A Complete Guide to Pre-Surgery Care for a Hair Transplant
The term hair transplant is often used interchangeably with the words “investment” and “confidence”. When properly executed, the end results are nothing short of remarkable. The performance of a hair restoration procedure is reliant on more than just the experience and deft of the entire surgical team on the day of surgery. The weeks and days leading up to your surgery are when the most meticulous prep work takes place. Pre-surgery medication and care are a vitally important piece of the success puzzle. Think of this preparatory stage of the process as priming the “soil” (scalp) to receive the “seeds” (donor grafts) that will grow, thrive, and produce a full, natural head of hair in the weeks, months, and years to come. This extensive guide will take you through every important detail and aspect of your pre-surgery medication and scalp care regimen. The clearer you are about the purpose of each step, the more likely you are to follow the clinic’s instructions, and the more you are setting yourself up for a successful transplant result.
Goals of Pre-Op Hair Transplant Care
These are the things that the pre-operative phase and scalp care regimen are designed to accomplish:
Optimize graft survival: Follicular unit grafts are extremely fragile. It is important that they are as healthy as possible and are “ready” for extraction to optimize the chances of a successful graft take rate (survival rate).
Optimize scalp condition: In order to ensure smooth graft harvesting and insertion, the scalp should be clean, supple, and healthy to reduce trauma and bleeding.
Reduce the risks of infection and other surgical complications: With a healthy scalp and no external, unnecessary risk factors, the risk of post-op infection and other potential complications is reduced to a minimum.
Comfortable and speedy recovery: The care you take before surgery will have a major impact on your comfort levels after surgery, as well as swelling and recovery times.
Your clinic will send you a checklist with specific instructions tailored to their particular surgery methods and medications. Reading and following those instructions is extremely important and not a step to be taken lightly. However, understanding why the rules exist is key to your motivation to follow each and every one to the letter. Take the time to read and digest all the information in this section before your surgery date.
Hair Transplant Prep Timeline: A 3 Phase Plan
Phase 1: Weeks Before Surgery (The Early Game)
Making adjustments and starting long-term medication regimens.
Pre-Surgery Consultation and Full Medical History Review: This is the single most important step of the entire pre-op process. Full disclosure with your surgeon is required and non-negotiable. You must tell your doctor about ALL pre-existing medical conditions. Even if you think a condition is completely unrelated to your surgery, you must disclose it. Here are some examples of things to bring up and discuss with your surgeon.
Autoimmune diseases: Alopecia areata, Lupus, etc.
Blood clotting disorders: hemophilia, etc.
Heart conditions
Keloid / Hypertrophic scarring history
Skin conditions on the scalp: Psoriasis, Seborrheic Dermatitis, etc.
Past / current infections
Medication Review: Do’s and Don’ts: As with the non-medical restrictions, your surgeon and their clinic will give you an official list of things to take, take regularly, and stop using before your surgery. However, these general rules apply:
STOP (2-3 Weeks Before):
Blood thinners: Aspirin, Ibuprofen (Advil, Motrin), Naproxen and other NSAIDs: These are anticoagulants which increase the risk of excessive bleeding and bruising.
Supplements: Vitamin E, Ginkgo Biloba, Ginseng, St. John’s Wort, Fish Oil (Omega-3), etc. : These supplements can also cause thinning of the blood.
Alcohol: Consumption of alcohol reduces the bloods’ ability to clot, dehydrates the skin, and leaves your body in a dehydrated state.
Smoking and nicotine (the single most important thing to quit): One of the primary reasons patients are instructed to quit smoking and nicotine use before their hair transplant is the presence of nicotine in the bloodstream which drastically affects blood flow. Nicotine is a powerful vasoconstrictor, meaning that it constricts blood vessels, dramatically reducing blood flow. Blood flow to your scalp and face delivers oxygen and nutrients to the healing tissue, including the transplanted grafts. Without a sufficient blood supply, transplanted grafts are more likely to die and fail to “take”. Most surgeons insist on patients being completely nicotine free (no vaping, patches, gum, etc.) at least 2-4 weeks before and after surgery.
CONTINUE (Unless Told Otherwise):
Finasteride (Propecia) or Minoxidil (Rogaine): These medications are often advised to be continued to further help control and stabilize hair loss.
Essential prescription medications for blood pressure, thyroid, etc. : Your surgeon will coordinate any necessary medication adjustments or timing with your GP if needed.
Lifestyle and Diet:
Nutrition: Pay attention to eating a balanced diet, including a variety of vitamins and minerals that are critical for hair growth and wound healing.
Zinc: Plays a critical role in tissue growth and repair.
Iron: Essential for oxygen transport in the blood.
Vitamin C: A powerful antioxidant that stimulates collagen production.
Protein: The building block of hair (keratin)
Hydration: Increase water intake and start drinking 8-10 glasses of water per day as soon as possible (but at least a few weeks before). Hydration helps keep skin pliable and promotes more efficient healing in the body.
Exercise: Don’t stop! Working out and regular exercise are beneficial for optimal wound healing and overall physical well-being. Just make sure to avoid activities near your surgery date that could result in head or facial injury.
