Swelling after a hair transplant, its causes and ways of dealing with it are described in detail in this article. In medical science, this phenomenon is called oedema. Head oedema is one of the leading complications of hair transplantation. A patient confronted with oedema has many questions on his mind. Is it normal? Should it be like this? How many days will it last? When will it go away? How will it go away? What are the risks? How does the swelling go down?

Swelling after a hair transplant is quite normal. Swelling of the forehead, face and eyelids is the most uncomfortable part of a patient’s life. The swelling combined with pressure creates a throbbing pain. There are some measures that can help reduce swelling after a hair transplant or avoid it altogether.

Why Does Face Swell After Hair Transplant?

Swelling of the face after a hair transplant usually occurs between the 2nd and 5th day after surgery. Sometimes it is very severe and you may experience pain and difficulty opening your eyes. In other cases, purpura of the eyelids (ecchymosis) occurs. In fact, purpura and swelling is a common consequence of hair transplantation.

Swelling after a hair transplant is a widely met situation. The forehead, face, and eyelid are the most affected areas, which brings inconvenience to a patient’s life. Swelling together with tension creates throb-like pain. There are some measures that can help to reduce swelling after the hair transplant or avoid it totally.

Micro-channels are opened on the recipient area to implant hair grafts with the classic FUE method. To implant the hair smoothly and easily, isotonic fluid (saline fluid) is injected under the skin. Under the influence of the fluid the skin becomes soft and swollen, which facilitates root implantation. Implanting the roots into the swollen skin with the canals already open is much more comfortable. Opening the canals and inserting the needle into the scalp are medically traumatic, even if they are small. Swelling is the result of the body’s defense mechanism. The isotonic fluid injected into the skin will leave the body 2-3 days after the operation.

Ecchymosis may also occur in the supraorbital area. In fact, these effects are caused by non-compliance with some post-operative instructions given by the doctor. More information on swelling after eyebrow hair transplant and women’s hair transplant is described on relevant pages.

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When Does Swelling After Hair Transplant Go Away? How Many Days Does It Last?

The swelling usually goes away naturally within one week. Fluid is eliminated from the body by the circulation through the kidneys and urine. Anesthesia injected to get the skin numb is eliminated in the same way. Be sure that swelling after a hair transplant is a normal process. If the doctor or his assistants explain to the patient all the possible consequences before the procedure, there will be no negative psychological consequences or unnecessary anxiety about it.

Oedema Swelling Classification

Swelling after the hair transplant can be classified according to the severity of the clinical condition:

  • Degree 0: No swelling
  • Degree 1: There is oedema only on the upper forehead. It resolves easily.
  • Degree 2: Swelling of the forehead and swelling of the upper and lower forehead. Medical intervention may be necessary.
  • Degree 3: Swelling of the supraorbital area. It is slightly more prominent.
  • Degree 4: Purpura appears on the supraorbital area. Treatment may last up to 10 days.

The picture below illustrates the Degree 3 swelling.

hair transplant swelling
What are the measures to prevent the swelling after hair transplant?

The correct sleeping position reduces swelling. It is recommended to sleep in a semi-sitting position. A head tilt of about 45 degrees is sufficient. Two pillows and the right angle can easily solve this problem. Do not sleep face down. This also causes post-transplant swelling and the implanted hair may be damaged or come off when in contact with the pillow. There are no other serious risks of swelling after surgery. You should follow all dietary and post-op care instructions given to you

We do not think it makes sense to forbid medicine such as aspirin. On the contrary, aspirin increases blood conduction and circulation in the capillary vessels (capillary circulation and permeability) that nourish the hair roots. Consume plenty of water. Once blood circulation in the body accelerates, swollen fluid leaves the body through urine excretion.

swelling after hair transplant
Bandage and Ice Application

Head wraps, compresses or ice packs around the forehead and face will also reduce swelling. Some doctors do not recommend bandages. In our experience, they do help to reduce swelling, but we do not apply them. We usually advise putting an ice pack in a towel and then applying it to the swollen area. Do not keep it in one place for more than 3-5 minutes. The ice pack may be applied again at intervals of 3-5 hours. Otherwise an ice burn can occur. Ice helps to slow down blood circulation in the capillary vessels, which reduces swelling.

