon of distilled water with 10 tablespoons of salt.
Soak gauze with salt solution and place on grafts, apply even pressure to grafted area for 5 minutes.
These soaks are applied 5 times a day, 5 minutes at a time, for 5 days.
The soaks help remove crusting and promote healing.
Day After Surgery:
Spray the grafted area with the salt water solution every hour throughout the day while awake.
On the day following your procedure, you will begin shampooing your hair using baby shampoo.
Do NOT touch or allow the shower stream to hit the grafts directly for 5 days.
To wash grafted area, pour a small amount of shampoo into a clean cup and fill cup with water to create a soapy solution.
Pour the soapy solution over the grafted area. Then fill the cup with plain water and pour over the grafted area until all of the soap is rinsed out.
You can wash ungrafted and sutured areas in a normal fashion.
On the 6th day following your procedure you will begin to wash your hair in a normal fashion by gently massaging all areas and rinsing underneath the showerhead.
On this day (day 6), you may begin to apply conditioner to the grafted area 15 minutes before shampooing.
This will help the crusts and scabs to soften and fall off.
Shampoo hair once every morning using the cup method described above.
Apply the salt water soaks application to the grafted area 5 times throughout the day.
Continue spraying the grafted area with the salt water solution every hour throughout the day while awake.
DISCONTINUE salt water soak gauze applications and spray after day 5.
Shampoo hair once in the morning, but discontinue the cup method and begin shampooing in normal fashion.
On day 6, you can begin using conditioner as described above.
Post-Operative Instructions for Graftcyte
Day of surgery
The pre-medicated pads should be applied to the grafted area on the evening of surgery at home for 45 minutes if they were not applied at the office prior to your leaving. They should then be applied to the grafted area twice daily for 45 minutes duration for the 3 days. Spray the grafted area with the hydrating mist once every hour throughout the day while awake. A thin coating of Bacitracin should be applied once a day (usually after showering). Bacitracin gel should be applied across the sutured area only – not to be applied to the grafted area.
On the day following your procedure, you will begin washing your hair using your Graftcyte shampoo. Do not touch or allow the shower stream to hit the grafts for five days. To wash grafted area pour a small amount of shampoo into a clean cup and then fill the cup with water creating a soapy solution. Pour the solution over the grafted area. Then fill the cup with plain water and pour over the grafted area until all of the soap is washed out. You can wash ungrafted and sutured areas in a normal fashion. On the sixth day following your procedure begin washing your hair in a normal fashion by gently massaging all areas and rinsing underneath the showerhead. On this day you may begin to apply conditioner to the grafted area 15 minutes before you shampoo. This will help the crusts and scabs to soften and fall off.
Click to Download Post-Operative Instructions for Graftcyte PDF.
Shampoo the hair once every morning using the cup method described above. After showering, apply the Graftcyte pads to the grafted area (the pads should remain on the area for 45 minutes to 1 hour). The 2nd Graftcyte treatment pad application should be applied in the evening. Continue spraying the grafted area with the hydrating mist every hour throughout the day while awake. Bacitracin is to be applied to the sutured area once daily. (apply only a thin coating).
Days 2 – 5
Shampoo hair once in the morning, but discontinue the cup method and begin to shampoo in your normal fashion. Spray the hydrating mist on the grafted area throughout the day while awake. Bacitracin is to be applied to the sutured area once daily. (apply only a thin coating). Note: On day 6 you may begin using conditioner as described above.
Days 6 – 8
Shampoo hair once in the morning, but discontinue the cup method and begin shampooing in normal fashion. Bacitracin is to be applied to the suture area only in a thin coat once daily. On day 6 you can begin using conditioner as described above.
Days 9 – 10
Continue to use the same instructions as days 6 – 8, but DISCONTINUE the use of the Bacitracin gel to the suture area. Be sure to apply the hydrating mist every hour throughout the day while awake until the bottle is finished.
Everyone is different but on average the new hair will begin to emerge from the surface of the scalp at the four month mark following surgery. The range within individuals is from 2-6 months and is not easily predictable. However, results will continue to improve for around 18 months following a hair transplant:
- A postoperative evaluation at 5-6 months should show early new transplant growth
- Abundant growth and consequent cosmetic coverage is not anticipated until the nine-month mark following the procedure
- By 12 months most all of the transplanted hair has begun growing
- Over the ensuing six to twelve months the individual hair shafts thicken to a fully mature state and this contributes significantly to the overall appearance of the transplant
A man or women with prior transplantation – particularly that done in the intermediate or remote past will not experience growth until later.
For the first week following the procedure the transplanted are will have small crusts associated with the creation of the receptor site incisions and a variable degree of redness depending on a patient’s skin type. Swelling of the forehead is a potential consequence of a hair transplant; particularly one focused upon the hairline and frontal aspect of the head. After a week or so, this subsides and the appearance is normalised.
