Post-Op Care

The healing or post-operative care period after a hair restoration surgery is important if you want to obtain the best results.

Hair Restoration Post-Operative Care

Below are our General Instructions Following Hair Transplantation (“GIFHT”). At the bottom are specific instructions for each day following your hair transplant.

• Before you leave our medical facility, we will take careful precautions to be sure that all bleeding has stopped. It is unusual for any bleeding to occur after leaving. However, if you observe any bleeding at any time after leaving, put firm and continuous pressure over the area using the palm of your hand, for 20 minutes, or until the bleeding stops. Although it is highly unlikely, if brisk bleeding should occur, maintain firm and continuous pressure directly over the area and telephone the MHT facility where your procedure was performed.  It may be necessary to return to our medical facility to simply place a suture over a bleeding point. If bleeding cannot be controlled by pressure and you are unable to contact our medical facility by telephone, please go immediately to the nearest emergency hospital and show the information contained in the box at the end of these instructions to the physician on duty there.

Medication Instructions – See Post-Operative Care Details Below

• You will have some scabbing or crusting in both the donor and recipient areas. To help minimize the duration of each and to expedite healing, we recommend following the routine below. These two items are very important for the proper healing of your grafts, and to minimize the chances for an enlarged scar.
• CARE OF DONOR AREA (the sutured or donor area in the back) – Apply a thick coating of antibiotic or vasoline (purchased over the counter at a drug store) across the donor area two times a day starting on Day 4 following your procedure. When the wound stops forming scabs and the wound looks clean and the sutures are easily seen, you may stop the daily ointment treatment. The ointment is also commonly called “triple antibiotic ointment’ Your pharmacist can help you locate this ointment should you have trouble at your local pharmacy. Keeping your wound greasy and covered with ointment will shorten the healing time and minimize the size of final appearance of the scar. Do not put the ointment on the grafts.
• You may shampoo your scalp 36 hours following the start of your procedure (the evening of the day after your procedure).  For the first seven (7) days you must use the Cup Method to wash your hair and scalp.
  • The Cup Method: To wash the recipient (where the grafts were placed) area, pour a small amount of shampoo into a large clean cup and then fill the cup with water and stir creating a soapy solution. Gently pour the solution over the grafted area and repeat this two times. Then fill the cup with plain water and pour it over the grafted area and rinse the area until all the soap is washed out. For the first two weeks use a mild dandruff shampoo or baby shampoo. Do not allow the shower stream to hit the grafts directly for 7 days (use the Cup Method of rinsing).  On the 7th day, you may shower normally, allowing the shower stream to hit the grafts, as long as the stream is gentle. You should gently massage your donor area every day while shampooing.
• Within one (1) week after your procedure, the crusts will begin to come off while shampooing. At the same time, or soon thereafter, the short shafts of your transplanted hair may begin to drop out. This is expected, normal, and usually occurs between weeks 1 and 6 following your procedure. You may encourage the removal of the scabs by rubbing your recipient area(s) with your fingertips (not fingernails) while shampooing. This will also help to loosen the scabs over the grafted area. Begin this on the 8th day following your procedure.

You will begin to see growth in the transplanted area approximately four (4) to six (6) months after your procedure. It’s important to note that the hairs go dormant for 3-4 months. You may not experience full growth for 9-12 months. Each person is slightly different. After your hair begins growing, it normally grows approximately one-half inch per month (six inches per year).

• A warm (not hot) hairdryer and mild hair spray may be used carefully after shampooing, beginning one week after the procedure.  Do not use hair or scalp coloring agents for fourteen (14) days after your procedure.
• You will be able to continue most of your usual activities immediately, but strenuous or excessive exertion should be restricted for fourteen (14) days.
  1. 1. Days 1-10 after the procedure: NO EXERCISE. Do not bend over at the waist. Keep your back straight and bend at the knees to pick something up. Walking is fine; keep the head above the heart.
     2. Days 10-14: Light exercise, like walking. (NO profuse sweating).
     3. Day 15 and on: You may resume all activities including getting a hair cut, using minoxidil (Rogaine and others) on the transplanted area, using sunblock, “perming” or coloring the hair and wearing a hairpiece with adhesive. If you have other specific questions, be sure to ask before leaving. The one thing you should not do is listed below in Item #8.
     4. No swimming for 4 weeks after surgery.
• Do not sunburn or tan your recipient areas for three (3) months after your procedure, to avoid possible hyperpigmentation (discoloration) of the recipient sites. Cover your head when in the sun for longer than brief periods.
• Typically, when the frontal hairline is being grafted, swelling occurs over the forehead and eyelid areas. This harmless swelling peaks on day three (3) or four (4) after your procedure. This harmless swelling lasts only a few days and will resolve by itself. Sleeping sitting up in a chair with your head elevated in a recliner along with icing and massaging of the forehead will help minimize the swelling (see instructions below).

