Guidelines and insructions for hair transplant patients.doc

Guidelines and Insructions for Hair Transplant Patients

Before The Transplant

1. Blood test for HIV is required and it can be done at the Hospital on the day before of the procedure.
2. Do not take Aspirin, vitamin, herb, non-steroidal anti-inflammatory agent or Propanolol for 7-10 days
before the surgery. Continue taking your regular medications unless your doctor tells you otherwise.
3. Avoid alcoholic beverages for 2 days before the surgery.
4. No haircut is advised before the transplant. Leave the hair long to provide better coverage.
The Transplant day
1. Please wear loose-fitting, buttoned clothing or shirt as you will not want to pull anything over
your head.
2. Before the operation, have a light breakfast with no tea or coffee.
3. Please inform the doctor regarding any drug allergy.
4. Please arrive at the hospital at the time specified.
5. You must have someone drive you home after your transplant due to the relaxing medication
that you will receive.
6. Please notify the doctor in case of any fever or sickness prior to treatment.
We perform the hair transplant procedure in an operating room, fully equipped with monitoring
equipment, emergency supplies, and sterile instruments. Prior to the procedure, photographs of your entire
head will be taken and the doctor will carefully trace your hairline. Then, you will be given relaxing
medication, only by mouth.
Placement of graft into balding area,once the relaxing medication has taken effect, a local anesthetic
will be injected, first into your donor area, and then as a block to numb the forehead and front of your scalp.
At this point, the entire top of your head will be numb. Therefore, in most instances, hair transplantation is
no more painful or difficult to undergo than a long dental procedure, and is done while you are relaxing,
listening to music or simply napping.
After your head is completely numb, a section of tissue is removed from the donor area which will be
closed with stitches. There will be a linear scar, which will be hidden by your downward combed hair in the
back. Then the tissue is dissected under microscopes into individual follicular units and placed into bald or
thinning areas. Within 24 hours, small crusts will form on each graft, and fall out in the next 7-10 days. The
grafted hairs will often start to grow within 3-4 months after the procedure and will continue to grow for a
lifetime without any special care of any kind.
After the transplant
1. Take special care not to hit your head. This often occurs while you are getting into a car.
2. Please do not touch the transplanted hair for the first 24-48 hours after the surgery since we want the
grafts to adhere solidly during this time. You can comb and style your hair but do not allow the comb
to contact the skin in the grafted area.
3. Limit all strenuous exercise (including lifting and sex) and swimming for the week following the
transplant. Also avoid all Aspirin and alcoholic beverages for 3 days following the transplant.
4. Taking post-operative medications as the doctor prescribed.
- Pain relief medication
Take 2 pills every 4-6 hours if needed, and start at the early stages of discomfort. Do not wait for
discomfort to get bad before taking medication. It is more effective to stay ahead of the
discomfort than to try to overcome it. Most patients are pain free after the first or second post
operative day.
- Antibiotic Take one capsule of antibiotic 3 times a day after each meal for 2-3 days until finished.
5. After 24-48 hours post transplant, return to the clinic to have your hair washed. After this you can
wash your hair everyday at home.
PDF created with pdfFactory Pro trial versi Instructions for washing hair

