Your Surgery - Post-operative instructions

1. Take the medicine contained in this envelope according to the prescription instructions.

2. Tomorrow you must return to Ruston Clinic to have your scalp washed and for a brief evaluation. You will receive a kit containing a special shampoo specifically for use during this post-operative period. This shampoo will speed up the process of the scabs falling off and should be used until all of the scabs have fallen off. After this period you may return to the shampoo you normally use. You will also receive a hat (to hide the region and protect the tiny scabs) and medicine to avoid swelling of the forehead.

3. PAIN: The medicines contained in this envelope are sufficient so that 90% of the patients feel only subtle pain in the region of the scar (the transplanted region never hurts). This pain and sense of “tightness” will pass in 24 hours. In other words, tomorrow, after washing the scalp, there will not be any further pain.

4. The first night of sleep: Maintain your head elevated (with 3 pillows) to reduce the risk of bleeding. You may rest the donor area normally on the pillow.

5. After four or five days, you may experience a slight swelling in the forehead region. Should this occur, you may apply cold compresses to the region (the longer the period and the greater the frequency, the better the results will be). The swelling should disappear within 2 to 3 days. On the day after surgery, medicine, which should be taken once a day, will be provided to reduce the chance of swelling.

6. AVOID:

• Smoking or consuming alcohol for three days after surgery;
• Playing sports, any excessive physical exertion, or swimming (pool or ocean) until all of the scabs have fallen off. NEVER PICK AT OR PULL OFF THE SCABS. LET THEM FALL OFF BY THEMSELVES, SPONTANEOULSY.
• Exposing the scalp to sun or excessive heat (ex. Sauna) during the scabbing phase.

7. The suturing in the donor area is done with absorbable suture that will fall out spontaneously 15 to 30 days after surgery. The scar will be red and sensitive until the third month post-surgery, and only then will begin to fade, returning to the normal skin color within one year.

This scar should become quite thin and imperceptible, easily camouflaged under your hair, however the quality and width of the scar depends on the elasticity of the scalp and the healing process, which is individual and varies from patient to patient.
The small scabs of the grafts will fall out spontaneously 7 to 14 days post surgery (depending on the patient, it can take up to 30 days), taking with them the transplanted hairs that were in the growth process at the time of surgery. NEVER REMOVE THE SCABS BEFORE THEY FALL OUT NATURALLY, as you can pull out the roots and harm the integration of the grafts. LET THEM FALL OUT SPONTANEOUSLY. We at The Ruston Clinic are not responsible for the integration and hair growth should they experience trauma or be removed.

8. Around 10% to 20% of the transplanted hairs will grow directly, and not fall out with the scabs, however around 80% of them will only reach the skin surface between 2 to 5 months post surgery.

Those that reach the skin surface earlier than usual (between 1 to 3 months) will find the skin hardened and undergoing the healing process (scarred), therefore smalls cysts (ingrown hair) or pimples may form. This occurs in less than 10% of the patients and only in some grafts, generally resolving itself naturally after all the hairs break through the skin´s surface (about 4 months after surgery).
If you wish, you may apply an anti-inflammatory spray (Cataflan, Voltarem or Diclofenaco) on these pimples twice a day to accelerate the recovery (contact us if necessary).
The sensitivity of the scalp both in the donor and transplanted regions will be altered (first it will feel numb, then some itching, some tingling, etc.) The sensations should return to normal between 1 to 4 months post-surgery.

9. In the cases of volume increase and in the areas of thickening, after the scabs fall out, there will be a temporary reduction of hair volume (more or less intense depending on each case), in other words you may feel balder than usual for 2 to 4 months. Do not worry as this thinning out is to be expected and this will be compensated in about 3 to 5 months post-surgery. No pre-existing hair is permanently damaged.

10. The definite hair growth will occur only 90 to 120 days after surgery and only then at a rate of 1 cm per month. Therefore the result will be noticeable only 5 to 6 months after surgery, with the final result occurring between 9 months to 1 year post-surgery.

11. Return visits: the day after surgery, after all of the scabs have fallen (not required), between 5-6 months post-surgery for a check-up (not required, but recommended), the last return visit should be between 9 months and 1 year for post-surgery photos and the final re-evaluation (this visit should be made).

12. If Propecia (1 mg) was prescribed to you, do not stop taking it until Dr. Ruston tells you to do so.

We kindly request that you contact us by telephone when necessary or when you have doubts, during office hours, at (11) 3661-8521 or write to info@clinicaruston.com.br and we will respond as quickly as possible.

FOR EMERGENCIES: (during non-office hours) call 55 11 9249-2327