You need to be extremely gentle with your transplants in the first 24-48 hours

Post hair restoration care Care immediately after your hair transplant

Immediate Care for your Transplants

Bandages

There seem to be two basic approaches to care after a hair implantation procedure is complete. Traditionally, the individual had a bandage applied to the scalp to cover the implant wound area.

The patient would then be sent home and returned to the clinic the day after to have the bandages removed and the implants examined. The alternative is to apply saline soaked gauze to the implant area and bandage it. The patient stays in the hair transplant clinic like this for a few hours before the patient is unbandaged and sent home. In each of these scenarios several layers of gauze are applied over the implantation site and then a long bandage is wound around the head to hold the gauze in place. The bandage applies some pressure to the scalp skin to help reduce any potential bleeding. More recently though, especially since the development of micrografting and follicular unit grafting, patients are not having their scalp bandaged at all. To use or not to use bandages after an implantation procedure is a topic of hot discussion among hair transplant surgeons. Some do some don’t and whether or not you have a bandage applied to your scalp will depend largely on the personal preference of the surgeon.

There are advantages and disadvantages to a scalp bandage. The obvious advantage is the bandage protects the implants while they heal into the scalp and any blood that bleeds out will be soaked up. The disadvantage is that the bandage “marks” the individual as having had surgery. However, at most the bandage only stays on for 24-48 hours and can be readily hidden by wearing a hat or cap when in public. The better answer may be to put aside the first two days after surgery and just to stay at home until the bandages come off. Depending on which approach is used, bandage or no bandage, the clinic should give you the relevant advice on what to do for the next 24 hours until they see you again – usually the next day.

Keeping the follicles in place

The implants most susceptible to falling out are the ones implanted last in the procedure, but the transplanted hair follicles almost always stay in place of their own accord. The little bleeding at the edges of the incision wound cut for the graft help to “glue” the graft in place. By the time the hair implantation procedure is complete, those follicles implanted first in the hair line are pretty much fixed in place by this blood glue. Of course this is exactly what blood is supposed to do. By bleeding the blood is exposed to air. This activates a cascade of events in the blood that results in blood coagulation. This is to seal an open wound and close it as quickly as possible. It also activates the formation of fibrin that builds up a meshwork in the wound site. This helps glue the wound together and provides a scaffold on which cells from the edges of a wound can grow into the wound and heal it. With larger wounds it takes longer for the blood to clot and seal the wound and it takes longer for the wound to heal over. With micrografting and follicular unit grafting each individual wound is so small that the blood can clot in a couple of minutes and the wound starts to heal within a few hours.

Never the less, you should be extremely gentle with all of the grafts for the first 24-48 hours after implantation. It is very rare for grafts to fall out. If they do and they don’t look dried out, it may be possible to just pop them straight back in if you are still in the clinic. If they fall out after you have left the clinic it is unlikely much can be done to save the grafts. However, you could try to put the grafts in a saline solution (salt water mixture), keep it cool at about 4-8 degrees centigrade and call the clinic to see if they can put the graft back in – it may be possible, but there are no guarantees it will be successful. Again though, a graft falling out is an extremely rare event. The biggest issue in the first 24 hours after a hair transplant is probably how best to sleep without disturbing the implants. The clinic should be able to advise on what they think is best depending on whether your head is bandaged or not. People may sleep in a sitting position for the first night and maybe longer, so that the head does not come into contact with a pillow. In general, you will not wash your scalp for the first 24 hours, indeed avoid touching it at all. Usually you do not wash the scalp with shampoo for the first 3 days after the operation. Your scalp will be cleaned at your next clinic appointment.