Some Questions Before My Transplant

[Doug Jarvis]

Hi, I have a couple of questions about a transplant scheduled for Dec 6th.

-- My doctor gave me instructions that say no aspirin two weeks before and no alcohol or coffee a week before my transplant. My friend ( who has had numerous transplants with 3 different doctors) says that it should be longer than this. Also, I take 10mg of an anti- cholesterol drug ( Lipitor ). My doctor says I can stay on this at all times. My friend thinks I should quit a month before my transplant and maybe for a few weeks afterwards as well. I asked my doctor again about this but he just repeated what he said before.

-- What are the keys to insuring maximum graft yield? When I asked my Doctor about this he just said rest for a few days then resume your regular activities and regimens.

-- Following up on that, my friend says that I can party all I want after a few days after the transplant and even have a few glasses of wine/ or a few beers the nest day. He says it will not affect healing or graft yield. My doctor says that I may want take it easy for 2-3 days but otherwise it's OK to drink after that. I do not smoke anything just drink red wine/beer mostly. But I've heard Dudemon and others say that drinking should be avoided for a one month afterwards. During the holidays though I frequently turn it up a notch :woot: Also, what about sex? OK to resume after a few days? ( This is a serious question )

-- Another thing, I'm 50 yrs old and take .20 of finasteride a day. Is that enough. I still seem to be losing hair in the crown. Should I increase it. My friend says Avodart is better than finasteride and several other folks seem to agree. I'm mostly concerned with keeping my crown area hair but I notice gradual loss over the last 3 years. Should I increase my finasteride daily dosage? I've been on it for 7 years. Should I switch to Avodart. Also, should I be using anything else? in addition to Avodart or finasteride?

My hairloss has %$#@&* up my life in major way! Jobs, relationships and simply going out of the house. I wish that I had known about a forum like this long ago! I nearly lost my mind, as well as a ton of hair!

Thanks for your help. Good luck to all.

 

[s.a.f]

I'd say as long as you take care for 3/4 days after and then ease back into things you'll be ok. I think that when it comes to graft yeild 90+% of it is down to what happens at the clinic. ie how the surgeon and assistants care for the harvested follicles. Non growth is more likely to come from damaged follicles/bad placement than anything you do lifestyle wise afterwards. Once those 3/4 days post op have passed thats the crucial period over.

 

[dfwguy]

Agreed with the above advice. I'm 2 days post op on my 2nd FUE procedure.
If you'd like to hear instructions directly from a clinic, I've pasted all the post-op instructions below because I've got all this time being a hermit in my hotel room. The assistant that did my insertions added on to the sex bullet point - saying that to avoid it for 3 days unless your partner is on top. In the end you really should just avoid any type of strenuous activity for at least a week; I'm trying for two weeks. They even mentioned about bending down too far to put your shoes on. I even am trying not to sneeze or even blow my nose this first week. Its just best to find some alone time for a week to nurse the grafts and donor area in my opinion. Good luck!

POST OPERATIVE INSTRUCTIONS:

After surgery, the transplanted area will be cleaned of blood and crust as best as we can. Don’t
touch the scalp until the next day. Wait about 18 hours before resuming any care. You can take a
shower (body and donor area only), with wetting the Recipient area. Just be careful because
movement could increase the blood flow into your scalp, and also increase the risk of popping the
grafts out. You can take a bath but do not submerge the head. Avoid Bleeding and high pressure
on your head because it could dislodge grafts!!

Immediately following your procedure please be sure not to place a tight fitting hat or
stocking cap on your head to avoid having grafts removed.

What could increase my scalp Pressure?

Sexual Activity. Stay away for three days.
Lifting heavy Items. Do not lift for 1 week (for FIT) and 2 weeks (for STRIP)
You may do a light workout in 3 days for FIT and 1 week in STRIP case.
Don’t bump your head. (car, doors, shelves….)
Don’t bend over to pick up an item on the ground for one week.
Don’t hit your recipient area with direct shower pressure for two weeks.

What could increase the bleeding?

1. MEDICATION: - Aspirin, NSAID (Ibuprofen, Motrin, Advil), and Vitamins in general.
Stay off for 5 days.
2. ALCOHOL: Avoid.
3. CAFFEINE: (Coffee, Coke Tea) tendency to increase blood pressure, therefore increases
bleeding. Decrease the quantity you drink.

Some outside factors could impair the growth of your grafts.
(a) Direct sunshine exposure for a long period of time. Avoid outdoor activities, or wear a
hat and use a strong sunscreen. Avoid sun exposure for 3-6 months.
(b) Smoking. Decrease as much as you can.
(c) Swimming pools because of the chlorine. Avoid pools for 2 weeks.

IN SUMMARY JUST TAKE IT EASY FOR ONE WEEK.

