Our Aftercare Protocol
We provide the first-24-Hours All-Round Backup after your procedure. Please follow our instruction to get the best result. Call the 24 Hours Number for any concern.
Getting into Cars
• Be careful when you get into a car!
• Your head should not hit the door rim or the roof - transplanted grafts can be dislodged
• For the same reason beware of the cupboard door
• With FUT and FUE, there is no need to sleep on sofa or chair
• Just sleep normally in bed
• It is normal to feel tight where the strip was removed
• If any discomfort lying on pillow, just roll a towel under your neck or use a neck pillow
• Take some pain-killer before sleep also helps
• Sleeping pills are also provided to be taken if needed
• Discomfort after FUT and FUE hair transplant is usually tolerable
• Everyone has a different pain threshold. Many patients do not take any pain-killer at all
• We provide simple pain-killers, to be taken as required
• Stronger pain-killer is avaulable on request
• Tightness around the donor wound will settle after sutures removal
Our Head Band
• The scalp is closed to bone with just a layer of skin
• To prevent damage we inject specially prepared "tumescence" fluid to lift scalp from bone
• 3 days after surgery this fluid may drain down to the forehead and around the eyes
• Once happens, takes at least a week to settle
• Our specially-designed headband has effectively reduced postoperative eye swelling
• We are adopting a water-proof hair transplant technique
• You are able to wash your transplanted area everyday to keep it clean
• The next day after hair transplant, we will demonstrate how to do it yourself at home.
Low Level Laser Therapy LLLT
• 2 sessions of low level laser therapy using the Sunetics laser Hood is included in your package
• Evidences showed LLLT after procedure to promote wound healing and reduce shock loss
• The first session would be provided the next day after the hairwash.
• Do not over eat the night after surgery
• It is normal to feel a bit nausea
• Can eat anything but not too salty for 3 days to reduce swelling of the forehead
Return to Wook
• Outdoor activities can be resumed almost the next day
• Most people can return to work after 2 to 3 days
Removal of Sutures ( FUT )
• Sutures may create discomfort at back of your head, but these are important to minimize donor scar
• We use 2 types of suture, one to be removed on Day 5-7, by us or your local doctor
• The other dissolves after 4 weeks
Improper Hairwash Affects Graft Survival
We strive to get the best possible result for you, taking care of every single step. A transplanted hair needs 7 days to re-establish blood supply. It is very fragile in this 7 days, easily damaged. Improper hair wash will have an adverse effect on the graft survival and final outcome.
Good Hair Wash Is An Important Part of Our Protocol
During his training, our doctor spent a few weeks just learning how to wash hair. All our staff are trained by Dr Ng how to wash hair for the patients.
Our office has 2 shampoo rooms and 2 hair stylists. The next day after hair transplant, we will demonstrate how to do it yourself at home.
Scabs are the tiny bit of skin tissue carried by the transplanted hair. The scabs first appear as red dots over the scalp right after the procedure. Over the next few days the scabs will dry up as brown crust over the recipient sites.
Proper and regular will easily remove scabs. We will teach you how to do it. If left alone, the scalp may look unsifghtly and also become itchy
Using improper shampoo may damage the newly transplanted grafts. Our staff would recommend which Shampoo is safe to use straight after your procedure.
|ACTIVITIES||DAY AFTER PROCEDURE|
|Wearing Hat or Banada||Same Day on Discharge|
|Indoor Activities||Next Day (Day 1)|
|Shopping, Dining Out||Next Day (Day 1)|
|Hair Wash at Home||Day 2 (Day 1 we shampoo for you)|
|Travel by Plane||Day 2 (We had patients leaving that same evening)|
|Drink Alcohol||Day 2|
|Office Work||Day 2|
|Light Exercise (Tai Chi)||After 1 week|
|Golf||After 1 week|
|Hair Styling Gel / Spray||After 1 week|
|Wearing Hairpiece / Wig||After 1 week|
|Resume Minoxidil Lotion||After 10 days|
|Moderate Exercise (jogging)||After 2 weeks|
|Hair Cut / Dye||After 4 weeks;|
|Strenous Exercise (weight lifting, soccer)||After 4 weeks|
|Swimming (pool or beach)||After 4 weeks|
|Sauna||After 3 - 4 months|
Say No to Antibiotic
• The most dangerous part of any surgical procedure is drug allergy
• Adverse reaction to antibiotic such as Penicillin can be fatal
• We have not been using antibiotc as routine for the last 7 years
• Proud to achieve an less than 1% infecton rate.
