Ice Compress to Reduce Swelling After a Hair Transplant?

Q:

Ice compress to reduce swelling after hair transplantHello Doctor,

My hair transplant recovery seems to be going well. I am beginning to see some signs of healing, but I am also seeing the expected swelling after the procedure.

I was wondering if it is okay for me to ice my forehead and the donor area to reduce the potential continued swelling. I will make sure to not touch the grafts in the recipient area.

A:

Thanks for the question. I am glad to hear that your recovery process is going well.

Some people may recommend putting a cold compress or ice, after a hair transplant, on the donor or recipient areas. However, it may not have much of an impact on the amount of swelling. The swelling which happens after a hair transplant is mostly post-inflammatory swelling. In general, post-inflammatory swelling is a secondary reaction to the healing of your scalp skin.

However, if putting ice around the transplanted area, such as on the forehead or on the donor area, makes you feel better, you may carefully do so as long as you take great care with the hair grafts. Make sure to keep the contact time with the ice to a minimum and do not leave the compress on one spot longer than a few seconds in order to prevent tissue ischemia (a deficiency of blood in the tissues that is caused by the blocking of local blood vessels).

Donor Thickness After FUE Transplant

Q:

Hello Dr. Mohebi, I had a 1500 graft FUE transplant with you about 2 months ago. In the procedure, 1500 grafts were taken from the back, left side of my head. I’m having concerns because at 2 months post op, there is a noticeable difference in the thickness of my hair between the left side and right side. In the donor area, a lot more of my head can be seen. I like to keep my hair short at a #2 guard and I’m just a little concerned because there is a noticeable difference at that length. My question is, is this normal or should I be concerned about it? Will it get better over the next few months? And is there anything I can do to fix this? Any help would be great. Looking forward to hearing back from you. Thanks.

A:

Removing 1500 grafts from one side of the scalp usually does not leave a noticeable change.  I have never seen this as a problem.  However, it is a bit difficult to judge it at this point since you may also be experiencing some of the neighboring hair going to resting phase known as telogen effluvium, due to the inflammation of the healing.  This will be reversed when the resting follicles start growing new hair, as time goes by.  Feel free to let us know if you have any other questions or concerns.

Exercise After Hair Transplant

exercise after hair transplantQ:

I am post op day 5 from my hair transplant. I exercise regularly and my regular fitness routine is an extensive swimming program in the pool. I usually wear a swimmers cap to reduce the friction as most advanced swimmers and to protect my hair from long term chlorine damage. How will this affect my hair transplant? As you probably know the caps are very tight.

A:

Exercise after hair transplant is generally allowed after the first few days.  Wearing a cap at this point is probably OK.  However, since the swimmers cap is very tight I prefer you are on the safe side and wait 7 days. This is the minimum time we like to recommend to re-engage in exercise after a hair transplant procedure.  If there are any further concerns we can certainly see you in the office, I anticipate all will be just fine with that waiting period.

Cold Feet Before Hair Transplantation Surgery

Q.

Dr Mohebi,

I hope you are well. As we get closer to my surgical date I have put together some questions for you.

I have been reading a lot on the hair restoration network and found this 1 individual called Megatron with a similar makeup to myself.

I have looked at his very detailed journal and find many similarities to myself. Because of this I have several concerns.

If you look through his journal you will notice that he has a similar hair type to myself. It appears he got acne throughout the donor and recipient area that looks horrible at about 2 months after hair transplant and continued for several months. I was very prone to acne as a child and as I mentioned in our consultation I have incredibly sensitive skin and very thin tissue. If I went to a spa and received a facial not only would my face become very red and inflamed but the benefit of the facial would not be realized for sometime due to the fact that I would most certainly get a breakout the following day. Seems like my skin does not like to be touched, squeezed etc. It also appears that he was treated for several infections around the 2 month mark as well which may have affected or increased his shock loss.

I am also concerned about the level of shock loss that he had. What are the common reasons for this and is there a way to minimize this other than the medication you have already prescribed? It appears as if he lost a good portion of the density at about 2-3 months in the recipient area. I am not sure if I am ready to go through that even for the greater good. I understand that everyone is different and will react differently to the surgery. I have always been on the side of having the most and weirdest reactions to everything that messes with my bodies natural makeup!

When would you say that a return to normal sleeping patterns is likely?

I am not sure if this can be considered a random case of cold feet but I just wanted to get some additional reassurance from you prior to finalizing everything today

 

A:

It is great to hear from you. I will be answering your questions in the order you asked:

1.      What is generally seen a few months after a hair transplant procedure in some individuals is called folliculitis. This happens due to an accumulation of sebum, oily secretions, of the hair follicles.  They are not seen in every patient and do not generally have to do with having a history of acne in the past.

2.      Having sensitive skin may indicate more swelling and redness for the first few days after surgery, but this might be controllable with steroids that we already give to most patients.

3.      Shock loss is most often seen in the areas where you have significant miniaturization, which in your case we know exists based on our microscopic evaluation.  However, we recommend using prescription medication after your hair transplant for a few months to minimize the shock loss.

4.      You can go back to your normal sleeping pattern after the 4th day after hair transplantation. Within the first four days you need to sleep in semi-sitting position, but there is no problem with putting pressure on the closed donor area.

In closing, be aware it is normal to have some level of anxiety before any type of procedure.  Please contact me if you have any other questions.

