At the time of surgery, your scalp was thoroughly cleaned of blood and crusts, but these will tend to re-form soon after your procedure. Care should be taken while cleaning the transplanted site during the 10 days following surgery, because it is during this period that the healing mechanisms of your body secure the grafts firmly in place. However, appropriate care of the recipient area will minimize crusting and make the transplant less noticeable and the healing more rapid.
The morning following surgery, remove your bandage and shower with comfortably warm water.
Allow the shower water to flow gently over the transplant area. You may partially block the flow of the water with your hand so that the scalp is not subject to strong, direct pressure. Lift up the hair in the back of your scalp so that water may irrigate the sutured areas as well. Place a small amount of mild shampoo like johnson and Johnson ( on the sponge that we have given you or on your finger pads, and gently apply the shampoo to the recipient area with a patting or rolling motion. Do not rub. As soon as the shampoo has been applied to the entire transplanted area, rinse the shampoo off with indirect running water. You may use the rinsed sponge or your finger pads to assist in removing the shampoo, but be careful that you pat the area and do not rub. Stop soaking your head as soon as the shampoo is rinsed off. It is not necessary to remove all of the crusting during the first shower. Repeat the showering and gentle shampooing three (3) times the day following surgery. On the second day after the procedure, shower and shampoo twice daily and continue this regime for 10 days. If the scalp becomes too dry, you should switch to Baby Shampoo on the fourth day and continue showering using only the Baby Shampoo for the remainder of the 10 days.
Resume your normal shampoo after 10 days and/or when the mild shampoo runs out.
If the grafts are soaked too long, they may swell and rise above the skin surface and appear as little white bumps immediately after showering. This is a problem more likely encountered the first few days after the procedure. It is not harmful to grafts, but indicates that you are soaking too much. As soon as you allow your scalp to dry, they will disappear.
It is important when shampooing, or rinsing the transplanted area, that you are gentle for the first 10 days following surgery. DO NOT RUB, PICK, OR SCRATCH, as this may dislodge grafts From one to four weeks post-op you can expect that some transplanted hair will begin to shed. This is a normal process and should not be a concern. The healthy hair follicles are firmly in place at TEN days post-op and cannot be dislodged. If there is still any residual crusting at this time,you may scrub them off in the shower. First, soften the crusts by soaking them in the shower under direct running water and then, using regularshampoo, scrub them all off. If this is not done, the crusts will eventually fall off naturally as the hairs are shed.Please note that when hairs are shed, there may be a crust at the top and a bulb at the bottom. Remember the bulb is not the root (the growth partof the hair follicle).
It is normal for the hair, bulb and associated crust to be shed and this does not represent a lost graft. If a graft is actually lost (something that may occur the first few days following the procedure) there will be bleeding at the site of the lost graft. Therefore, if you don't see any bleeding, don't be concerned.
Do not use tar shampoo (a dark-colored, medicated shampoo used for psoriasis) on the transplanted area for 10 days following your procedure, as this may interfere with the growth of the grafts.
The morning following surgery, remove your bandage and shower with comfortably warm water. Gently wash the donor area with your hand using mild shampoo. The shower water may hit the area in the back of your scalp directly. If this is uncomfortable for you, turn down the water pressure or partially block the water with your hand.
The purpose is to soak off the crusts from the donor area, so that it will heal well, and to remove crusting from the hair in the non-transplanted area. This may take 15 minutes or more in the shower. You will not hurt the donor area by using directly running water or by rubbing or washing the area gently.
After the shower, pat the area dry. If the physician has given you Ointment, you should apply a very THIN LAYER so that it LIGHTLY covers the entire donor area. These ointments are to be applied and reapplied to the donor area throughout the day to keep the area greasy and to keep it from drying out. You should continue applying the ointment for 5 / 15 /30 days. It is not necessary to use ointment after that.
At bedtime, If at any time there is bleeding in either area, do not be concerned. Apply direct pressure with a dry, clean cloth until the bleeding stops. This may take several minutes. If you have any concerns or questions, please contact us.
You may dry your hair with a warm, NOT HOT, hair dryer. Hair spray should NOT be used for the first week.
You have been given Alprax 0.5mg (Aprazolam) tablets to help you sleep. If the pills are strong, you can break the tablets in half.