Be careful not to get too close to the implanted area while applying an ice compress and cause damage. Applying ice can easily help you through stages 1 and 2 listed above. If you have purple circles under your eyes, don’t worry, they can be covered with sunglasses.

Steroid Treatment in Swelling After Hair Transplant

Edema in stages 3 or 4 can easily be relieved by a physician with a medical steroid treatment. This treatment is also known as cortisone treatment. It is used in many medical cases as well as for swelling. There are several approaches to the use of steroids:

  • a) Oral Steroid Treatment. Dexamethasone (Dekort) or Prednisolone (Prednol) treatment: It is taken orally. Do not take it without a doctor’s prescription. Despite the steroids to be widely implemented in medicine, they have some side effects. Do not use it without consulting your doctor. This is very important for candidates having diabetes or hypertension. When the salt amount in food is not reduced, cortisone can turn into its opposite and increase the swelling.
  • b) Steroid Application as Intramuscular Injection (intra-hip): Applied at the doctor’s discretion in critical cases of edema. We do not give any information about the doses, because they depend on each patient individually and must be considered by the doctor. Intermuscular injection of steroids leads to faster results than oral treatment in cases of edema after hair transplant.
  • c) Use of steroids mixed with anesthetic solution: To reduce or prevent oedema from the start, steroids are added to the anaesthetic used during the operation. It is favored by some doctors. The steroids are mixed with triamcinolone and anesthetic solutions. Studies have shown that normal saline solution of 100cc, Adrenaline 1/1000 1cc, Triamcinolone 40 mg application solves the problem of swelling after hair transplant by more than 97%.

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Swelling After Hair Transplant and the DHI Method

Hair transplant with the DHI method does not cause swelling or less swelling compared to other methods. In DHI method, no physiological saline solution is injected. Only some water is injected along with anesthesia. We, however, do not consider it practical to inject water under the skin. Hair transplantation with this method is already an easy procedure, and it doesn’t cause swelling. Hakan Doganay has been practicing hair transplants with pen implanter for more than 19 years. Even if swelling occurs as a result of his surgeries, it is minor and quickly goes away.

Physiological saline is injected into the donor hair area to swell the skin. This is done to create better tissue for easy and quick extraction of the grafts. Swelling that occurs at the back of the head or on the lower part of the head does not bother the patient too much. Therefore, postoperative swelling of the donor area is not relieved by any special means.

The result

Even though swelling after hair transplant is a natural condition, many patients still prefer not to have it. In most cases, swelling resolves with improvised measures (such as ice); in rare cases, it requires medical intervention.

Frequently Asked Questions

What is Correct Sleeping Position After Hair Transplant?

After hair transplantation you will be given or advised a neck pillow. This is a common pillow that is used when travelling. You will sleep comfortably if you put it under your neck. Also, if possible, try to put two more pillows under your head to stay in a more seated position. The most important thing is not to sleep face down, as this leads to swelling and displacement of the roots from their places by contact with the pillow.

When Does the Pain in Donor Area Pass?

Actually, pain occurs in a few cases and even if there is pain, it can easily be relieved with analgesics. The pain lasts a maximum of one week. We advise you to refer to your doctor if the pain does not pass.

What Are the Complications After Hair Transplant?

Necrosis is one of the least wanted complications after hair transplant. Despite this, there are other predictable situations that should not be considered as complications. For instance, swelling, shock popping, hypokinesia (numbness), etc.

Is Nape Swelling After Hair Transplantation Considered Normal?

To extract the roots comfortably, fluid is injected into the skin after anesthesia. It is salty water, which is called isotonic. Swelling in the neck area may occur due to this liquid. It will naturally pass within a few days.

In how Many Days Does the Swelling Pass After Hair Transplant?

If you follow all instructions given by your doctor, it will pass in a maximum of 7 days

References
  1. Gravity position to prevent facial edema in hair transplantation. Sungjoo Tommy Hwang. Hair Transplant Forum International May 2009, 19 (3) 77-82; DOI: https://doi.org/10.33589/19.3.0077 https://www.ishrs-htforum.org/content/19/3/77