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After Each Session
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A
crust or scab forms over each graft shortly after the
procedure, and remains attached for 5 to 14 days. (The
smaller the graft, the faster the crust tends to fall off.)
When the area is healed, the crusts separate from the scalp
leaving a clean, pinkish area to indicate the site of each
graft. Although these crusts are visible during the five-day
to two-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). DFUs, TFUs,
“slot” grafts and round minigrafts leave much less visible
marks than standard round grafts, and are virtually
undetectable within 7 to 10 days. The holes made for
micrografts disappear within a few days to a week. The hairs in the transplanted grafts are shed between the 2nd and 8th week after the procedure. Sometimes, they fall out attached to the separating crusts; occasionally they persist longer. Rarely, some 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 until 10 to 14 weeks after the operation, during which time the follicles recuperate to produce new hair. A new generation of hair is usually visible at the surface of the scalp by the 12th week after transplanting, but this may occur slightly earlier, or up to eight weeks later in a few patients. These hairs grow at the same rate as they did in their original location (which is usually 1/2 inch per month). When a large area is transplanted, swelling of the forehead frequently occurs. While this swelling is usually mild and lasts only two to four 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 two to three 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, it's advisable to schedule, if possible, a holiday to coincide with the 1st session. Please be assured that the swelling is ALWAYS temporary and has no harmful effect on the healing grafts. (An intra-muscular injection of a cortisone-type drug can be given at the time of the operation to help minimize swelling). 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 controlled simply by applying pressure. The donor area is stitched closed to produce better scars and to minimize bleeding. The stitches are normally removed 7 to 10 days later. The nurses will wash your hair the day after surgery when any bandages are also removed. You should begin a bathing routine twice per day, beginning the second day after surgery, during which you soak your head for 10 minutes while gently massaging your scalp, and massage while shampooing your head for an additional 10 minutes. This accelerates the separation of crusts from the recipient area and any crusting in the donor area. Patients from out of town are required to stay in the city overnight after the transplant procedure. This allows us to remove the bandage and properly cleanse the area the day following surgery. Patients should not drive themselves home on the day of surgery because of the lingering effects of medications. Ingrown hairs are, occasionally, a temporary problem, beginning 8-12 weeks after surgery. This is more often the case when DFU and TFU grafts are used or 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 or more small areas. |
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