The most important medication to use when trying to sleep is the pain medication; be certain that the pain in under control before using any additional sleeping medication, as the additional pill will often not be necessary. DO NOT DRIVE under the influence of Alprax.
DO NOT DRINK ALCOHOL WHILE TAKING ANY MEDICATIONS GIVEN TO YOU FOR SLEEP, PAIN or HICCUPS.Pain Pills
You have been given Lornoxi-p / Enzoflam for pain. Take 1-2 tablets every 4-6 hours as needed for the first 72 hours. After 3 days, you may take 1-2 tablets per day.Hiccups
Do not drink carbonated beverages (such as beer, Coke, Pepsi, or any other diet or non-diet soda) the day of and the day following your procedure, as this increases the occurrence of hiccups during the recovery period. If hiccups occur and do not resolve quickly, call the doctor with the phone number.Itching
You may experience some itching either in the transplanted area or in the donor area following your procedure. In general, itching is part of the healing process and should not be a cause for concern. A common contributing factor may be dryness. You may also experience itching as the new hairs grow in. If the itching is bothersome to you, purchase Hydrocortisone Ointment 1% in 30 gram tubes which may be bought over the counter (it must be in Ointment form, not a cream). This may be applied locally to the areas that itch, as needed, up to four times a day. It is also possible that you may be using too much shampoo or shampooing too long which can dry the scalp. If you feel that this is a factor, please cut back on the shampooing. DO NOT SCRATCH THE SCALP as this may dislodge grafts.
Less commonly, itching may be a sign of a skin infection or an allergy to the given ointment or the shampoo. In the transplanted area, this may present as small pustules and/or redness. If you suspect that the itching is due to either of these caused, or if the itching is persistent, please contact the office, as this may require specific treatment.Minoxidil (Rogaine)
Rogaine may cause severe irritation to the scalp. If this occurs after a hair transplant, it can interfere with hair growth. If you choose to use Rogaine after your procedure, you should wait a minimum of one week after surgery. If any sign of redness, irritation, itching, or burning occurs, stop the medication and call our office.
If there is significant swelling, it usually occurs around the 2nd to the 5th day post-op. The swelling usually begins at the hairline and then, from gravity, it gradually moves down the forehead and settles into the bridge of the nose and around the eyes. Occasionally, it may cause the eyelids to swell shut for a short period of time. Sometimes the swelling is extreme, but it always resolves by itself after a few days and does not require any special treatment. It should not be a cause for concern. If you would like, you may place cool compresses over the area that is swollen, as long as it is not placed over the implants. Sleep with your head raised at a 45-degree angle for the first 3 nights after the procedure; this may help to prevent swelling. You may use a recliner chair or 3-4 pillows. If the swelling is associated with redness, pain, tenderness, fever or chills, it may indicate an infection. If any of these symptoms occur, please call our office.Bleeding
Before you leave the office, all bleeding will be controlled. Rarely, some bleeding may occur after the procedure. If bleeding occurs, put firm, continuous pressure on the area. We suggest using a rolled up, clean towel and lying your head on top of it. APPLY CONTINUOUS PRESSURE FOR A FULL 20 MINUTES. If the bleeding does not stop, call us at the above numbers and follow the directions given.
If you are unable to contact us through this beeper, then go to the nearest Emergency Room and show these instructions to the physician on duty.Lost or Dislodged Grafts
It is not uncommon to loose a few grafts after the procedure. Do not be concerned, this is expected.Activities, Alcohol and Other Restrictions
The day after your hair transplantation, take it easy. You will be tired from the sedatives given the day of your surgery. If possible, spend this day at home, or in a comfortable place, and concentrate on showering properly and following the post-op instructions.
You may perform normal daily activities the second day following the procedure including moderate exercise. Abstain from sexual intercourse and alcohol for THREE days following the procedure. For the first 10 days, you should avoid any activities that rub or put direct pressure on your scalp. After 10 days, you may resume your normal daily activities and exercise.Smoking
Smoking causes constriction of blood vessels and decreased blood flow to the scalp, predominantly due to its nicotine content. The carbon monoxide in smoke decreases the oxygen carrying capacity of the blood. These factors may contribute to poor wound healing after a hair transplant and can increase the chance of a wound infection and scarring. Smoking may also contribute to poor hair growth.