What You Should Do Before Surgery
• If you have diabetes, first consult your family doctor to well control the blood sugar level
• Quit or cut down on smoking
• Wash your hair with our antiseptic shampoo the night before procedure
What You Should Do First 2 Weeks After Surgery
• Avoid strenous exercise
• Avoid wearing a hair piece or tight helmet
• Wash hair at least once a day
• Finish all the antibiotics as instructed
• Avoid eating spicy food
• Contact us if the wound is moist with oozing
What You Should NOT Do First 2 Weeks After Surgery
• Strenous exercise and excessive sweating
• Wear a hair piece continuously for over 10 hours per day
• Not washing your hair
• Eating very spicy food
• Frequent touching of the recipient areas
For Oversea Clients
Don't worry if you are overseas and cannot attend our scheduled follow-up. We have developed a safety protocol and online backup program. A local dermatologist has agreed to look after our patients in Macau.
Hair transplant is a surgical procedure. Most complications, if diagnosed early, can easily be fixed. Wound care by our professional staff is provided for free the first 4 months after
• Next day after procedure
• 5- 7 days after for wound check +/- removal of sutures
• 1 month after, checking for shock loss and folliculitis
• 4 month after, checking for new hair as well as healing of donor wound
About The Follow-Up
• With our FUT and FUE techniques we do not anticipate any major problems or complications
• The most difficult time is the first 4 months after procedure, when you see nothing
• You can voice out any concern. Our staff will answer questions you have in mind
• We will pluck away the old hair shafts to make way for the new ones
• Also our staff will assess the progress of your hair loss in non-transplanted areas
Adjuvant Therapy After Hair Transplant
Objective - Optimize Result
We used to believe that when you have hair transplant, you don't need to take medicine; when you take medicine, you don't need hair transplant. Not anymore! Surgery and medical therapy is no longer mutually exclusive. Adjuvant Therapy is the current trend when surgeons transplant the recipient site, and use FDA-approved medication to improve and maintain the non-transplanted areas.
The use of medication after a hair transplant procedure, whether as topical preparations or as oral drugs, is called Adjuvant Therapy. It can be used as short or long term.
Rational of Use
From our 10 years of experience, growth of the transplanted hair can be stimulated by a hair-growth-promoting agents such as Copper Peptide, and low level laser energy
Tricomin Follicle Spray
We have imported the Tricomin Follicle Spray from USA which contains Copper Nutritional Complex for use after hair transplant.
• Encourages healthy growth of the transplanted hair follicles
• Protects transplanted grafts against environmental factors that may cause hair to fall-out more rapidly
• May help to treat the underlying cause of hair loss
• Triamino Copper Nutritional Complex powers-up the natural defense process to protect hair from environmental damage
• Panthenol repairs and nourishes damaged hair
• Amino acids and minerals build body in the hair to produce a fuller appearance
Who Should Consider using Tricomin Follicle Spray ?
• We recommend all patients to use for at least 4 months after the procedure
• Women would find it usefuk to prevent "Shock Loss" - temporary shedding of transplanted as well as existing hair
• Most use it up to 12 months and experience an early growth of transplanted hair
Low Level Laser Therapy LLLT
• 2 sessions of low level laser therapy using the Sunetics laser Hood is included in your package
• The first session would be provided the next day after the hairwash
• Evidences support the use of LLLT after the procedure to promote wound healing and reduce shock loss ( READ MORE )...
Rational of Use
Hair loss due to AGA progresses if left untreated. Further loss of existing hair degrade surgical results over time, so the preservation of hair with adjunctive therapy can play a role in sustaining the cosmetic benefits of surgery.
Although occipital donor hair does not respond to oral 5α-reductase blockers,their growth can be stimulated by a hair-growth-promoting agents such as minoxidil.
Benefits of Minoxidil
• Convert resting follicles into active follicles and promote new hair growth
• Growth of existing hair contributes to good results after just 1 or 2 transplant sessions
• Slowing down miniaturization of existing hair helps to maintain satisfactory coverage
• Avoid the need for further sessions to add on density.
Who Should Consider using Minoxidil
• Those receiving transplants in the whorl area (vertex)
• Patients with existing fine hair in the recipient area
• Younger males and women with diffuse thinning to prevent further loss of existing hair
• Those with strong family history of advance hair loss
• Those planning hairline transplant but already have thinning crown
• Those with very limited donor hair
What and How to Use Minoxidil
• Use 5% Minoxidil topical lotion or foam
• Apply to donor and recipient sites once daily
Oral 5α-reductase blockers
• Men should consider using both topical 5% Minoxidil lotion and oral 5α-reductase blockers
• This is a prescription medication so please consult your physician before use
Healing of Transplanted Area
Once a hole is made in the recipient area, wound repair starts immediately. Three phases are found: inflammatory, proliferative, and revascularization.