CARING FOR THE RECIPIENT AND DONOR AREAS

DO NOT wash the area(s) treated with PRP for 48 hours.
DO NOT wash donor areas treated with ACELL for 48 hours

It’s mandatory to wash your hair at least once a day. We also encourage our patients to keep
their recipient area moist, (or wet) to decrease the itching and speed up the healing process.
Our surgical kit has a special product that you can spray every hour for the following three
days, post-op and then you can space that until the product is finished. One week is enough.
We have an alternative for those who don’t use the surgical kit.

Scar Repair:
Sleep with a neck to prevent dislodging the grafts and if possible try to sleep with your
head elevated.

RECIPIENT AREA: - (Both FIT and STRIP)

18 Hours after your procedure should be the best time to start washing your hair. You can use a
regular non medicated Shampoo (baby shampoo is best) or use the one we recommend
formulated specifically for hair transplant patients by http://www.HairCycle.com
Procedure:
1. Wet your hair gently.

2. Lather the shampoo in your hand and make it soapy.

3. Apply the shampoo over your head. Just dab it up and down, do not scrub.

4. Rinse it by pouring gently water with a cup. (Some people block with their hand the
shower pressure and let the liquid flow gently on to the scalp)

5. Dry your hair using a bath cloth (just Dab it) or hair dryer, turned on cool setting.

6. Use a normal saline solution or mixed in a gallon of distilled water, nine tablespoon of
regular salt and spray that on your head.

This is for the first week.

Repeat the same events the second week. But you can start massaging your scalp with
fingertips while applying the shampoo. It helps the scabs to fall off. After the second week
you can go back to regular shower and we recommend you rub the scalp aggressively to
remove the remaining scabs.

DONOR AREA:

Be aggressive the next day after the procedure. Rub the area with the shampoo and hit with a
good shower pressure to rinse it. After drying the area, apply a layer of Bacitracin or
Neosporin for two to three days.
In strip case, we have (absorbable or dissolvable) sutures that will fall off on their own
around 3 to 4 weeks post-op.

You or we can still remove them after 12 days if it’s bothering you.

WHAT TO EXPECT IN POST-OP

DONOR AREA

Day 1: You may have some oozing and pain.
Just apply pressure with a bath cloth for 15 minutes.

FOR PAIN (This is more applicable in STRIP than in FIT cases), we have prescribed Vicodin
(pain killer) and you can apply an ice bag – 20 minutes on / 20 minutes off. It alleviates the
pain and reduces the tightness sensation in the back in STRIP case.

Day 3 Post-op
You may have some swelling in the forehead and eyes.
Sleep in 45 degree angle or your head elevated (it helps the liquid drain backward) if you are
able to. If not, do not worry about it.

You may see some swelling above the forehead after your procedure. Swelling may
also become extreme, but do not be concerned. In the next few days you may see that
the swelling has moved down into your eyes, it may even move down below your
eyes also feeling discomfort in your teeth due to the swelling as the day’s progress.
Some things that you might want to look for with swelling is that it may make your
eyes look puffy and/or may make them shut, however do not be concerned. Generally
swelling usually last for 3 days.

Here are a few things that can be done to decrease swelling:
While sitting upright in a chair, place the back of both thumbs with fist closed on
center on the forehead and rub in an outward motion. (Continue this process
several times.)
You can get a head band and place it on your head in the temple areas place some
rolled up gauze or a few cotton balls to help drain the fluid involved with
swelling.
Place a piece of tape on forehead very tight and begin to rub the swelling to the
temples to help drain fluid involved with swelling.

Your scabs will turn brown w/ crust on it.

Day 7 Post. The scabs will start to fall off, and this will occur during two weeks. The scalps
usually turn red, due to the inflammation and blood activity. It can last one month or more in
some patients.

3 Months Post-op. The first Growth.

8 Months Post-op. Good time to schedule a follow up consultation to assess the growth.
(80% of your hair should be growing)

9 Months to 1 year Post-op: Full benefits of your surgery in term of cosmetic and growth.

MEDICATIONS:

(a)

Pain Medication.
Vicodin 0.5mg. 2 Pills by mouth as needed. Start just after the procedure.
Side effect, Drowsiness, Dizziness.
Don’t do anything that will require you to be alert. For example driving or
manipulating sharp instruments.
(b)
Tylenol extra strength 2 Pills, 3 times a day. For minor pain as in FIT.
(c)
Sleeping medication. Ambien 10 mg. As needed.
(d)
Anti swelling Medical. Prednisone. Decreasing dosage for 5 days. (20mg, 15mg,
10mg, 5mg and 5 mg). Take it with food. (upsets your stomach)
(e)
Rogaine: Vitamins for hair. Wait three days before you restart your treatment.

NB: Any medications that you take which are not vital or necessary stop them prior to your
procedure and restart those 3 to 5 days after the procedure.

***You may have your first haircut or color/dye your hair 14 days after your procedure. Do
not shave your head with a razor for at least one month.

 

[Doug Jarvis]

Thanks very much for the input guys. You did a better job than my doctor's office did at explaining what I should be doing post-op. Many thanks!