The sutures placed inconspicuously in the donor region are removed on the 10th day following the transplant.
The transplanted hair frequently responds to the act of relocation by entering the dormant or resting stage of the hair growth cycle. When a hair enters this stage the hair shaft breaks off and is shed leaving the follicle residing beneath the skin alive and well.
From this resting follicle a new hair shaft will grow in 3 to 4 months. The hair then continues to participate in the natural cycle of hair growth for several years alternating with ‘rest periods’ of several months length.
Yes, proper use of follicular units will be detectable only under a microscope or to a trained professional. The only people who know will be those you tell.
Hair loss surgery is not what it used to be. Microscopic Follicular Unit Grafting as performed our team of Surgeons, has reached new heights of artistic and scientific perfection. “Natural” is by far the most common reaction we hear about our work.
The transplanted hairs will last and grow forever. This is the result of harvesting follicular units from the permanent zone of hair in the back and sides of the scalp. This hair is genetically different than the hair on the top of the head and within the crown that is affected by the hormone DHT [the culprit in male hair loss responsible for miniaturization of the hair and eventual baldness].
When these ‘lifetime’ follicular units are transplanted they maintain their original immunity and thus grow as they would have within the donor area. This phenomenon is termed ‘donor dominance’ and though not entirely understood from a histochemical standpoint is the well established foundation for hair transplantation that is now time tested over nearly fifty years.
You will bathe the next day and wash your hair at that time. We will give you specific post-operative instructions on the day of your procedure as to how to care for your hair in the post-operative period. In short, the transplanted zone is washed by gently pouring a mild shampoo and water mix over the head and similarly rinsing is accomplished by carefully hand pouring water over the transplanted zone.
The remainder of your scalp including the sutured donor region can and should be washed in a normal fashion on a daily basis following the transplant. Hair can be either air dried, gently patted dry with a towel or dried with a hair dryer on a cool setting.
We recommend that you wait five to six weeks after the procedure before coloring or dying your hair. Hair can be colored within the week leading up to the procedure.
You can have your hair cut or styled one week after the sutures are removed from the donor area. The sutures are typically removed ten days following the transplant.
We will provide you with a complete list of all activities that should be avoided in the post-operative period. Strenuous physical activity inclusive of vigorous aerobic exercise and power weight training should not be performed until two weeks following the procedure. After the sutures are removed at ten days one can slowly begin to reintroduce an exercise regiment beginning with cardio and slowing adding back weight training.
Early excessive movement and particularly stain on the healing donor wound can increase the likelihood of a widened donor scar. Ideally patients should reduce their activity profile and ensure adequate rest during the week immediately following the surgery.
We recommend taking at least taking three days off from work following the procedure.
Thereafter it becomes a question of one’s comfort level in terms of appearance as to the timeframe of returning to the workplace. As residual erythema (redness) typically lingers for 5-6 days after the procedure, many individuals take off a full week from work. In instances where a hat can be worn, detectability is concealed immediately.
We instruct you to sleep in a reclined position at about a forty-five degree angle. If you have a recliner at home this is an ideal sleeping device for the first several nights following the procedure. Alternatively, utilizing two or three pillows in bed will do the same.
Any medical treatment for hair loss carries with it some slight risk factors. Shock occurs in a very small percentage of recipients of hair transplantations. Shock can occur when placing grafted hair between growing hair. Trauma from the procedure can cause some additional hair shedding. The strong hairs will grow back, while the weak hairs that were destined to fall out may or may not return.
The medical term for ‘hair shock’ is telogen effluvium. This entity is an event in which a population of one’s native hairs synchronously enter the dormant or resting stage of the hair growth cycle and are shed. A number of situations can precipitate telogen effluvium inclusive of a hair transplant. The impact on one’s appearance if he or she experiences ‘hair shock’ is usually not cosmetically significant, though on occasion the temporary loss can present an additional styling challenge to someone already contending with less hair than they are comfortable with. All competent hair transplant surgeons are aware of this potential consequence of a hair transplant and attempt to minimize it’s occurrence through careful recipient site creation and avoidance of injuring the native hair in the region. Our extremely small instrumentation further minimises the risk.
The fate of a hair involved in ‘hair shock is related directly to its state of health. If the affected hair was genetically coded to live for an extended period of time then the hair will return as actively growing hair in about three month’s time. If conversely the involved hair was approaching the end of its natural life cycle, then the possibility exists that the transplant procedure may prematurely end this hair’s existence.
In general the higher the percentage of mininiaturized hair one has and the more rapid the pace of one’s hair loss, the greater the risk of telogen effluvium shedding from surgery. Patients with longstanding and stable patterns of hair loss are less likely to be affected by ‘hair shock’.