The deleterious effects of smoking wear off slowly when one abstains, particularly in chronic smokers, so that smoking puts one at risk to poor healing even after smoking is stopped for weeks or even months.
Although it is not known exactly how long one should avoid smoking before and after a hair transplant a common recommendation is to abstain from 1 week prior to surgery to 2 weeks after the procedure.Sun
Please avoid unprotected exposure to sunlight for 3 months. Wear a hat when you are going to be outside. After two weeks you may use a strong sunscreen with a SPF of 30+.Infection
Redness, swelling, and slight tenderness are to be expected for the first few days after a procedure. If the redness, swelling, or tenderness increases after the second day, call us. Rarely, one or more grafts may become infected. They present as white pustules (pus pimples) or redness around individual hairs. They may be associated with a yellow colored crust and may be tender. If this should occur, please contact our office. It may require antibiotic treatment.
Virtually everyone will develop a few pimples in the recipient area starting at about a month following surgery and continuing for several months. These are new hairs breaking through the skin. They occasionally can be confused with a true infection, but pimples tend to resolve on their own in 3-4 days. As individual pimples resolve, new ones may crop up. They generally do not require treatment. Larger pimples can be unroofed by removing the thin top layer of skin with a sterile needle, and then any fluid can drain. If more than just a few develop at one time, or the skin in a larger area becomes swollen, red, tender and hot, then you should call us as antibiotics or drainage by the doctor may be necessary.
Ingrown hairs may cause a cyst to develop in the area of a graft. They can develop over a graft that was placed several months earlier. Cysts present as local swelling and redness, with or without tenderness. We can treat these easily in the office.
If the donor or transplanted area becomes infected, swelling, pain, or tenderness may be present. There also may be a discharge or puss in operated areas. Fever and/or chills are also indications or infection. If any of these conditions should occur, please contact the office.Numbness
Numbness, tingling or similar sensations may occur temporarily on your scalp. These are the results of cutting small nerve endings in the skin during the course of harvesting the donor grafts and creating the recipient sites. This generally disappears within a few weeks to months, as nerve endings re-grow.Hair Coloring and Cosmetics
Do not dye your hair for 4 weeks following the procedure. Do not use cosmetic camouflage agents (such as Toppik) for at least 7 days following your procedure. When applying the cosmetics, or washing them out, be very gentle through day 10.
Basic Follow up can also be done by phone/Whatsapp Images/Skype etc
Few Important to take care of it:-
1)Its takes around 9 to 10 days to fix grafts to the scalp.
2)If any boil/infection occurs doctor should be informed immediately.
3) Remember real hair growth starts 6 to 12 months so dont be disappointment before 6 months of procedures. final thickness of the hair will be visible by 18 months.
Hair Loss in Men
Male pattern baldness, or androgenetic alopecia, is very common in adult men. It is caused by genetic traits that are passed down through a person’s inherited DNA. The genes can come from either parent. Depending on the age of the patient and the stage of his hair loss, the baldness can typically be classified in one of twelve classes of patterned hair loss described in the Norwood Classification. This system helps determine treatment options and, if the patient is a candidate for a hair transplant, it can aid the physician in designing the hair transplant from an aesthetic perspective.
In women, the diagnosis of hair loss is more complex, as the most common presentation of balding, a diffuse pattern, can have a variety of non-androgenetic causes. These may include pregnancy, gynecologic problems, birth control pills, and thyroid disease. Because underlying medical conditions can produce hair loss that closely mimics the diffuse pattern seen in genetic hair loss, a careful diagnostic evaluation by a doctor is particularly important for female patients.
Classification of female genetic baldness is often more simple than in men, since women’s hair loss can be observed in only three patterns or stages. The Ludwig Classification system for hereditary hair loss in women describes diffuse hair loss as Type I (mild), Type II (moderate), or Type III (extensive).
