Post-operative instructions after a hair transplant: procedure and other hair loss advice to avoid scalp problems.

The first night

The first night is the most important. Avoid touching the grafts because they could fall out of the incisions.
Sleep in a semi-upright position: try to sleep with 2 or 3 pillows to elevate your head.

Sleep in this position the 3 first nights following surgery.
Ideally you should spray the grafted area with the lotion provided by the clinic.

The spray

The physician will provide you with a spray (growth factor) for use at home. Spray the lotion on the grafted area every 30 minutes the first night after surgery. Keep on spraying the lotion on the grafts until there is no more spray left.

How to wash your hair.

You can use shampoo 48 hours after surgery and, then, every day during at least 1 week.

1. Use a ph-balanced shampoo
2. Put some water and shampoo in a plastic recipient and start to massage your hair, the grafted area and the scar with your fingers and thumb.
3. To rinse your hair, during the first days, pour some water over your head using a receptacle. On the fifth day after surgery, you can use a shower jet on your head.

Some white spots may appear, after washing your hair, at the root of the grafts: this is due to a swelling of the grafts. These spots will usually disappear after 30-40 minutes.

As regards the donor zone, the suture must be regularly and energetically washed (using a small brush for example): this will avoid crusting, which impede scarring and the removal of stitches.

If you wish you can start cleaning the donor zone from the first night onwards in order to remove any traces of blood.

Physical efforts

Please avoid all physical efforts in the first week after surgery: avoid leaning forward, avoid blowing your nose too strongly... Please limit your physical activities at least during 1 week after surgery (no sexual activity for 7 days).

Avoid going to the swimming pool for at least 2 weeks after the surgery.

The antibiotic creme

You will be given an antibiotic cream after your surgery. Please start applying this cream to your scar from the morning after surgery for one week, twice a day (this cream promotes scarring and avoids any type of infection).

Swelling

Some swelling may occur. This is perfectly normal. Your forehead may begin to swell the 1st, 2nd or 3rd day after surgery.
If this does occur, please continue to take all the medicines prescribed and also put some ice on your forehead
(never apply the ice to the grafted area).
Please take all the medicines even if no swelling occurs.

If you notice that the oedema keeps on swelling, you can take 8, even 10 corticoids. However, if the oedema does not continue to swell, you can gradually reduce the number of corticoids: taking 4, then 2, then 0.

Bleeding

Some bleeding may occur occasionally: all you have to do is apply compression to the bleeding area with some compresses or any clean linen.
Ice packs may be used on the back of the scalp (donor area) but not on the grafts.

After 10 minutes, the bleeding should stop.

Pain

You may feel some pain after surgery: this is perfectly normal and the medicines prescribed will help you to relieve the pain.
Normally, the pain should not be intense.

Infection

Infected grafts or an infected scar are very unusual as you will be taking antibiotics (it is very important to follow the antibiotic treatment until the end).

If you notice a beginning infection (redness, heat, local pain), please contact Dr Devroye immediately.

Decreased sensitivity

You may feel decreased sensitivity in the recipient area: do not worry. Over the next 4 to 12 months sensitivity will be restored.

Crusts

During the healing phase, some small crusts will generally cling to the hair grafts: wet compresses will help make them disappear more quickly. Generally, crusts fall off within 7-10 days.
DO NOT pick at them.

Once you start washing your hair normally, the crusts will fall off: gently massaging your scalp while shampooing will speed up removal.
Often some of the grafted hairs and their bulb will fall out with the crusts. Please do not worry: the stem cells remain and they will ensure the growth of new hair.

Stitches

The stitches in the donor zone must be removed at the earliest 14 days after surgery. If there were no complications following surgery (irritation, infection), the stitches can be removed 15 to 18 days after surgery.

Growth

Remember that it takes 3-4 months after the transplant before the hair starts to grow except when the grafts do not fall out (5-10% of patients do not experiment graft loss). Sometimes growth is slower, it can take 6 months!

Shock Loss

Part of the hair already present in the grafted area may begin to fall out. Don’t worry; hair lost will grow back once the grafts begin to grow.
If some of the grafts fall out, there is no cause for alarm: the general aspect of the grafted area will not be changed.

Alcohol

You may not drink any alcohol at all for 48 hours after the surgery.

The sun

As long as your skin is red, you cannot stay out in the sun (or go to the tanning bed) in order to avoid any bleaching of the skin (in the grafted area).

You can use a cap the day after the surgery.

Minoxidil - Proscar

Start using Minoxidil from the 5th day after surgery.
You can continue to take Proscar before, during and after surgery.