Yes, you can, but it should be clipped on and not attached with glue or another adhesive. Tape can be used in the front, but only so long as it is lower than the level of the grafts and will not interfere with the transplanted hair.
There are a variety of ways to transition out of a hairpiece, and we can help you work through these scenarios.
Today’s hair restoration surgery is a low risk and very safe procedure and complications of any form are a rarity. Infection is virtually unheard of provided one adheres to postoperative instructions. An adverse or allergic reaction to the local anesthesia is possible through practically never encountered.
Ingrown hairs can occur when the hair first begins to emerge from the scalp. These are a minor nuisance and will resolve completely. Postoperatively patients experience transient numbness in the donor region which abates within weeks. This is a normal consequence of the procedure. Swelling involving the forehead and in extreme instances the whole of the face can occur following a hair transplant; particularly one focused upon the hairline or the front of the head. If swelling occurs it begins the day following the surgery and resolves within the first five days postoperatively in most instances.
Light hair on light skin has minimal contrast and results in a very natural look. Dark, thick hair on light skin is the most surgically challenging. This is true when dealing with either men’s or women’s hair loss. Curly or wavy hair can also give the appearance of greater density. When styling, it is better to part the hair to one side. This will create a layering effect and the appearance of greater density.
This is always a difficult question to answer. Density is a function of hair shaft thickness and number of hairs. One thousand thin hairs do not appear as dense as one thousand thick hairs. Your surgeon can help you understand this concept. The appearance of thickness or density will depend on how you style your hair, how much existing hair you have, how much hair you continue to lose, and how big the area is that you wish to transplant into.
Completely bald patients need to understand that, when they had full heads of hair, there were about 60,000 hairs on the portion of the head into which we usually transplant and about 30,000 hairs when they began to notice they were thinning. If you transplant 2,500 follicular units, you will get about 6,000 hairs. If you spread these out over the entire head, you can imagine that it will not look as thick as when you had 60,000 hairs over the same area. Having said that, the results of this type of procedure can make a dramatic and positive impact on one’s appearance.
We work very hard to meet the needs of our patients. However, there are some patients that have unrealistic goals or do not understand how a transplant is going to look once it grows in. Our surgeons have a lot of experience designing hairlines that look natural according to age, race, and gender. More importantly, they understand how they will look once they have grown in. We enjoy working with our hair loss patients on the custom surgical plan, but if a patient insists on something that our surgeon believes would be cosmetically inappropriate, then the surgeon has the right not to perform the procedure.
Unlike the unnatural looking hair plugs of old, we specialise in creating natural looking hairlines. The best way to see what your hairline might look like is through a consultation with a professional.
Although the cosmetic benefit can be dramatic a hair transplant by nature involves the relocation of hair that is redistributed within the transplant zone in a density that is less that nature’s original density. As such the goal of literally replacing all the hair that is absent from an area is usually impossible unless the involved area is quite small.
Fortunately the appearance of full or at least substantial coverage can be obtained by the introduction of a smaller number of hairs into the affected area(s) provided they are artistically arranged to create an optimal cosmetic effect. We have the technological proficiency to provide density on par with industry leaders and our team is unsurpassed in the even more important area of creative artistry.
Transplanted hair does tend to have a slight wave as we are extracting hairs from your donor area (which tends to be wavier) and creating natural looking results through follicular unit grafting. If your donor hair is straight, it will not become curly.
Occasionally following a hair transplant the emerging hair exhibits characteristics dissimilar to one’s native hair in the early stages e.g. excessive curl. It is felt that this uncommon and temporary phenomenon is related to collagen activity in the skin surrounding the grafted hair its impact on the hair’s attributes as the hair emerges from the skin’s surface. The usual outcome in this scenario is the normalisation of hair characteristics over the ensuing twelve months.
Definitely yes. The Ziering Blades offer your Surgeon the ability to precisely locate and create each recipient site opening. They are custom designed with a diamond shaped tip to allow for better graft fit. This refined instrumentation allows for the recipient sites to be made as close together as possible which correlates with a greater density of transplanted hair. The use of these smaller blades also results in cumulatively less trauma to the scalp and individually faster site healing.
Dry hair is felt to be causes by excessively tight trimming of the follicular units during the graft preparation stage and the inadvertent removal of the sebaceous glands surrounding the hair follicle. These glands provide a lubricating action to the surface of the hair and skin and their absence can create dry hair. Proper attention to detail during the process of graft preparation eliminates this. This is a temporary post-operative effect.
Every day following the procedure the transplanted grafts become more secure in the scalp. Graft loss should be only 1%. If a graft is lost it is almost invariably associated with some sort of trauma to the head and accompanied by bleeding.
Hair shedding is a different entity than graft loss and is expected following a transplant session. This hair will regrow after its dormant phase.