Medications serve as an important role in both the prevention and treatment ofhair loss. They are particularly useful in the early stages of the balding process. There are two FDA approved medications for common baldness in men (androgenetic alopecia); the oral medication Propecia(that contains finasteride 1mg) and the topical medication Rogaine (that contains minoxidil).Because medical therapies work to thicken hair in areas that are thinning (miniaturized), rather than grow hair once it has been lost, medical treatments are best started as soon as genetic hair loss is diagnosed. Propecia is significantly more effective than Rogaine in treating hair loss, but they have additive effects when used together.
This section focuses on FDA-approved medications, although only two, finasteride and minoxidil, are actually approved to treat androgenetic alopecia. The other drugs commonly used to treat hair loss are approved for other purposes. Avodart (dutasteride) is only approved to treat prostate enlargement (BPH); and Aldactone (spironolactone), a diuretic, is approved for the treatment of high blood pressure. In this section you will learn how these medications — and several others commonly used for hair loss — work, how they should be used, and their potential problems.
Low-Level Laser Therapy (LLLT):-
Low-Level Laser Therapy (LLLT) is a treatment for hair loss based on the principle of photo-biotherapy. This involves the use of laser light to stimulate cell growth. The laser stimulates hair follicles on the scalp producing thicker hair shafts and a fuller appearance.
LLLT appears to be most useful in patients with diffuse hair loss (the most common pattern seen in women). As with drug treatments, patients who seem to respond to this form of therapy have areas of thinning, rather than areas of the scalp that are completely bald. Read more about Low-Level Laser Therapy (LLLT) »»
Camouflage Techniques:- Using cosmetic camouflage is a common way of hiding ones hair loss and is often used by persons who are just starting to thin, especially in the crown. A number of over the counter products are now available that can make the hair look thicker. They come primarily in powders, sprays and creams such as Toppik and Dermatch. The main limitation of these products is that, unless the person has a significant amount of hair to hold the cosmetics in place, it doesn’t look natural. Wigs, hats (particularly baseball caps), and scarves are all used to hide one’s balding. In recent years, elaborate hair systems, attached by glue or sewn to the patient’s existing hair, have evolved into a major industry. The problem with these systems is that they must be periodically adjusted, requiring repeated visits to the salon and significant expense. Because they can’t be removed at night, they cause traction hair loss, making the user even more dependent on the hair piece. They are also difficult to clean and often give the wearer the appearance of having too much hair.
Herbal Hair Loss Treatments:- The most common herb that has been claimed to grow hair is Saw Palmetto. This is a small plant that contains two types of oils, fatty acids and sterols. It has also been marketed as an aphrodisiac, a steroid to help build muscle tissue, a treatment for natural breast enlargement, and as an aid in the treatment of prostate enlargement.
The exact mechanism of action is unknown. Saw Palmetto appears to be somewhat effective in alleviating the symptoms of prostate enlargement and is commonly recommended for this condition. However, there have not been any controlled, scientific studies to show that it can re-grow a person’s hair and it has been the experience of physicians who treat hair loss that it is not effective for the treatment of this condition. Many other herbal remedies have been used for hair loss over the years, but none seem to have any substantial benefit in growing hair.
SCALP MICROPIGMENTATION We offer smp at our clinics for complete scalp scalp and also for increasing density appearance in both hair transplant patients and patients taking non surgical medical treatments.
There are some minor preparations before your Follicular Unit Extraction procedure at nigam.s goodhealth pvt ltd clinic.The following instructions are organized according to the days and weeks before your procedure.
When you enroll with us, please call our office , to confirm your appointment and verify that we have received your laboratory test results.If you are taking any blood thinners, please let the doctor know immediately, as they may represent a contra-indication to surgery. These medications include Plavix, Coumadin, and Heparin.If you are taking broad beta-blockers, such as Inderal (Propranolol), please contact Dr. Bernstein as this medication may need to be changed to a select beta-blocker in advance of the surgery.With larger sessions of FUE, the entire back and sides of the scalp will be shaved to 2mm in length the morning of surgery. For those having a smaller session, the doctor may shave a long strip that can be covered by the hair above it. If the doctor has indicated that he may be shaving a limited area, please leave your hair as long as possible on the back and on the sides, to cover the harvested area after your procedure. If there is any question regarding length, it is better to leave your hair on the long side as we can trim it to the appropriate length the morning of surgery.
Do not drink any alcoholic beverages for at least three days prior to your procedure.
