Post Operative Care
IMPORTANT INSTRUCTIONS: PLEASE READ CAREFULLY 4 TIMES. THIS IS IMPORTANT.
Important things to remember for the first night:
-Spray routinely every 15 minutes when awake.
– Be ahead of your pain THE FIRST NIGHT (don’t let the pain start first), especially if you had a strip hair transplant.
– Call Dr Sean in the evening just to check in
– Sleeping the first night: If you have had work done on the front of the scalp, I would like you to sleep at a 45 degree angle. You may want to place few pillows behind your back.
If you had the strip procedure and have staples on the back of your scalp, you may want to use a neck pillow or roll a towel underneath your neck.
Call Dr. Sean Behnam the night of your procedure. He wants to know how you are doing.
1. You will develop swelling underneath and around your eyes starting from day 2-5 if you had grafts placed above your forehead. If you do develop swelling, this is normal. If you wear the special tape provided on your forehead for 4 days and nights, you will not develop swelling.
Also begin icing your forehead from the following day three times daily. Do not place ice on the grafts. You can ice over the tape on your forehead for about 5-10 minutes three times a day starting the day after the procedure for two days.
You may start wearing a CLEAN baseball hat from the following day. Please make sure its washed.
2. For scalp hair transplant: Start Rogaine Foam by day 8. Rogaine is available at the office. Apply it to the scalp twice daily. This is important in preventing temporary shedding.
3. Important: Spray your scalp with the saline provided every 15 (fifteen) minutes, about 5-10 sprays for the 1st night. Starting the following day, spray 5-10 times every 30 minutes. Please use the spray mode, not the shooting mode. The goal is to wash away the blood from around the grafts so there are no blood clots. There are typically some oozing from the graft sites the first night, so spraying it every fifteen minutes will not allow for the blood to clot and this will also keep the grafts moist and clean and prevent crusting. The dressing around your head will absorb the fluid. If you use a gauze to pad it down after you spray, blot in the same direction of the hair, ie for the grafts in the front of the scalp, blot backwards to forwards.
You do not have to spray while sleeping.
4. You may experience shedding of your own natural hair in areas of thinning hair after hair transplant. 90% of time, this does not happen. If it does, it is temporary due to impact of hair transplant. It will grow back.
5. For those who had the Extraction Procedure (FUE) (not the strip method): Do a vertical and horizontal squeeze on the donor area, this will eliminate ingrown hair in that region. Do this twice daily for seven days. Then apply thick moisturizer, ie. aquaphor or neosporin liberally, twice daily for seven days.
6. Take it easy for the remainder of the day. DO NOT get sweaty and hot. DO NOT do any heavy lifting or strenuous exercise for at least 7 day. DO NOT lean over to tie your shoes or pick up objects for the first 48 hours, as this may provoke bleeding or swelling (you may bend at the knees).
7. Treadmill is ok after 7 days. Heavy lifting after 14 days. Extreme sports, ie sky diving, surfing, please allow for one month.
8.DO NOT drink any alcoholic beverages for 2 days following the transplant procedure, to avoid excessive bleeding. Also avoid the use of marijuana or other chemical substances not prescribed, for one week following the surgery.
9. If you are planning to take any sleeping medication, please inform Dr. Behnam before you take it to make sure there is not any interaction.
10. No swimming for two weeks. No swimming in ocean or Jacuzzi for 4 weeks. Do not lean over for 2 days after the procedure as this may promote bleeding. Bend at knee level to pick up objects. DO NOT BUMP YOUR HEAD . Be especially careful getting in and out of your car.
11. Do not perform any sit-ups for one month after the procedure in order to prevent stretching of the scar on the back of the scalp.
12. Bleeding is rare in the donor area because there are 3 layer of closure. But if bleeding occurs in the donor area, apply firm, steady pressure for 20-30 minutes. Repeat if necessary. Call Dr. Behnam immediately at 310-237-8760. If bleeding persists, locate the exact bleeding point and apply pressure directly to the area with an ice pack. If you are out of town, go to the nearest emergency department, ask the attending physician to suture the area. If he/she has any questions, they should call Dr. Behnam at (310)237-8760 any time of the day or night.
