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Take
a test for HIV and hepatitis and have a general medical examination
If you have committed to getting a hair transplant there are few
things that need to be done in preparation. Usually your transplant
consultant will explain this to you, but here is a general summary
of what to expect prior to your hair transplantation.
Most hair transplant clinics will expect you to take a blood test
prior to the procedure. This is not so much for your benefit but
to protect the surgeon, nurses, and anyone else who will be involved
with your transplant. Hair transplants involve taking tissue (skin),
dissecting it, and then implanting it to you. Each of these steps
involves needles and scalpels and the possibility of the surgeon
and nurses cutting or injecting themselves with a scalpel or needle
contaminated with your blood is a very real possibility. Whilst
these risks can never be completely avoided in any surgical operation,
most clinics seek to avoid exposure of their employees to the risk
by having prospective hair transplant recipients take a blood test.
At the very least HIV and Hepatitis C is tested for. There may
be tests for other infectious agents as well. You might need to
arrange a test with your family doctor or the clinic may conduct
the test themselves. Usually the test results are anonymous – the
blood samples tested don’t carry your name, just a reference
number that is given to you.
In the event that you are positive
for an infectious agent it need not stop you from having a hair
transplant. The clinic, surgeon, and nurses may take extra precautions
like using double gloves and being extra careful with needles
and scalpels.
The blood test may also include an examination of
bleeding/blood
clotting time, and a blood platelet count. A urinalysis may
also be required to look for diabetes and other diseases. The hair
transplant clinic will also probably want you to get a full medical
check
up to make sure you are generally healthy enough to undergo
a
surgical procedure.
Grow
your hair before the hair transplant
You should grow your hair fairly long over the donor site at the
back of the scalp. The hair should be about 5cm long or more. This
hair can then be combed over the donor site immediately after surgery
so that the wound and the sutures are not visible. At the time
of taking the donor skin and hair follicles, the surgeon or nurse
will clean the donor area with antiseptic and use hair clips to
hold the long hair out of the way. On completion of the surgery
the hair clips are taken out and with some careful combing you
can immediately hide the donor area. In a couple of weeks the wound
will have fully healed and the sutures will be removed. The remaining
scar should be virtually invisible except with close examination.
At this time you can get you hair cut to a shorter hair style if
you wish. Though, you should remember that there will always be
a very fine scar line on the donor area so a close clipped or shaved
scalp back is not suitable (unless you are not bothered of course).
When you go to get your hair cut after surgery make sure that your
hairstylist understands the situation and does not cut the hair
too short. It is probably best to avoid having the hair cut at
all in the 3 weeks prior to surgery so that you can be sure you
have some long hair ready to comb over the donor site.
In addition to growing the hair long around the donor area, you
can also grow your hair long to comb over the recipient site. For
the first few days your head will be bandaged to help the transplanted
hair follicles heal into the skin. Once the bandage is taken off
though you will have a large area of still bald skin, your scalp
will probably be somewhat red and inflamed, and the implants will
be fairly obvious and a bit “crusty”. The inflammation
should subside in a few days and the hair follicles will be fully
healed in a couple of weeks. Eventually the hair will grow, though
it may take 6 months from the surgery before you get a really good
hair growth. Until that time you may want to comb long hair from
the sides over the implantation site. If so, make sure you grow
your hair long before the hair transplant procedure is done so
it is ready to be arranged over the hair implantation site as soon
as the bandages come off.
Avoid
drugs that may complicate the hair transplant Medication prior and during surgery is a significant issue. You
should inform your surgeon in advance of any medications you are
taking including herbal and other alternative medicines. There
are several classes of drugs that are known to increase bleeding.
Aspirin will reduce the ability of blood to clot and should be
avoided. Any anti coagulant drugs like warfarin can create significant
problems with blood clotting. St John’s Wort increases drug
metabolism which may reduce the effectiveness of anaesthetics.
You should avoid alcohol for 10-14 days prior to surgery. It is
believed that alcohol can increase the rate of bleeding. Although
there is little hard proof of this, it has been shown that alcohol
can affect the bleeding time after an injury (eg Hillbom 1985)
so it may be best to play on the safe side. Vitamin E, vitamin
E derivative drugs, and even foods with high vitamin E content
(most green vegetables, eggs and products containing eggs like
mayonnaise, most vegetable oils, etc) may prolong bleeding, particularly
in those with a vitamin K deficiency (Corrigan 1974; Kappus 1992),
and should be avoided prior to surgery. Niacin, and several of
the vitamin Bs, can also increase bleeding. In contrast, vitamin
K improves blood clotting speed. Fro women some of the older oral
contraceptives with high estrogen content can reduce blood clotting.
If you are using minoxidil to treat your hair growth you will be
asked to stop using it until after surgery as minoxidil is a blood
vessel vasodilator as well as a hair growth promoter. There are
many other potential issues with drugs and surgery too numerous
to list here. Make sure you talk to the clinic and give them a
complete list of all the drugs, herbs, and supplements you are
taking. They should then advise you on what you should not take
prior to surgery.
If you are a smoker you may be asked to stop smoking a week prior
to hair transplantation. Some surgeons believe that smoking (nicotine
and carbon monoxide) reduce blood clotting speed. However,
the scientific evidence to support this view is conflicting and
in fact some studies have suggested smoking actually improves the
rate of blood clotting (eg Ring 1983). However, there are other
studies that suggest smoking can reduce hair growth (Trueb 2003)
and given the general health implications of smoking, having a
hair transplant may be a good occasion to quit smoking and start
a new, more healthy, more hairy life!
Pre
hair transplant operation guidelines and procedures references
- Trueb RM. Association between smoking and hair
loss: another opportunity for health education against smoking?
Dermatology. 2003;206(3):189-91.
PMID: 12673073
- Lanas AI, Arroyo MT, Esteva F, Cornudella R, Hirschowitz BI,
Sainz R. Aspirin related gastrointestinal bleeders have an exaggerated
bleeding time response due to aspirin use. Gut. 1996 Nov;39(5):654-60.
PMID: 9026478
- Holvoet P, Collen D. Lipid lowering and enhancement
of fibrinolysis with niacin. Circulation. 1995 Aug 15;92(4):698-9.
PMID: 7641345
- Kappus H, Diplock AT. Tolerance and safety of vitamin
E: a toxicological position report. Free Radic Biol Med. 1992;13(1):55-74.
Review.
PMID: 1628854
- Hillbom M, Muuronen A, Lowbeer C, Anggard E, Beving
H, Kangasaho M. Platelet thromboxane formation and bleeding
time is influenced
by ethanol withdrawal but not by cigarette smoking. Thromb Haemost.
1985 Jun 24;53(3):419-22. PMID: 4049313
- Ring T, Kristensen SD,
Jensen PN, Mourits-Andersen T, Madsen H, Dyerberg J. Cigarette
smoking shortens the bleeding time. Thromb
Res. 1983 Dec 15;32(6):531-6. PMID: 6665771
- McQueen EG. Hormonal steroid contraceptives: a further review
of adverse reactions. Drugs. 1978 Oct;16(4):322-57. PMID: 359313
- Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin
E ingestion. JAMA. 1974 Dec 2;230(9):1300-1. PMID: 4479598
- Doar JW. Metabolic side-effects of oral contraceptives. Clin
Endocrinol Metab. 1973 Nov;2(3):503-25. Review. No abstract available.
PMID: 4591141
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