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Instructions

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 first three nights following surgery.

Shampooing

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

-Use Baby jhonson & jhonson shampoo.

- 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.

-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 the next 2 weeks.

Posible complications

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 Deepak Kalia 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 10 days after surgery. If there were no complications following surgery (irritation, infection), the stitches can be removed 12 to 15 days after surgery.

 

Miscellaneous 

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.

Sunlight

As long as your skin is red, you can not 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
Start using Minoxidil from the one and half months after surgery

The following table describes the usual course for persons having hair transplant. There will generally be significant person to person variability, so if you do not follow the course exactly, do not be concerned.

POST-OP	THE TRANSPLANTED AREA	THE DONOR AREA
The Day Following Surgery	Patients are instructed to wash their hair gently, but thoroughly, so that the scalp is free of any blood.	Expect some soreness, tightness and possibly some numbness.
Days 2-3	Scabbing is largely gone. Moderate redness may be present. Some swelling may appear on the forehead.	Soreness in the donor area begins to disappear. Some numbness may continue. There is generally no discomfort in the recipient area.
Days 4-6	If there is significant swelling, it may settle across the bridge of the nose and around the eyes and cheeks.	In the donor area only, any residual crusting can be removed with directly running shower water.
End of Week 1	Swelling usually has subsided. Redness is faint or absent. The hair transplants look and feel like a week-old beard. Patients are seen in follow-up.	Soreness is generally gone. Rarely there is some persistent numbness.
Day 10	Grafts are firmly in place. Any residual crusting may be gently scrubbed off.	Sutures or first set of staples will be removed.
End of Week 2	The grafts are permanently in place and cannot be dislodged. The transplanted hair begins to be shed. Patients may return to normal shampooing, brushing and combing and may get haircuts.	Sutures begin to absorb. Numbness is uncommon. If staples are used, some or all will be removed.
End of Week 3	The majority of the transplanted hair has been shed.	The knots at the ends of the absorbable sutures begin to disappear. Remaining staples are removed.
End of Month 1	The follicles enter a resting phase. You will look very much like you did before the procedure. Patients may dye their hair.	The donor area should still be protected against strenuous activity that stretches or puts undue pressure on the back of the scalp.
Months 2-5	The newly transplanted hair starts to grow, initially as very fine hair. Some or all of the original hair that was shed begins to grow back.	Any residual numbness in the donor area has generally resolved.
Months 6-9	Hair is groomable, but it continues to grow and thicken. Slight textural changes in hair are occasionally present.	The donor area regains most of its strength.
Month 10	Patients are seen in follow-up. If a second session is considered, it will be discussed.	Donor laxity has been restored.
1 Year	The final appearance of the hair transplants can begin to be appreciated.
1-2 Years	There may be additional fullness. Any textural change in hair usually returns to normal.