13.Pain Medication: The first night you will have some discomfort especially in the donor area where the staples are. Take your pain medication at the first signs of discomfort. DO NOT WAIT UNTIL YOU HAVE SIGNIFICANT PAIN. Take one tablet approximately 20 minutes before retiring for the evening. Take this medication with food. If you take Vicodin for pain, DO NOT drive afterwards or do any activity that would compromise your health if you become dizzy. If you do not want to take much vicodin, you can add Ibuprofen and Tylenol. Please remember that vicodin has 500mg of Tylenol in it and you can take up to 4000mg a day. No Alcohol while you are taking vicodin or Tylenol.
14. Staple Removal: Staples are removed by the 10th day. You are already scheduled for this appointment. You should have received a business card with the date and time on it.
15. How to make the staple removal more comfortable? One day prior to the staple removal date, apply a thick layer of Vaseline or Aquaphor or neosporin and rub it into the staple area. Apply it in the morning and at night. Also apply it on the morning of the staple removal and one hour prior to coming in.
16. We have provided you with disposable pillow cases for use on top of your pillow. Sleep in a semi-upright (45 degree angle) position the first 4 night. Elevation of your head lessens the chance of swelling or bleeding. Some people may benefit from a neck pillow.
16. Crusts (scabs) will form over the transplant sites and solidify by the end of the first week. DO NOT pick at these crusts at any time. If you pull out the crusts, viable grafts will come out with them. On day 8th, apply a conditioner to the grafts and let the conditioner sit for 5 minutes and then shampoo it.
17. How to apply conditioner :
Items needed are a bowl, a piece of gauze and good quality conditioner. Pour lukewarm water into the bowl. Add a small amount of conditioner. Lather a small amount of conditioner onto the gauze or your fingers. Blot the grafts. When blotting, blot in the same direction of the hair, ie for the grafts in the front of the scalp, blot backwards to forwards. Let the conditioner sit for 5 minutes. Then take a cup and rinse over the grafts.
18. Infection is really rare. In fact, it has If in the unlikely event you have a fever, redness or pain, call the doctor immediately.
19. Wait 2-3 weeks before wearing a hair system and do not place tape directly on the grafts.
20. You will have a bandage and dressing on your scalp for the first night. DO NOT ATTEMPT TO REMOVE THE BANDAGE. It will be removed in our office the next morning. If you’re not coming into office it can be removed the following day. In select circumstances, we allow you to remove the bandage, particularly if you live out of town. Cut the bandage using a scissor on the side and remove it. Do not pull over your head.
21. Ingrown hair is very common as the hair is growing out. It feels like acne and its painful. this is normal. Finishing your antibiotics will decrease rate of ingrown hair. If you do get it, Dr. Behnam can prescribe clindamycin solution 1% to get rid of it.
22. Itching at the donor site and the recipient site is very common. Dabbing it can help. If you have a lot of itching, Dr Behnam can prescribe you topical steroid to get rid of the itch.
23.Please remember that it takes 4 months after transplant before the hair starts to grow. Please BE PATIENT! Hair grows only one inch every three months after the procedure starts. Full growth by 15 months.
Follow up visits:
You get 10 laser sessions. Please try to complete them within the first 2 months following the procedure. Please call the office (310-315-4989) to make appointments for laser sessions.
Please make regular appointments to follow your progress at 3 months, 6 months, 8 months, and 12 months and 15 months after the procedure. Dr. Behnam would love to continuously follow up to make sure everything is going well.
There are few medications that Dr. Behnam will give you.
1. Prednisone: This is a steroid and it is used an as anti-inflammatory. Please take it as directed in the morning with food.