A. Wet your head with a bowl of cool water or with a gentle stream of cool water from the shower.
B. Lather up with an extra mild or baby shampoo in your hands first.
C. Pat the shampoo on the transplanted area gently. Do not rub. You may scrub any area that does not
have any graft including the sutured line. Wash your hair in this manner for 10 days.
D.Rinse off shampoo with a lot of cool water or a gentle stream of cool water from the shower.
E. Pat dry your hair gently with a towel (do not rub) or with a cool blower if desired.
F. After ten days you should start to gently rub the grafted area and gently remove any remaining scabs
while they are moist. Never pick at scabs while they are dry. As you do this, some of the scabs and the
accompanying hair may fall out but the hair roots remain behind. This is normal, and should not alarm
you. New hair growth will begin after 90-120 days.
G. Usually you may have itchiness at the donor or grafted area. If this occurs, apply a few drops of pure
olive oil (obtainable from the supermarket) onto these areas 3-4 times a day. Never pick at scabs
while they are dry.
6. A loose-fitting hat or hair piece may be worn with care after your procedure. 7. Wear a head band for a few days and try to keep your head in the upright position in any activities. This will help prevent swelling of your forehead. On occasion swelling may still occur, this usually begins on the second or third day but it is painless and will not affect the growth of the graft and will be gone in a week. 8. Rarely, slight bleeding may occur from the donor or grafted area. If this occurs apply gentle but firm pressure to the area for 5-10 minutes with the gauze provided. The bleeding should stop. If it doesn't stop , notify the doctor. 9. On occasion you may develop a folliculitis (pimple like lesion) at the grafted site. If this happens, please notify the doctor to prescribe a specific medication for this problem. 10. Suture removal at the donor site will take place 10-14 days after the transplant. Absorbable sutures will be used for those who cannot return for suture removal. 11. At least 2 days are needed for the procedure (one day for hair transplantation and the other day for washing hair.) 12. You can return to work 1-3 days after the transplant. 13. It is important to realize that a dense result cannot be achieved with one session of hair transplant. generally 2-3 sessions are needed. Each session may be done as far apart as the patient wishes, but there must be a minimal 6 months interval between sessions. 14. Remember, after the transplant, dry scabs will form at each graft site. As these are shed, the accompanying hair may also be shed with it. These events are to be expected and are not a cause for concern. New hair growth may not be noted until the third to fourth month after each procedure. Please do not become concerned if you do not see growth before the fourth month! After that time, your transplanted hair will gradually grow, generally, about 1/2 inch per month. PDF created with pdfFactory Pro trial versi What to expect after the surgery?
Patient may experience mild to moderate swelling on the forehead area for a few days following the
surgery. There will be many scabs where the grafts were implanted and some redness on the recipient area.
The redness will eventually go away on its own, while the scabs will start to flake off about 7-10 days after
the transplant. Severe infection is extremely rare due to the abundant blood supply in the scalp. In occasions,
some pimples or acnes may occur on the scalps at the transplanted sites but will simply respond to
antibiotics. Patient who receives megasession hair transplantation is more likely to have some degree of
numbness on the scalp that could last for months, but the symptom will gradually subside over time.
During the first 2-6 weeks postoperatively the transplanted hairs will continue to grow in their new
location. Then virtually they will fall out, which is completely normal and is to be expected, and will leave
behind the transplanted follicles beneath the scalp. It will take another 2-3 months before the new hairs
begin to erupt from these follicles. Finally, the new, healthy hairs will grow normally and continue to
thicken the same way as the hair in the donor site does. The grafted sites in the recipient frontal area usually
heal with almost no visible scarring and are covered by the transplanted hair. Minor scar that occur in the
donor scalp as a result of the removal of donor skin is narrow and can also be hidden in the surrounding
Facts about Hair Transplantation
Before considering a hair transplant, it is very important that you understand what hair transplantation
really is as well as its benefits and limitations.
Hair transplantation technique does not increase your hair volume; instead it moves hair from one area to
another. The procedure involves both medical and artistic principles with the goal to achieve final density. It
requires the hair transplant surgeon to redistribute your limited supply of hair follicles from the donor area
on the sides and back of the head to the bald area to create natural-looking hair for years to come.
Because pattern baldness is a progressive condition, hair loss will continue as you age. The extent of hair
loss is unpredictable and unknown; it is also different from person to person. As you lose hair, the size of
the balding area increases while the donor area with hair decreases.
Due to the limitation of your donor hair supply and the progression of your hair loss, only finite amount
of hair can be removed. Each time the donor hair is removed, the density of the remaining hair decreases.
Scientists are looking for a way to transplant hair using hair follicles from different persons, with the hope