Two Weeks After Hair Transplantation – What to Expect

Q.

Hi Dr. Just got back from my vacation in XX, had a good and relaxing time. While I was gone for 2 weeks all the scabbing from my hair transplantation is pretty much gone in the donor scar and the implanted areas. Also I noticed that I did lose hairs as you mentioned would most likely happen. the hairs that fell that looked like the grafts were just the hair shaft that I saw fall. I did not see skin attached to the end of the hair shaft so I assume the follicle survived in the skin where it was implanted. not all have fallen but I did notice a good amount. I also notice small dark hairs sprouting in the implanted area. I assume these are coming from where the original grafts shed?

Its almost a month post op and I feel no pain and have all feeling back on my scalp. I pretty much wash and style my hair as usual.

Is all this normal progress after the surgery?
Thanks.A.

It is good that you had a nice vacation!

One month after hair transplant surgery is the general time which you should have lost most of your transplanted hair shafts.  The follicles are now part of your scalp and will be growing new hair in 2-3 months.  Your inflammation should be subsided on both the transplanted and donor areas.  Minor itching might be noticed at this time which is a good sign of the scalp wound healing.  You may have lost or will soon lose some of the bulk of your existing hair due to the shock loss. You will be noticing new hair growing in 2-3 months from now and the hair shafts will continue getting longer and thicker till about one year from the time of your hair transplant.

 

Redness and Inflammation After a Hair Transplant

Q:

Hi Dr. Mohebi,

I hope this email finds you well. I am still waiting for a date to open up for me to come in and undergo my hair transplant, In the meantime I was once again looking at “before and after” photos on your website. I have a question regarding a couple of them.

In some patients, their “after” photos were taken eight months after the procedure but it looks like the scalp is still rather red.  I’m wondering how many months will I possibly have redness, scabbing or other obvious signs of the procedure?  Thanks very much for taking the time to answer my question!

Best wishes,

A:

The recovery process, covering healing and hair growth, is usually not complete anywhere before ten months to a year after the hair transplant.  In fact, some people do not see their best results until eighteen months after their hair transplant surgery.

One of the stages of any healing wound is the inflammatory stage. In this stage inflammatory cells accumulate in the wound. Along with inflammation of the scalp, there will be an increase in the amount of blood that supplies the area. This is what makes the skin red after a hair transplant.

Redness and any inflammation of the skin is usually resolved after the first few weeks. However, some patients with a lighter skin color may continue to have some signs of remaining inflammation and redness after a hair transplant. This may be followed by slowly disappearing pinkish discoloration for many weeks or even months. Thankfully, these conditions will eventually resolve on their own.

If the redness after hair transplants is interrupting the day-to-day life of the patient, we can use medication to minimize or eliminate that.  Since the redness is secondary to the skin inflammation after a hair transplant, which is an important stage in healing, we do not want to suppress it too early. However, if it continues to bother patients after the first week or two, it could be treated with mild steroid creams and other medications that help reduce any inflammation of the skin.

Covering Newly Transplanted Hair After Hair Restoration

Q:

Dr. Mohebi, I have already made an appointment for hair transplant surgery on Wed April 20th per your recommendations and paid the deposit. If you don’t mind I have a quick question.

Do you think it’s realistic for me to see patients on Monday following my procedure? I have clinic that day and OR the next (will need to wear surgical cap), is this okay in the week following?

A:

Because we will be transplanting a large number of hairs in the frontal area of your scalp, we expect significant swelling until day 4-5 after surgery.  Occasionally patients may experience swelling until day 6-7, but your surgical cap use is okay and should easily cover it.

In addition, some patients occassionally get swelling and bruising around their eyes (which may be difficult to cover). Probability of bruising/swelling around the eyes is minimal but its possibility should still be notated.

Can I Get an Infection After a Hair Transplant?

Q:

Dear Dr. Mohebi,

I had a hair transplant back on October 31st, 2009 (a Halloween treat for me) I started to notice some red boils along my transplanted area (suspected to be folliculitis) in January and I have been taking Accutane for the last month.

My general question to you is…Why did this happen? I was advised to get such a heavy drug that I feel it has changed the overall tone of my face (somewhat like getting severe dryness).

Lastly, why do you think there are a few patchy spots located in the infected area? They look like bald patches on my scalp. Do you have any suggestions or medical advice for the future?

A:

It looks like you know that pimple-like scalp lesions that develop after a hair transplant surgery are typically diagnosed as being folliculitis.

Folliculitis can typically be seen after hair transplant surgery in both the implanted and donor wound areas in the first few weeks to months after a hair transplant.

The development mechanism of folliculitis is similar to acne. It is usually due to a blockage that is found in the exit pores of the sebaceous gland (skin oil glands). The obstruction of these pores can occur following a hair transplant surgery. Sebum (skin oil) cannot be emptied to the skin surface so it begins to accumulate underneath the skin surface and the result is red or white head-like pimples.

The recovery from this condition is generally spontaneous. If too many of these lesions develop, or if there was any sign of a secondary infection (such as redness or swelling around the area), the lesions may need to be drained by your physician and a patient may occasionally be recommended to use antibiotics to deal with the lesions.

Thanks to the generous vascular supply of scalp skin, an infection occurring on the scalp skin after hair transplant surgery is extremely rare.

– MA