THE DAY OF YOUR PROCEDURE
Shower the morning of your procedure and wash your hair very thoroughly using your regular shampoo. Do not apply sprays, gels, or any other styling products to your hair. If you wear a hair system, please remove it prior to shampooing and do not wear it before your procedure.Wear loose, comfortable clothing which does not need to be pulled on over your head. This will prevent dislodging your bandage or damaging your grafts immediately after surgery.
Please do not wear any cologne or perfume the day of your procedure.
Eat breakfast the morning of your procedure. We will provide lunch. If your surgery is scheduled for the afternoon, have a light lunch before you arrive.
Do not drink coffee or any caffeinated beverages on the day of your procedure.These substances may increase bleeding and your sensitivity to medications used during the procedure.
You may be receiving medications during the procedure that can make you drowsy. Because of this, you cannot drive yourself home following your procedure. Please arrange to have a responsible person drive you to your destination. If you are unable to have someone drive you home after your procedure and you live near our office, we will call a taxi for you and you will be responsible for the charges.
Please do not bring any valuables to the office on the day of surgery. This includes laptop computers.
The night of your hair transplant and for the next few nights, you are encouraged to sleep with your head elevated on pillows. Medication is given for sleep and pain (if needed). Antibiotics are generally not required. The morning after your hair transplant surgery, you will remove the headband and shower and shampoo your scalp three times – just for the first day. We’ll call you the next day to make sure that everything is OK. You won’t need to come into the office at this time, but are welcome to do so.
For the remainder of the week, you should shower twice a day. When showering, you will be instructed to gently clean the transplanted area with a special shampoo. The follicular unit grafts are made to fit snugly into the recipient sites and will not be dislodged in the shower, if you follow the instructions given to you. After your first shower, no further bandages are required.
Although you must be very gentle for the first week after hair loss surgery, normal shampooing, brushing and hair care can be resumed after ten days since, by this time, the grafts are firmly in place. You can also have a haircut at this point. You are able to dye your hair, if you choose, four weeks after the hair transplant.
You should avoid alcohol for three days following your hair replacement procedure and abstain from smoking for two weeks. When in strong sunlight, you should wear a hat. After two weeks you may use a sunscreen with a SPF of 30+.
Generally patients can resume normal daily routine almost immediately. Exercise can be started the second day following your procedure. For the first 10 days, you should avoid any activities that rub or put direct pressure on your scalp.
We ask you to return to the office for a ten day follow-up visit, but for those who live at a distance from our facilities this can generally be handled by phone.
If the post-operative instructions are followed carefully, in most patients, the hair transplant is barely detectable after ten days. Patients are given medication for swelling at the time of hair loss surgery, but some still experience swelling of the forehead that settles across the bridge of the nose and around the eyes. If this occurs, it is almost always gone by the end of the first week.
The newly transplanted hair begins to grow at around 10 weeks. It is long enough to be groomed in about 6 months and, in most cases, will be fully grown in at one year. In the few months following hair surgery, before the new hair starts to grow, there may be some shedding of your original hair so that the transplanted area may temporarily appear slightly thinner. This is a transient phenomenon and will be corrected when the new hair begins to grow. It should not be a cause for concern.
The following table describes the usual course for persons having Follicular Unit Hair Transplantation. There will generally be significant person to person variability, so if you do not follow the course exactly, do not be concerned.
Some shedding after a hair transplant is relatively common. The correct medical term is “effluvium” which literally means shedding. It is usually the miniaturized hair i.e. the hair that is at the end of its lifespan due to genetic balding that is most likely to be shed. Less likely, some healthy hair will be shed, but this should re-grow. Interestingly, if hair transplants are spaced less than one year apart, one often notices some shedding of the hair from the first transplant, but this hair grows back completely.
For most patients, if effluvium occurs, it is a minor issue and should not be a cause for concern. In the typical case, a patient looks a little thinner during the several month time period following the hair transplantation, when the transplanted hair is in its latent phase. The thinning is often more noticeable to the patient than to others.