ICE AND MASSAGE TO REDUCE FOREHEAD SWELLING:
Take an ice pack or a package of frozen vegetables and apply to your forehead for 20 minutes at a time. DO NOT let the ice pack touch the grafts – use some type of cloth cover.  Following the icing, use your fingertips to rake fluid away from your forehead and toward your temples.  Do this ice and massage routine 4 – 5 times per day with each session separated by about 90 minutes (1 ½ hours).

• Numbness, tingling or similar sensations may occur temporarily on your scalp and are the result of cutting tiny nerve endings in the skin during the course of taking donor grafts and creating recipient sites. This virtually always disappears within a few months, as nerve endings regrow.
• If, at any time after the second day following Hair Transplantation, any raised or red areas occur in your donor or recipient sites, please contact the MHT facility.
• Your first check-up appointment is at the time of your suture removal (if applicable), but we will be happy to see you at any time if there are any problems.
• Hiccups can be a rare side effect of the medications, usually mild and limited to two (2) or three (3) days following the procedure.  If the hiccups become severe enough to interrupt your sleep or cause pain, please contact the MHT facility.

Post Operative Care Detailed Instructions By Day

FIRST NIGHT
PAIN

• • FUE – the non-steroidal, non-narcotic Ketorolac (Toradol) pain medication given during the procedure should prevent any significant pain.
    • If you have breakthrough pain, take 1 narcotic hydrocodone/acetaminophen (Norco) tablet.
    • If the pain persists after 1 hour, take 1 more tablet
    • You may take up to 2 tablets every 6 hours if needed
  • STRIP (FUT) – the incision in the back will hurt once the anesthesia wears off.
    • Please take 1 narcotic hydrocodone/acetaminophen (Norco) tablet after eating prior to the anesthesia wearing off- within several hours after the procedure
    • If the pain persists after 1 hour take up to 2 tablets every 6 hours as needed

SWELLING

• • Be sure to take the last 2 steroid methylprednisolone (Medrol) pills to complete day 1 of the 6-day course

SLEEP

• • Take 1 Zolpidem (Ambien) sleeping pill if desired, 2 if necessary

REMINDER

• • Sleep with your head elevated above your heart – propped up on pillows, or in a recliner. For strip patients, a neck pillow support takes pressure off the incision, making sleep more comfortable. No bending over.
  • If you do not tolerate Ketorolac (Toradol) or hydrocodone/acetaminophen (Norco), you may substitute with non-prescription plain acetaminophen (Tylenol) by itself or in combination with a nonsteroidal such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn). Follow the label dosing directions.
  • If you do not tolerate Zolpidem (Ambien) for sleep, you may substitute diphenhydramine (Benadryl), 1-2 tablets
  • If you feel the headband bandage is too tight, with pain/redness/swelling, unwrap the outer self-sticking bandage, and rewrap less tight, keeping the underlying gauze non-stick dressings in place.
  • If you are still having significant pain despite taking 2 Norco every 6 hours, contact us
  • If you have bleeding that does not stop after your hand compression for 10 minutes,, or distinct swelling under the strip incision, contact us
  • If you are not able to contact us, you will need to go to an urgent care or ER facility

DAYS 1, 2, and 3

• • HEADBAND BANDAGE – Maintain for at least 3 full postop days
  • PAIN PILLS – Take as directed, only if necessary. FUE patients typically require only a few days of Tylenol or Ketorolac. STRIP patients typically require Norco in addition to ketorolac (Toradol).
  • SLEEPING PILLS – Take only if necessary
  • SWELLING PILLS – Continue daily decreasing the dose
  • EXERCISE – No vigorous exercise for at least 10 days. Walking is fine. Keep head above heart.

DAYS 4 and 5

• • HEADBAND BANDAGE – May remove in the shower. Use warm soapy water; clean scalp gently using Cup Method (detailed in GIFT packet).
  • Reapply ointment (antibiotic or vasoline) over donor punch sites/ incision, grafts, for faster healing.
  • Put a clean towel over a pillow at night. Finish steroid anti-swelling pills.

DAYS 7-10

• • STRIP – suture removal needs to be completed
  • May wear a loose-fitting hat

AFTER DAY 10

• • Contact us if you develop pimples in the donor or recipient area, increasing swelling, redness, or pain
  • May resume vigorous exercise after 2 weeks and swimming after 4 weeks