that they will find the successful solution some day. Until then, your doctor must create a long-term plan on
how to effectively use your precious donor hair both now and in the future.
This does not mean that hair transplantation will not produce sufficient hair density. By creating 50%
density of the original, it visually looks like normal hair density. In order for human eyes to see the
difference of hair density, one has to lose more than 50% of hair, or hair texture becomes thinner as affected
by male hormones.
With extensive skills and experiences of our medical team, We offer hair transplantation using DENSE
PACKING TECHNIQUE to achieve the 50% density in a single session if the bald area does not exceed 60
square centimeters. For larger area, it is impossible to cover the whole area in just one session, and
subsequent procedures will be required. The estimated volume of grafts and the density of transplanted hair
for the same bald area may vary up to 50% from clinic to clinic depending on each doctors experience and
PDF created with pdfFactory Pro trial versi People with curly and large hair shaft benefit greatly from increased hair volume; therefore less hair is needed to cover the bald area. On the other hand, individuals who have straight, finely textured hair need not only more hairs, but also possibly additional sessions to achieve similar density. As seen from the before-and-after photos in our patient gallery page, some patients with large area of baldness are satisfied with the outcome after the first session while others who have smaller bald areas choose to have another session or two depending upon individuals expectation. Younger men, whose final balding patterns cannot be determined, may choose to have additional procedures later on in life. In some cases, hair transplantation alone may not be enough to achieve the total coverage because of the patients limited available donor hairs. Hair transplantation technique does not stop your remaining hair from falling out either. Further hair loss continues to exist right after having hair transplantation done unless it reaches the final balding stage. Taking hair-loss medication regularly after the surgery is necessary and always recommended. It can effectively reduce extra hair loss and additional hair transplant procedures in the future. Typically, transplanted hairs start to grow 3-4 months following the surgery and most, if not all, of them will grow out after 6-7 months or up to a year for some patients. As a result, you should wait at least a year after the first surgery to allow complete healing and full growth of transplanted hairs before assuming any failure of transplanted hair-growth. For those patients who have had their hair transplants done at The hospital , if any of the transplanted hairs did not grow after a year, we will be gladly replace them with no extra cost on the next session. Knowing what hair transplant does and its benefits and limitations not only help you decide whether it’s right for you but also guide you to set a realistic goal and expectation if you choose to have it done. Setting a realistic goal and expectation mean that you completely understand that hair transplant, if done correctly, gives you a natural-looking-hair appearance that is appropriate for your age now and decades to come. It does not produce a dense-hair appearance that you had years and years ago, which is not appropriate for your age now or in the future. You also understand that the limited supply of your own donor hairs can be harvested only for a certain amount per procedure and your doctor must try to conserve it for the future as well. Once you take all of these factors into consideration and possess a realistic goal and expectation, you will be more likely a good candidate for hair transplant who will enjoy its benefits and outcome. PDF created with pdfFactory Pro trial versi After My Hair Transplant What Do I Do Now.?
After my hair transplantation,I want to be careful not to lose any of my grafts.How do I accomplish this?
I.Care of Grafted Area
I should wear a paper medical capon my head following the transplanted procedure for three days when I
sleep.I should apply a thin layer of antibiotic ointment with my fingertip to the stitches on the back of my
head twice daily for 7 days.I do not need to havemy stitches removed.They will dissolve in 10 to 14 days.
Count the day of surgery as Day One
II. Shampooing
A.On the 4th day,I may begin gentle shampooing of the grafts.Gently means I do not allow the force of
the shower to strike the grafts and I do not aggressively massage the grafts with my fingertips or
fingernails.I may simply lean my head forward as I shampoo the back and sides of my scalp.This allows the
suds and water to gently wash over the grafts,which is OK.Preferably use dandruff shampoo like Head and
B.On the 7th day,I may shampoo normally.I may gently massage the surface of the grafts with my
fingertips and remove any crusts present.
III.Hair Grooming
A.Combing my hair_I may gently comb my hair(except the grafted zone)from the first day after
transplantation.I should not touch the grafts themselves with the comb.I may normally comb all my hair
including any hair that may be presented in the grafted zone on the seventh day as I did before the
B.Hairspray/Hairdressing – I may use hairsprays,conditioners and other hairdressings after seven
days.Since the grafts will be well healed,I will not harm them if the spray or other hair products come in
touch with the grafts.
A.Swelling –I have oral medication,prednisolone,to take as instructed to help prevent swelling after the
B.Pain- I have oral medication,Vircodin,to take as instructed for pain.