In general, the more miniaturization one has and the more rapid the hair loss, the more likely there will be shedding from the hair restoration surgery. Young, rapidly balding patients would be at the greatest risk. Older patients with stable hair loss would have the least risk.It is important to differentiate the phenomena described above from shedding of the hair in the graft. This shedding is an almost universal characteristic of a hair transplant and occurs because during hair transplantation a graft is temporarily stripped of its blood supply. As a response to this insult, the graft sheds its hair. The shedding is noticed beginning a week following the procedure and can continue for up to six weeks. A very small percentage of patients do not shed and the transplanted hair continues to grow. In others, the transplanted hair remains on the scalp for months until a new hair pushes it out. Whether a patient sheds or not has no bearing on the outcome of the hair restoration.There are a number of ways to minimize the effects of post-operative shedding: the first is using medication, the second is timing the hair transplant properly and the third is performing a procedure using a sufficient number of grafts.Medication
Finasteride 1mg reverses or halts the miniaturization process in many individuals and its use may decrease the risk of shedding following hair transplants. Its ability to prevent shedding, however, has not been proven in controlled studies.Timing and Size of Hair Transplant
It is important to wait until a patient is ready to have hair transplantation surgery, and then to perform one of sufficient size so that if there is some shedding, the procedure will more than compensate for it. A problem that patients often run into is that they seek a hair transplant when they have very early actual hair loss, but have a significant amount of miniaturization. The doctor performs a small procedure that does not take into account possible shedding or the progression of the hair loss. The result is that the patient is thinner than he/she was before the procedure. The doctor rarely blames the problem on the fact that the procedure was too small or that there the miniaturization was not taken into account, but only that the patient continued to bald. The better solution is to treat early hair loss with medication and once you make the decision to begin surgery, have a procedure large enough to make a significant cosmetic improvement.
As a final point, it is a fallacy that some doctors’ techniques are so “impeccable” that they can avoid effluvium or that a very small procedure will avoid shedding. Of course, bad techniques and rough graft handling will maximize effluvium, but effluvium is what hair naturally does when the scalp is stressed and it is stressed during hair restoration surgery from the anesthetic mixture and the recipient site creation, regardless of the technique, so that it cannot be totally prevented. Despite claims to the contrary, Follicular Unit Extraction has no bearing on this process of shedding as it is a harvesting rather than a placing technique.
In sum, the best way to deal with effluvium is to treat with Finasteride when hair loss is early, perform a transplant only when indicated and finally, to perform a hair transplant with skill and to use sufficient a number of grafts.
A significant advance in Follicular Unit Extraction has been the addition of “blunt” dissection to the original technique of “sharp” dissection followed by extraction. This was described by Dr. Harris at the International Society of Hair Restoration Surgery (ISHRS) in 2004. In this three-step technique, a sharp punch is used to score the epidermis (cut just the upper part of the skin) and then a dull punch is used to bluntly dissect (separate) the follicular unit grafts from the surrounding deeper dermis. The third step is the same, namely removing the follicular graft from the scalp using fine forceps.
At nigams goodhealth pvt ltd,a proprietary dissecting instrument is used that allows us to efficiently perform this 3-step technique with minimal transection. The instrument is positioned around the scored upper part of the follicle allowing the surgeon to remove the entire follicular unit from the scalp. This new design has the advantage in, hair transplant technique over the original two-step process is that using a dull punch minimizes follicle transection (damage). As the blunt-tipped punch is advanced into the dermis, the follicles, which naturally separate deeper in the skin, are “gathered together” within the opening of the instrument, rather than risk the lower portions of the follicles being cut off. Another significant advantage of the new technique is that it increases the number of patients who are able to benefit from FUE.
The SAFE System, developed by Dr. Jim Harris, is a device that uses blunt dissection to isolate the follicular units from the surrounding tissue. The device allows the physician to perform precise Follicular Unit Extraction with minimal damage to follicles. By using a motorized instrument, it significantly increases the speed of the procedure.
The machine powers a slowly rotating blunt punch that slows down even further as it passes deeper into the tissue, thereby minimizing rotational injury and trauma to the grafts. The initial rotation speed is just enough to allow the instrument to penetrate the skin and the slower speed allows the dull punch to pass deeper into the scalp and separate the follicular units from the surrounding dermis, causing minimal transection (inadvertent cutting of the follicles).
The isolated follicular unit grafts are then removed with forceps, sorted and counted under a microscope, and then planted into the recipient area using standard placing techniques.