Characterized by clot formation, deposition of fibrin, and an influx of inflammatory cells in the wound.
Fibroblasts and epithelial cells migrate to repopulate the wound. Wound contracture and epithelization occurred during this interval. Multiple cytokine growth factors (PDGF, TAGF, TBGF, EGF, and VEGF) increased in the wound during the inflammatory and proliferative phases.
Growth factors are the engines or modulating factors that drive wounds to heal. Growth factor activity includes the following:
• The transforming alpha growth factor(TGFA) appears on day 1
• The rest of the growth factors appear on day 3
• Day 7 to 21 show slight to moderate activity of all the growth factors
• Day 28 only epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) are present
These growth factors play key roles in initiating and sustaining the phases of tissue repair. They ultimately diffuse or disperse from the wound site to be degraded by inhibitory proteases. Specialized fibroblasts and growth factors from the dermal papilla also play a key role in the control and induction of the normal follicular growth cycle.
After the graft is placed in the recipient site, a “survival” process occurs. Three phases of revascularization:
Stage I Plasmatic imbibition
1–3 days post-op, during which the graft absorbs plasma from the recipient site.
Stage II Primary inosculation
3–7 days post-op, during which early revascularization occurs and connections form between the hair graft and recipient site.
Stage III Secondary inosculation
Day 7, during which there are further changes in the blood vessels (including lymphatics) with coiled vessels extending deeply into the dermal papilla and with budding around the follicular implant. These changes take place simultaneously with the increase in inflammatory cells and growth factors.
A hair follicle is a living tissue. A lot of things take place after the follicle is planted into the new site. Understanding of the natural histochemical process is crucial, as a better graft survival means a better outcome.
After the graft is harvested from the donor area, it is placed in a storage solution for preservation until implanted in the recipient area. Its original blood supply is detached. Oxygen is depleted and waste products begin to accumulate. The ability of the graft to receive nutrients from the recipient site and undergo revascularization (formation of new blood vessels) therefore determines survival. After the graft is inserted into one of the slits, the wound healing process immediately takes place. There is a cascade of cellular activities – edema (swelling), erythema (redness), hair shedding, new hair formation, and the revascularization of the hair graft.
Most patients would have slight to moderate edema in the transplanted area immediately after surgery. The swelling usually disappears after one week.
Erythema is present after the surgery but decreases gradually over time. In most case the redness is not noticeable after 2-4 weeks.
The Scab (Dead Skin)
It falls off after 1-2 weeks, facilitated by the use of olive oil.
• On day 1, only edema is found
• By day 3, important influx of neutrophils and occasional eosinophils
• By day 7, neutrophils and macrophages are both present
• By day 14, predominant cell types seen are macrophages, fibroblasts, lymphocytes, occasional histiocytes
• From days 21 to 28, inflammatory cells decrease and then disappear
• Collagen III and IV present from day 1 to 6 months
It may take 4–8 hours to complete the insertion. The elapsed time is critical for hair growth and survival because increased time results in decreased survival. As oxygen is depleted and waste products such as carbon dioxide, sugar, and urea begin to accumulate, a newly planted hair graft will be acidotic. The first 48–96 hours after implantation is critical. If the circulation cannot be re-established (the primary inosculation) to correct the metabolic imbalances, the hair graft won’t survive and could die.
Reperfusion after ischemia can also produce apoptosis and/or necrosis of the hair graft and the release of free radicals. This is called "ischaemic re-perfusion injury". The revascularization phase for a hair graft is gradual. Therefore it is critical to decrease the ischemia time and accelerate the revascularization phase. Maintaining a healthy blood supply to the scalp and minimizing hypoxia and ischemia of the hair graft during hair transplant surgery and up to a minimum of 4 to 5 days post-op should increase the survival rate.
Shedding of the Transplanted Hair
After the transplanted hair graft is taken and survives, the process may continue with one of the following scenarios:
• A small percentage of hair continues to grow from day 1 with no shedding
• Most hair will fall out after 1–6 weeks (anagen effluvium)
• Some hair will take a longer 7–12 weeks to fall out (telogen effluvium)
After the hair falls out a new hair will begin to grow 2–4 weeks later. By the 6th month most of the recipient area shows new hair growth. As hairs within a single follicular unit can have different hair cycles: some hair grew and some fell out. It is unpredictable but seems to be helped by the use of Minoxidil as adjuvant therapy.