Phase 2: Week Before Surgery (The Mid Game)
The finish line is in sight, and your actions in the final week have a more direct effect on surgery day.
Finalize Details: Book time off work (average: 5-7 days, but your surgeon can give you a more precise estimate). Arrange for transportation to and from the clinic (do not plan on driving yourself home), and set up your “recovery cave” at home with extra pillows to keep your head elevated after surgery.
Scalp Care: Your clinic may prescribe an antimicrobial shampoo to use in the 3-4 days before surgery. Products that contain Ketoconazole reduce scalp microbial load and the risk of infection. Avoid harsh chemical treatments, dyes, and scalp exfoliants in the week before surgery.
Avoid Caffeine: In the final 24-48 hours before surgery, it is best to avoid caffeine as it can contribute to elevated heart rate and blood pressure, which in turn leads to increased bleeding during surgery.
Haircut: If you are not already sporting a shorter hairstyle, some clinics will want you to cut your hair short to better access the donor area (back and sides of the scalp). Do not shave your head or use an electric trimmer. The surgeon needs some hair to use as a guide for angle and direction of transplanted grafts.
Phase 3: Day Before Surgery (The End Game)
Wash Hair: Wash your hair with the recommended shampoo to thoroughly cleanse the hair and scalp.
Pack Comfortable Clothing: Pack a loose button-down shirt or wide-necked top, and loose-fitting trousers. You won’t want to pull any shirt over your head once the procedure is finished.
Eat a Healthy Meal: Unless you are receiving sedation and instructed to fast by the clinic, you will be encouraged to have a normal, light meal the night before surgery. This will stabilize your blood sugar and prevent lightheadedness during surgery.
Sleep: Get a good night’s sleep. A well-rested body recovers faster and copes better with the physical stress of a lengthy procedure.
The Pre-Surgery Medication Protocol
In the hours and days leading up to surgery, the medications prescribed or recommended have specific purposes. It is important that you follow the clinic’s dosage and timing instructions exactly.
Antibiotics:
Purpose: Prophylactic, or preventative, medication to ward off post-op bacterial infections. The scalp will have thousands of micro-wounds post-surgery, and is therefore a potentially inviting entry point for bacteria and infection.
Timing: Antibiotics are often prescribed for the morning of surgery or to be started the day before.
Anti-Inflammatories / Steroids:
Purpose: Reduce swelling and edema (swelling). Swelling is extremely common, especially around the forehead and eyes, after FUT or large FUE sessions. Controlling edema in the days and weeks after surgery is critical for optimal healing and a smooth, comfortable recovery.
Timing: A short course of oral steroids, like Prednisone, is typically prescribed. It will begin either the day of or day after the procedure, but will be included in the pre-op instructions.
Multivitamins:
Purpose: These supplements are used to give your body all the necessary co-factors for optimal healing. A simple, well-balanced multivitamin is often sufficient. Mega doses of specific vitamins are not recommended unless they are specifically advised by your surgeon.
Pain Medication:
Purpose: While local anesthesia means the procedure itself is not painful, you will be given a prescription strength painkiller for use after the anesthesia wears off.
Important: This is typically Acetaminophen (Tylenol) as it is not a blood thinner like NSAIDs. Instructions will be given to avoid Ibuprofen and Aspirin.
Reminder: Medications to Avoid:
In case you missed it in the week before surgery section, here is the final reminder. This means ABSOLUTELY no alcohol, nicotine, or any other supplements, over-the-counter, or “natural” drugs that have not been approved by the clinic.
The Day of Surgery: Making Sure You Have Everything
Eat a Light Breakfast: Unless you have been instructed to fast for sedation, you are recommended to eat a normal breakfast. This is to keep your blood sugar levels stable and prevent any light-headedness during the procedure.
Wash Hair: Give your hair and scalp another wash with the provided or approved shampoo. Do not use any styling products, oils, or creams on your hair before the procedure.
Get Dressed: Comfortable clothing is key for this procedure. Put on your button-down shirt and loose-fitting trousers.
Relax: It’s normal to be nervous. Your clinical team will work hard to make you feel comfortable, but a little nervous energy is normal. Remember, you have placed your trust and a large sum of money in the hands of one of the best clinics, and have done the work to educate yourself. Believe in the process.
Putting Yourself in the Best Position to Achieve the Best Possible Result
Hair restoration is a partnership. The surgeon and clinic provide the skill and artistry, while the patient provides the canvas. Your pre-surgery scalp care and medication regimen is your means of preparing that canvas for planting by optimizing your scalp’s health and resilience, giving your transplanted grafts the best possible chance of successful graft take rate. By carefully following these guidelines, stopping all prohibited substances and medications, taking all pre-op medication as prescribed, optimizing your diet and hydration, and following through with scalp care, you are not just blindly following instructions. You are actively giving yourself the best chance of successful graft take rate, minimizing risk of surgical complications, and the most comfortable and speedy recovery. All of which lead to the ultimate end goal of getting the hair that you have always wanted and deserved. Natural, thriving hair that will restore your appearance and your confidence. Your journey starts not in the surgical chair but in the diligent and conscientious decisions you make in the weeks and days before you arrive for your surgery.
