First Week After Hair Transplant Surgery

Q:

It is now 4 days following our procedure and everything seems to be going quite smoothly.

I have been taking care to wear a hat during the day outside and shampoo as I was instructed twice a day.  I have experienced no bleeding thusfar and the swelling has dissipated and gone.  The redness is diminishing and I now have sensations back in the back of the head.  Actually, the sensitivity there was back within 12 hours or so.  The pain is minimal and I have only taken generic Tylenol twice for it.

I am VERY happy with your work thus far and please feel free to quote any of my questions on the blog, anonymously.  I have attached two pics for you to see my status: 1 from last night and 1 from today with my hair styled.  No swelling!

Now, for my questions:

1) I go back to work tomorrow, the 5th day post op.  You instructed that I can begin to shampoo and normally style my hair then, correct?  Does this apply to any leave-in conditioners or should I wait on those?

2) A few pesky blood-caked scabs aren’t washed off and dry, flaky skin is forming around the middle of the sagittal.  I believe this is all normal and part of the mitosis process.  Right?

3) Can I start applying over-the-counter ointments like neosporin to my hairline to aid with the elimination of the tiny red dots of incision?

4) The back of my head feels quite tight.  Will the procedure on Saturday help with this or is this just a process of healing?

5) And finally, I know this is a really really silly question, but it seems fairly obvious that the grafts are growing.  I know more than likely this is actually just them getting ready to shed and go into dormancy.  But, I wonder, if you think, given that I have been on finasteride since the beginning of December and the hairline and temples were the first areas worked on, if there’s a good chance I get to keep most of them?  I also hope that I will experience little to no “shock loss” with the ‘native hairs’ so they should not theoretically go into a ‘dormant’ phase, correct?  The problem is that it would be very hard to conceal the growth I have with my longer hair if it wasn’t for something to work with, as it were.  The tiny hairs provide an anchor to rest longer hairs on.

I apologize for the length and perhaps detail of my questions but as I’m sure you know, this is a VERY personal procedure.

THANK YOU SO MUCH.

A:

I am glad you had a smooth post-operation period after your hair transplant surgery.

Here are the answers to your questions in the order you asked them:

How to use shampoo and conditioner use after hair transplant?

Yes,  anytime after day 4 you can go back to your normal routine in terms of using shampoo and conditioner and combing your hair normally.

How to deal with scabbing, dried blood removal after hair transplant?

Flaky skin could be seen any time in the first few days to weeks following a hair transplant surgery.  Dried blood due to some oozing in the first few hours after hair transplant should be dealt with carefully for the first 4 days and if still present after your instructed hair wash in the immediate post op period, it needs to be washed off more efficiently.  After day 4, you can shampoo your scalp and keep the foam for about 10 minutes each time.  This will allow the dried blood to become loose and come off easily with the soft brush that was provided to you after your hair transplant.

Do I need antibiotic ointment after hair restoration surgery?

Neosporin and any other antibiotic ointments are not necessary after hair transplant.  You have medications that were provided to you after your hair restoration which are used to help minimize the redness following surgery.  The small red spots that have been seen from the incisions or local anesthesia injections will be gone in 4 to 7 days following the day of surgery.

How about tightness of scalp after hair transplant?

The donor area is closed with staples that might be felt a little bit before we remove them at day 10 after hair transplant.  We also removed a strip from your scalp with significant number of grafts.  That stretches the skin, but the tightness that you feel know will be gone in a week or two after hair transplant.

Am I going to keep the hair or lose it?

I hope you are among the small group of people who does keep their transplanted hair and begins growing from the day of surgery.  However, the general rule is “Don’t count on them”.  We put most of our patients on finasteride after their hair transplant, but still about 80-90% shed all transplanted hair.

What is the chance of shock loss after hair transplant?

Shock loss is a different story and considering that you have been on finasteride before and will continue it after hair transplant, you have a good chance to prevent and significantly reduce the chance of shock loss.

I look forward to seeing you soon for your post operation visit at day 10 after hair transplant.