I can expect some swelling around the area of my forehead and maybe around my eyes.
Swelling peaks between the third and fifth day and will be gone by the 7th day.
Rarely does blood work its way down into the eyelids producing a black eye,but this can happen.

VI.Other Problems

A.If my grafted area or the stitches in my donor area bleed,I can usually control the problem by applying
pressure to the area with a cold pack.I can use a soft cloth saturated with ice-cold water,or I can use an
ice cube wrapped in a wet cotton cloth.If the bleeding does not stop with firm pressure applied for 15
minutes,I will call Dr.Piyapas or his staffs.
B.Numbness may occur for a short period of time after transplantation.It will resolve on its own,in most
cases,within 3-12 months.
C.My stitches could besomewhat uncomfortable and this is normal.If my graft or donor area become
hot,inflamed or very uncomfortable,I should call Dr.Piyapas.If he is not available,I should call my
personal physician.
D.I may experience some dandruff-like scaling,redness,or itch during the first month after transplantation.
I can use over –the counter hydrocortisone cream or lotion to the area 2-4 times each day to clean this
up.Small crust may form at the micrografts sites.These will come of with the shampooing in 7-10 days.
The small spicules of hair still begin growing as expected three months after the transplant.Some
“ingrown hair” type of pimples may occur during the regrowth phase ,45 to 90 days after the
PDF created with pdfFactory Pro trial versi procedures.I can use over -the-counter benzoyl peroxide preparation to the area two times each day for
the 3-5 days to help clear these up quickly.
E.I will contact Dr.Piyapas or staffs if any of these uncommon complications occur:
- Loss of grafts
- Vascular growths at surgical areas
- Tender scar formation
- Any signs of infection
- Any other problem I believe out of the ordinary
Many of these problems will be resolves on there own.Some will need the attention of Dr.Piyapas or his
Normal Activities you may resume after the number of days indicated

Activities to be Resumed
Light exercise(walking,etc.)
Return to brushing normal non-grated
hair as usual
Use of Aspirin

Very gentle shampooing of the grafts
Vigorous shampooing of the grafts
Use of a hair dryer
Use of hair spray
Use of mousse or gels
Gentle brushing of the grafts
Use of hot rollers
Chemical hair treatment and perms
Swimming and other water reports
Resume use of Rogaine
PDF created with pdfFactory Pro trial versi Things to Remember After your Transplant

• Follow instructions carefully to avoid loss of grafts • Growths will not be as thick as you or I would want.The top of your head originally had between 30,000 – 50,000 hairs before it began to lose hair.Typically,even with multiple procedures ,we only move 12,000 – 18,000 hairs. • Growth will not occur as fast as you would like ,in fact,you will probably see no growth before four months.Be patient.It takes most people at least 4-6 months to begin seeing the positive change and 12 months to see the full benefit. • In some cases,you may actually look a little thinner after the transplant.This is more likely to occur when pre-existing hairs are presented in the transplanted zone .These hairs may thin out in the three months after transplantation but will usually grow back about the same time and rate that the grafts grows in .Do not worry if you look thinner at three months after transplantation-your rewards come at 6-12 months. • You will not get the maximum benefit from your transplant until 9-12 months after the procedure because the hair must have this amount of time to regrow lenth and thickness of the shaft.You will see improvement at four to six months in the form of fine hair but results peak out nine to 12 months. • Hair loss is a relentlessly progressive; therefore,you likely will want additional replacement procedures in the future to thicken or cover new areas of loss.This is also the reson we strongly reoccmend the use of Propecia or Avodart and Rogaine to help prevent this progression.If you are not on these,we strongly encourage you to consider the potential benefit. • We are always available to discuss any questions or concerns you may have .Do not hesitant to call. PDF created with pdfFactory Pro trial versi



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