What to expect after your surgery
It is expected that you will get some swelling around the head and eyes about three days afterwards. It will not be painful but it will be noticeable. Most people take nothing for pain after a day or two but we do supply any medications you would need. If you wanted no one to notice that you had the procedure done, you would have to take about 5-7 days off. However, you will feel well enough to work the next day assuming you do not do any heavy lifting. Once again, if you want to be undetectable you need a few days off but you will be physically well enough and comfortable enough to carry on with most of your activities the next day. You can wear a hat so that the transplanted area is hidden.
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POST OPERATIVE INSTRUCTIONS
SLEEP – Sleep on your back for 7 consecutive nights, using a pillow. It is best to sleep at about 45 degree angle with 1 or 2 pillows to elevate your head. The stitches or staples are secure. You may sleep right onto the donor area totally flat. However, a little elevation will make it easier to sleep with less pressure on the donor area. You may want to roll a towel into a neck support pillow shape like the pillow used during surgery. It helps take the pressure off the staples which may allow you to sleep better. *You may want to try the pillow in the post operative package you purchased. It is normal for blood to leak out form the back area for the first two nights. Do not worry. This is just fluid leaking back out. I recommend that you put a blue pad on your pillow to prevent the pillow from getting stained with blood.
ICE: Start applying ice packs on the forehead. Apply crushed ice in a bag, a cold blue gel pad, frozen peas or frozen corn. Apply the ice for about five minutes at a time. Start icing the night of your surgery and continue to ice 4 or 5 times a day for the first 7 days after surgery. Excessive swelling is to be expected. It will occur 2-3 days after surgery and will pass. DO NOT BE ALARMED. When swelling occurs, it usually last for 3-4 days. Swelling may start in the front of the forehead and possibly into and around the eyes creating some redness and bruising for an additional few days. Some swelling may even move into your cheeks or lower neck. Depending on the patient, the amount of swelling and discomfort varies. No matter how much swelling you get or how strange it may look, it is never dangerous!
PAIN: Take your pain pills as needed. There are two types of pain pills. Plan A is Tylenol#3. This is Tylenol with codeine. If this is not strong enough you can take Plan B which is Percocet. Wait an hour between Plan A and taking Plan B. I recommend that you take whatever you need for pain as directed on the pouches. However, for the first two nights, I recommend that you take something for pain and sleep when going to bed even if you think you do not need it. I usually recommend you take one Plan B, one Gravol and one Imovane when you go to bed to make sure you get a good nights sleep. I call this the “Sleep Cocktail”.
DAY#1 (the next day) After Surgery – Continue taking pain pills as needed and continue with ice packs. Do not perform any heavy lifting for about 7 days after the surgery. At night, take the “sleep cocktail” again and put down your blue pad again.
DAY#2 – You can take your first shower or bath the second morning after surgery. This will be about 36 hours after surgery. From the neck down you can shower normally. No water pressure is to hit the top where the grafts are in place for the first seven days.
Fill a mug with water .Pour the water all over your head. Everything can get wet. * You can use the specially formulated shampoo that came in your postoperative package. It is very gentle.You can shampoo the donor area where the stitches /staples are fairly normally. It will be tender but you can get a good lather going. Don’t dig in your nails, use your fingertips. Rinse thoroughly by pouring lots of water all over your head with a cup. On the transplanted area (red dots), you can fill the cup with water and mix in a little shampoo to create a bit of a soapy solution. Pour this soapy solution all over your head several times. Then dab gently with gentle vertical pressure to create a bit of lather. Do not rub across. Rinse with water several times. You may towel dry the donor area fairly normally. It will be tender so you will need to be a bit gentle. Gently pat the transplanted area to dry it. Do not rub. You may notice some oozing or discharge from transplanted area. This is considered normal. Do not worry about getting the grafts or stitches wet. After your showers, apply antibiotic ointment to the stitches or staples once a day. Do not apply to recipient area.
You may prefer to take a bath and soak the entire head in water to help the crusts come off. You can submerse the entire donor area and soak it for a few minutes to help the crust come off. On the recipient area you can pour the shampoo/soapy solution from a cup/mug all over your head several times and then rinse with clear water. Take a bath or shower everyday to cleanse the area and remove crusts. After your baths, apply antibiotic ointment to the stitches or staples once a day for the next 7 days.
Day #3 – You can start spraying the top of the head with saline on the third day – please read separate sheet. *The saline and spray bottle are in your post operative package that you purchased.
