Navigating Your Hair Transplant Recovery Journey

The last suture is tied, the last graft implanted and you’re finished. The wait is over, the transplant operation is done and you’re ready to sit back and watch the process take care of itself. Although the procedure itself has ended, in some ways your journey has just begun. If you want your hair transplant to succeed, it won’t just be the surgeon’s skills and experience which are important. Care and patience in the coming weeks and months will play a large part too. This is how to enjoy a great hair transplant recovery.

Expectations, Timeline and Results

Hair transplant recovery, like the transplant itself, is a very predictable biological process. The scalp you see in the mirror will go through a series of expected changes over the coming months as it gradually matures and your hair grows. Although your transplant surgeon will explain these details with you in advance, it’s always good to have an idea of what to expect and when you might see your results. Hair transplant results do not happen overnight, and there are many factors which affect timing. Setbacks or irregularities are not common, but they can occur. For best results, think of your recovery in terms of 4 distinct ‘acts’.

Act I: Post Operative (Days 1-10)

Act I is all about protecting the grafts and allowing them to heal into position.

Act I: Day 1-2

The first 48 hours of your hair transplant recovery will see your scalp at its most vulnerable, and you at your most uncomfortable. Your scalp will be bruised, swollen and covered in what looks like thousands of fine scabs. Swelling will often concentrate on the forehead and around the eyes, reaching its peak on around day 3. The most important rule during this entire time is that you must be extremely gentle. Your scalp will be sore, tender and very easy to damage. Scratching, bumping or touching the scalp must be avoided. If you cannot sleep sitting upright at around 45 degrees for the first week, you must do so now. Sleeping at an angle makes a huge difference in reducing swelling and protecting the grafts. Avoid any strenuous activity that might increase blood pressure and risk bleeding.

Act I: First Wash

Your first wash usually takes place on around day 3 or 4. Wash day is one of the most important times in your transplant recovery. It is an activity that must be performed very carefully and with great respect. Do not attempt a normal shampoo. Instead, use a cup to pour water and a small amount of the mild shampoo given to you by your surgeon over the top of your head, allowing the water to gently run over the scalp. The scalp must not be touched at all and a soft towel must be used to pat the hair dry. A good first wash will soften and clear away the majority of the first crust, without dislodging any of the grafts.

Act I: Week 1

By day 7-10, most of the swelling will have gone and the worst of the crust will have flaked away. Most of the grafts should be completely settled into place, but the hairs are not yet permanent. As the pain subsides you will likely be able to return to work (provided your work is not particularly active or strenuous).

Act II: The Ugly Duckling (Weeks 2 – 3 Months)

Act II is all about patience.

Act II: The Great Shed

We mentioned above that transplant shock causes the implanted follicles to go into a resting state. The hair shafts connected to those follicles will also go into a resting state and begin to shed. This can begin anywhere from 2 weeks to a month after surgery. At the end of the first month it is likely that most or all of the transplanted hair will have fallen out. If you are noticing that this is happening it can be a very worrying sign but in fact it is a very good one. The follicle is still very much alive and intact underneath, now it’s just a waiting game.

Act II: The Return to Normality

The scalp also begins to look relatively normal as the redness recedes and you can usually return to a full normal activity level including full-on exercise at around this time. For most this will be the most difficult period to stay patient. A bald scalp with no signs of new growth can be a difficult pill to swallow. Your surgeon will be able to use trichoscopy to view the follicles directly, and it is possible to see them before a naked eye can detect any difference.

Act III: Reawakening (Months 3-6)

Act III is where things finally start to happen.

Act III: Pioneer Hairs

Around 3 months post-op, the first signs of new growth will be visible. Light, wispy and often very fine hairs will begin to poke through the surface of the skin. At this stage the density of new hair growth is usually very patchy and uneven as different areas wake up. Hair texture can also be abnormal in the early stages. Curly or kinky hairs are not unusual as the new hairs push their way through the healing tissue. The hair will soften over the coming months.

Act III: Gaining Momentum

Growth between 4 and 6 months will be more consistent and during this period it becomes very visible. The hairs get thicker, darker and longer as time passes. The new hairline will start to take shape, and the hair will visibly fill in and get denser.

Act IV: Maturity (Months 7-18+)

Act IV is the home straight.

Act IV: Thickening and Maturing

Months 7 to 12 see further thickening of the shafts as they mature into the size of your native hair and the growth across the scalp evens out and synchronises. Hair is now long enough to cut and style in a normal fashion.

Act IV: The Final Result

While you can make a good estimate of your results at 12 months, the final and definitive answer may not be clear until 12-18 months post-op. In larger sessions, or for patients with slower growth cycles, small but incremental improvements can continue to be seen beyond this period. You can expect your transplant to be permanent, because the grafts have all been taken from an area of the scalp genetically resistant to balding.

Hair Transplant Recovery Best Practices

Best Practice: Sun Protection

A healing scalp is very vulnerable to sun damage and pigmentation problems and direct sunlight can also damage fragile follicles. A hat or specialist sunscreen (sanitised and approved by your clinic) is a must for the first 6 months.

Best Practice: Proper Diet and Supplementation

Your body will need the tools to create new hair, including protein, water and key vitamins and nutrients such as Vitamin C (collagen), Zinc and Iron. Eat well and stay hydrated.

Best Practice: Lifestyle

Smoking nicotine constricts blood vessels and will impair blood flow to the scalp, greatly affecting healing potential and graft survival. Alcohol is a dehydrator and can contribute to swelling. It’s not essential to give them up, but avoid both, especially in the first month, if you can.

Best Practice: Follow Through

Follow your surgeon’s aftercare instructions closely and without deviation. These are given to you for a reason and they are instructions for success.

Hair transplant recovery is an exercise in patience and biology. It has a relatively predictable timeline and the results, with the right approach and commitment, are reliably excellent. It’s a process with a clear set of steps. You go from initial vulnerability and fragility, through a quiet period of patience, then a very exciting time as growth starts, to a final period of maturation as the true results take shape. By understanding what to expect and how to best partner with your body’s natural healing processes you will set yourself up for a great recovery and the restoration of your confidence for years to come.