Shortly after your hair transplant treatment a crust or scab will form over each graft, and will remain attached for 7 to 14 days. Once the area is healed the crusts will then separate from the scalp and fall off, leaving a clean, pinkish area to indicate the site of each graft. Although these crusts are visible during the 1 to 2 week healing period, many patients can camouflage them by combing the adjacent hair over the transplanted site. If a hairpiece is normally worn, it may be used to conceal the crusts after the first week (and should be worn as little as possible for an additional week). Follicular unit made up of 2 follicular units very close together with 4-6 hairs leave minimally visible marks and are virtually undetectable within 7 to 10 days. The holes made for 1-3 hair single follicular units essentially disappear within a few days to a week.
The hairs in the transplanted grafts are shed between the second and eighth week after the procedure. Sometimes many of these hairs fall out attached to the separating crusts; occasionally they persist longer. Rarely, 1 or 2 of the transplanted follicles do not shed their hair at all, but continue to grow immediately after the procedure. With these exceptions, the grafts are usually bare for a period of 10 to 14 weeks after the operation, during which time the hairs are shed and the follicles recuperate to produce new hair. A new generation of hair is usually visible at the surface of the scalp by the twelfth week after transplanting, but this may occur slightly earlier, or up to 8 weeks later in a few patients. These hairs grow at the same rate as they did in their original location (which is usually ½ inch per month).
When a large area is transplanted, swelling of the forehead frequently occurs. While this swelling is usually mild, and lasts only 2 to 4 days, it occasionally can be severe enough to cause a large amount of puffiness around the eyes (approximately 1 out of 50 patients have swelling bad enough to cause “black eyes”).
Generally, the swelling begins 2 to 3 days after the procedure and is most noticeable after the first session; with subsequent treatments, it usually occurs in a milder form or not at all. In view of this, if possible, it’s advisable to schedule a holiday to coincide with the first session. Please be assured that the swelling is ALWAYS temporary and has no harmful effect on the healing transplants.
Contrary to what many patients have been told, the scalp (hairy or bald) has an excellent blood supply. A certain amount of bleeding during the transplant procedure is expected and is simply controlled by applying pressure. The donor area is stitched closed to produce better scars and to minimize bleeding. The stitches are removed 7 to 10 days later.
The physician or nurse will wash your hair the day after surgery. You may gently shampoo on the second day after transplanting. Even if you do not have a bandage, which is rare, it is highly recommended for you to return the next morning to have your hair washed and all the grafts inspected.
Patients from out of town are required to stay in town overnight after the transplant procedure, so that the area can be properly cleansed the day following surgery. They should not drive themselves home on the day of surgery because of the lingering effects of medications.
Ingrown hairs are occasionally a temporary problem, especially when follicular unit grafting is used and especially if the hair tends to be naturally curly. It is easily controlled, does not cause any permanent damage and does not occur in a majority of patients.
A temporary decrease in scalp sensitivity is always noted after transplanting, because nerves are cut as donor grafts are taken and recipient sites are prepared. Usually this will correct itself completely in 3 to 18 months as the nerves regenerate. Rarely there may be a permanent slight degree of decreased sensitivity in one area or another.