Day #4 – (Tuesday/Wednesday) Showering You may now use a soft brush to wash the recipient site. You must still avoid shower pressure on top of the head. Pour water all over your head from a mug and get it all wet. Shampoo the back and sides normally. You can use the brush in your package and add shampoo to the brush to create a soapy lather. You can brush the donor area vigorously with the brush and then rinse with lots of water.This will help remove crusts. For the top/recipient area, lather up the brush to create a soapy lather and brush across the top gently several times. Use the same motion as if using a shavng brush.This will create a real lather on the recipeint area and help remove the crusts more easily and sooner. You can use the brush in your post op package that you purchased.
The top of your head may feel some numbness for a few days or even weeks. This is normal. This change in sensation means you must be careful not to accidentally hit your head. For example, be careful when getting in cars. Put your hand on the frame of the car and use your hand as a visual point of reference so you can duck under your hand and get in the car. When you bend down to pick
up something, make sure you keep your head up and bend at the knees, not at your waist. You must also make sure you are careful when putting on hats or combing your hair. Make sure you look in the
mirror and keep the comb above your scalp when you comb your hair. If you put on a hat make sure you look in the mirror and keep any part of the hat from rubbing the transplant.
The back (donor site), usually feels tender or tight for a few days after the surgery. There will also be a numb or tender feeling for a couple of months. You will regain the feeling back. A pulling sensation will be evident especially around the sides of the head. Every patient’s level of sensitivity is different.
Shock Loss: Some people may notice that some of the hair present before the transplant may fall out. This can happen in the recipient area or donor area. If it happens, the hair will always grow back. Shock loss, if it happens, starts about two to three weeks after the transplant
You will need to have your sutures/staples removed 10-14 days following the procedure (unless indicated otherwise by the Doctor.) You can book an appointment with us, your family doctor or walk in clinic.
Stitches are to be removed after 10- 14 days. Call our office to book an appointment.
In order to prevent infection, try to avoid any exposure to any dirty environment for one week after the procedure. Try to leave the transplanted area open to the air as much as possible. Avoid using a hat or hairpiece as much as possible. The crusts will begin to fall off 7-10 days following the procedure. Do not pick the crusts off. Let them come off naturally. In most cases all scabs are off within 2 weeks. There will be some itchiness on the head after the procedure, which is natural occurrence in the healing process.
For the first week after the procedure, avoid strenuous exercise, heavy lifting and alcohol. Failure to follow these instructions could affect the results of your surgery.
Exercise – You can go for a walk the next day after the surgery. You can start sweating, running and jogging one week after the surgery. You can lift weights two weeks after the surgery. You should avoid flat heavy bench press exercises for one month after the surgery. Try to avoid any excessive tension on the donor area for at least one month after surgery.
DAY#7 – ONE WEEK AFTER THE TRANSPLANT – You can stand under the shower and let the water pressure hit the top. Gently shampoo the top of your head with your finger tips but do not dig in with your finger nails. * You can continue to use the specially formulated shampoo that came in your postoperative package. You can also make the crusts come off sooner if you apply hair conditioner first, let it sit on top of your head for two or three minutes, then wash it out. After you rinse out the conditioner, you can shampoo your head. The crusts will start to fall off. They feel like bread crumbs. You may see a hair in the crust; do n ot worry the root is firmly in place.
Dr Ferreira’s notes and recommendations: Saline Sprays.
*You can get the saline spray and bottle from the post op package you purchased.
**Start on the third day after the transplant**
Over the years I have found it helpful to have patients spray the recipient area with a fine mist of normal saline a few times a day. Normal saline is basically salt water that is the same concentration as the fluids naturally found in your body. By spraying the transplant area with saline three or four times a day, the scabs will come off sooner and healing seems to occur more quickly as well.
Here is what you can do: Go to your local pharmacy and ask for a bottle of normal saline. Normal saline is also known as: 0.9% sodium chloride or 0.9% NaCl. You will need to ask the pharmacist since this product is found behind the counter and not on the regular pharmacy shelf. Do not get the ready-made saline spray bottle from the pharmacy; it is too powerful a spray. *You will find a saline bottle in the post-operative package you purchased.
Buy a simple spray bottle like this. You can find small spray bottles in the pharmacy. * A small spray bottle is included the post operative package you purchased. Rinse the inside of the bottle with a bit of saline and then pour out the saline. Fill the bottle with the normal saline, put on the finest mist setting, and then spray the top of your head three to four times a day. Just enough so the area is covered with a fine mist. Typically the scabs will fall off sooner and the recipient area will be less itchy.
*Post Operative Supplies can be purchased at SHI Finch Office