After your hair transplant procedure, you will be given written instructions that explain in detail how to care for your scalp until your return visit. Prescriptions for medications may be given at that time (or before the procedure). Most doctors give their patients an analgesic such as Tylenol with codeine. Antibiotics may be prescribed to prevent infection. Some doctors give medication to prevent swelling, although these have limited value. Tranquilizers and sleeping medications are prescribed to help the patient over the first few days of healing.

Immediately following surgery, your grafts are held in place by fibrin (the body's natural glue) produced by a chemical reaction in serum when the graft sites are made. The grafts are loosely held in place for the first 2-3 days and become fully secure at about the eighth day. The hairs that are present in your new grafts usually fall out during the first 2-6 weeks after the procedure (see Growth of New Hair section below). At this time, the patient will usually look just like he did before the transplant.

Follicular Unit Transplantation is a relatively minor surgical procedure; most people recover in several days, and many return to work right away. Some discomfort generally exists in the donor site for a few days after the surgery. The discomfort is best managed beyond the first day in most people with Tylenol (with or without codeine). Athletic activities should be restricted for 1-2 weeks. Some limited restrictions apply in the second week. Although we caution patients not to put undue stress on the donor area for several months, normal activity may be resumed 1-2 weeks after the procedure.

There are several different approaches to post-surgical treatment. The patient may leave with no bandage after the surgery or he may be given a small sweatband to keep pressure on the donor area. The recipient area is left open or lightly covered. This enables the transplanted area to be exposed to the air for drying and healing.

Patients often worry about the potential visibility of their new grafts. Scabs that tend to form on the scalp surface should be washed off as they accumulate for the first few days following the surgery. With the very small sites used in Follicular Unit Transplantation, no new crusts will form after the second day. Other than the stubble of transplanted hair and some faint redness, the transplant should not be visible after the first week.

For those individuals who wash their transplanted grafts well, the full extent of the transplant looks and feels (in the days following the procedure) just like a five o'clock shadow. Swelling of the forehead is present in 25% of people between the third and fifth day, but rarely lasts more than one day. Rarely, swelling of the eyelids occurs.

Sutures

After three years of research, Bernstein and Rassman have switched to a totally absorbable suture for most of our hair transplant procedures. The results of this study, recently published in Dermatologic Surgery concluded "Poliglecaprone 25 (Monocryl) is a very strong synthetic, absorbable, monofilament suture with low tissue reactivity that can be used in hair transplantation to close the donor wound with a single, running cutaneous stitch. If specific surgical techniques are followed, suturing with Monocryl can produce a fine surgical scar superior to metal staples and can result in a more comfortable post-operative experience for the patient."

We are pleased to offer this new suture to our patients. Besides the convenience of not needing to have the suture removed, it is skin colored and is literally invisible, even with the hair relatively short. We still encourage our patients to come by for their 1-week follow-up visit if they live close by, but suture removal is no longer a hassle.

Growth of New Hair

Growth of new hair appears to be rapid in the first 1-3 weeks, but this usually represents the beginning of the shedding of the hair shafts, which is common as the hair follicles go into a "dormant phase." This phase reflects the shock to the grafts from the transplant process. When the dormant phase occurs, it usually lasts 3-6 months from the time of the transplant before the new hair growth becomes evident. The dormant phase has lasted as long as eight months or longer in a small number of patients. It is during this period that the greatest anxiety occurs. The patient wonders if the hair will ever grow and if the decision to undergo the procedure was a smart one.

In most people, hair growth usually starts within 3-4 months. Growth occurs in cycles, each cycle starting a few days or weeks from the previous cycle. When the hair initially starts growing, the thickness of the shaft is often smaller than normal. This changes as the hair reaches a length of about 1/2 inch. A slow growth process is preferential for most men, because the hair growth is less noticeable. The return of hair reflects a reversal of the balding process, rarely noticed by friends or family as anything out of the ordinary. By 8 months, most people can see the effect of the process, and by 12 months, the growth and bulk will have reached 90% of its total growth. Hair can continue to mature as long as 24 or more months following the transplant procedure. For this reason, patients should not expect to see the preponderance of benefits from the hair transplant process for at least 12 months.

Wound healing is relatively fast. The surgical wound in the donor area usually heals within 1-2 weeks, although it may take many months to regain its full strength. In about half of the patients, the transplants on the top and crown of the head are barely visible within the first week. The existing hair can easily hide the donor incision. Those with more persistent redness in the recipient area often have a fair complexion or red hair.

Patients often express doubt or skepticism about the rapidity of the healing process with Follicular Unit Transplantation. Such doubts are most evident in those individuals who received traditional hair transplants because they remember the ugly, obvious wounds on their heads and the impact on their lives after their procedures. For those individuals in particular, it is critical to see and speak with a patient who is one or two weeks post-surgery. Most are more than willing to show prospective patients the results of their work at this early stage.

Delayed or Reduced Growth

As growth cycles vary widely, some patients may experience significantly delayed growth. This can produce substantial anxiety for these patients. Causes for delayed growth have theoretical explanations (published in the literature as H- or X- factors), however this phenomenon is not well understood and is, fortunately, uncommon. We have seen significant growth between 12-24 months following a hair transplant in a few patients who presented with delayed growth. In the rare case of reduced growth, additional work may be necessary.

Hair Loss Research Home  | Top of Page  | Expectations  | Contact Us