2. Antibiotics: Antibiotics prevents ingrown hair. Please try to finish.
3. Pain Medication: You can take pain medication every eight hours. Please do not wait until you have a lot of pain. If you have a lot of pain, please call Dr Behnam.
1.Please wait 24 hours before your first shampoo.
2. Gather a large plastic cup or bowl. Pour lukewarm water into the bowl. Add a small amount of Shampoo. The shampoos recommended are baby shampoo or tricomin shampoo, available at the office.
3. For the first 4 days, shampoo by rinsing only. Take a cup and remove some soapy water from the bowel and rinse it over the grafts. Then rinse clean water over the grafts to get rid of the residue.
4.From the 5th day on, please shampoo the following way: Lather a small amount of shampoo onto the gauze from the bowel. You will blot the grafts with the gauze.
4. When blotting, blot in the same direction of the hair, ie for the grafts in the front of the scalp, blot backwards to forwards. Do not wipe OR rub.
4. Wash the grafts gently with the gauze using a light patting motion. Gently rinse your entire head with lukewarm water using a cup. No Shower pressure on the grafts for the first 2 weeks. You can shower from neck down from the following day.
5. Carefully blot your grafts with a dry towel.
6. This is how you will wash for the next 14 days. After the 14Th day, use your fingertips on the grafts with a light circular motion and increase the pressure each day. You can also go under the pressure of the shower after 14 days.
7. Scabs may form by the eight day, please follow conditioning instruction as stated above.
8. Be sure to also cleanse the donor area thoroughly with your fingertips starting from the 2nd day after the procedure. You can use shampoo and wash the donor area well.
9.By the 14th day, shampoo regularly under shower.
- After 1 weeks, you may use your blow dryer at a cool setting to blow dry your hair until your grafts are healed. You may also use gels, mousse or hair spray sparingly. Use caution when combing or brushing your hair. Keep the comb or brush off of your scalp as you style.
SUMMER POST-OPERATIVE INSTRUCTIONS
- No swimming in pools for 3 weeks. No hot tubs or saunas until the areas are completely healed.
- Ocean water swimming allowed after 4 weeks.
- No direct sunlight for the summer. (Please be sure to wear a hat when out in the sun for more than 20 minutes,)
Things that may delay or prevent your hair from growing:
- Smoking: Smoking cigarettes or marijuana will prevent your hair from growing. This is because smoking constricts blood vessels and doesn’t allow oxygen to get to the grafts. So please stop smoking, definitely for the first 2 weeks.
- Trauma to the scalp: Please be careful. Don’t do anything that can traumatize your grafts, ie surfing, motorcycling, bungee jumping . In case you fall, these events can damage your hair follicle and prevent them from growing.
- Not taking care of your grafts: Please follow instructions carefully.
- Picking at scabs: Don’t pick at the grafts. If you have scabs, please follow the instructions above.
- Significant weight loss in a short amount of time.
- General stress, shock etc. Stress can play a huge role in preventing hairs from growing. For example, death in the family, bad car accidents may cause a delay in hair growth.
Things that may accelerate hair growth after the transplant:
Protein Shake: Certain protein powders have been shown to make hair grow out faster. This is whey protein concentrate and can be purchased at www.helphair.com. Please have one scoop in the morning and one multi vitamin in the evening. It can be stopped once the hair has grown out.
Rogaine: This can also accelerate hair growth. May be used twice daily. It can be obtained from any pharmacy. It can be stopped once the hair has grown out.
Propecia: This is an oral medication. It’s taken once daily. It can be used until hair has grown out.
Hair Transplant timeline
This is a general timeline. Your hair growth may vary.
Weeks 1-4: The transplanted hair started falling out. This is normal course for the transplanted hairs.
Months 2-4: There should not be much going on.
Months 4-7: hair should be sprouting out.
Months 7-12: Hairs should be growing longer.
Months 12-15: hair Shaft should be getting thicker.
Month 15: Please make a follow up appointment with Dr Sean to take post op pictures.