hair transplant oedema

Swelling After Hair Transplant

This article describes the reasons for swelling after the hair transplant and ways to cope with it. In medical science, it is called oedema. Head swelling takes one of the main places in after hair transplant complications. Many questions come to the mind of a candidate with the swelling. Is it normal? Should it be this way? How many days will it last? When will it pass? How will it pass? What are the risks? How is oedema treated?

Swelling after the 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.

Why Does the Face Swelling Occur After Hair Transplant?

Face swelling after the hair transplant usually occurs between the 2nd and 5th days after the surgery. Sometimes, it is very severe and a patient has pain and difficulties to open the eyes. In other cases, it results in the purpleness of the eyelids (ecchymose). In fact, the purpleness and swelling are a regular consequence of the hair transplant.

Swelling after the 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.

Why Does the Face Swelling Occur After Hair Transplant?

Face swelling after the hair transplant usually occurs between the 2nd and 5th days after the surgery. Sometimes, it is very severe and a patient has pain and difficulties to open the eyes. In other cases, it results in the purpleness of the eyelids (ecchymose). In fact, the purpleness and swelling are a regular consequence of the hair transplant.

The microchannels are opened in the receiver area to implant the grafts with the FUE technique. To implant the hair smoothly and easily, isotonic fluid (saline fluid) is injected under the skin. The fluidized skin gets soft and swelled, which simplifies the roots implant. The root implant to swelling skin with already opened channels is much more comfortable. Channel opening and needle injections into the scalp skin are referred to a trauma, even if it is small. The oedema is a result of the body’s defense mechanism. All in all, isotonic fluid’s effect injected to the receiver area passes 2-3 days after the surgery.

Face swelling is very often met in the channel hair transplant method. It strikes the forehead and eye area in an advanced degree. Moreover, ecchymose can occur in supraorbital. Actually, these consequences take place because some after surgery instructions of the doctor is not followed. Swelling after the eyebrow hair transplant and hair transplant in women is described in the due articles.

When Will the Swelling After the Hair Transplant Pass? How Many Days Does It Last?

Normally, swelling passes naturally in one week. The fluids are excreted by the body circulations through the kidney in the urine. Also, anesthesia injected to get the skin numb is excreted in the same way. As understood, swelling after the hair transplant is a normal process. If the doctor or his assisting personnel explain all possible consequences to a candidate before the procedure, there will be no negative psychological impacts or needles worries.

Oedema Swelling Classification

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

  • Stage 0: No swelling
  • Stage 1: There is oedema only on top of the forehead. It passes easily.
  • Stage 2: There is swelling on the forehead and oedema on the top and bottom of it as well. Medical treatment may be needed.
  • Stage 3: Oedema is on the supraorbital. It is a little more severe. 
  • Stage 4: There is purpleness on the supraorbital. The treatment can last up to 10 days.

The picture below illustrates the Stage 3 swelling.

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

There are some methods to prevent swelling. A correct sleeping position reduces oedema. It is advised to sleep in a half-sejant pose. About 45 degrees in head position is enough. Two pillows and a proper engle can easily solve this problem. Do not sleep faced down. This causes swelling after the transplantation and also implanted hair can be defected or removed from their places when contacting the pillow. Despite this, there are no other serious risks for swelling after the surgery. You should follow all nutrition and care instructions given to you after the procedure. Too salty products increase fluid retention and cause swelling. It is better to consume food which contains just a little salt for some period after the transplantation. Moreover, try to not disturb the sleeping routine.

We do not think that there is any sense to prohibit antibiotics like aspirin. On the opposite, aspirin increases conduction and blood circulation in vessel capillaries (capillary circulation and permeability) that nourish the hair roots. Consume a lot of water. Once the body circulation accelerates, oedema fluid leaves the body through urine excretion.

swelling after hair transplant
Application of Bandage and Ice to the Head

The headbands, compressor bands, or the application of ice bags on the forehead area and face also reduce swelling. Some doctors do nor recommend using headbands. Due to our experience, they actually help to decrease the swelling but we do not put on the bandages. We advise you to put an ice bag into the towel and then apply it to the area. Do not keep it for more than 3-5 minutes at one spot. You can repeat the ice bag application with an interval of 3-5 hours. Otherwise, an unpleasant situation like ice burn can occur. The ice helps to decelerate blood circulation in the capillary vessels which reduce the swelling.

Be careful not to get too close to the implanted area while applying ice or ice compress. The ice can affect and cause a defect for hair roots. Ice application can easily help you to pass through listed above Stages 1 and 2. If there is purpleness under the eye, you can cover them with sunglasses.

Steroid Treatment in Swelling After the Hair Transplant

An advanced degree swelling at the 3rd or 4th stage can be easily cured by the doctor with medical steroid treatment. The steroid is commonly known as cortisone. It is used in many cases in medicine as well as in oedema. There are several approaches of steroid application:

  • a) Oral Steroid Treatment. Dexamethasone or Prednisolone treatment: It is consumed orally. Do not use it without a doctor’s prescription. Despite the steroids to be widely implemented in medicine, they have some side effects. Do not use it unless consulted with your doctor. This is very important for candidates having diabetes or hypertension. When the salt amount in food is not reduced, cortisone can switch to its opposite and increase the swelling
  • b) Steroid Application as Intramuscular Injection (intra-hip): It s applied by the decision of a doctor in critical oedema cases. We do not give any information about doses because they vary depending on every patient individually and should be considered by the doctor. Intermuscular injection of steroids leads to faster results rather than oral treatment after hair transplant swelling.
  • c) Steroid Application mixed with Anesthesia Solution: In order to reduce or prevent oedema from the beginning, steroids are added into the anesthesia that is applied during the surgery. It is favored by some doctors. The steroids are mixed with triamcinolone and anesthetic solutions. It has been proven by studies that normal saline solution of 100cc, Adrenaline 1/1000 1cc, Triamcinolone 40 mg application solves the problem of swelling after hair transplantation for more than 97%.

Swelling After the Hair Transplant and the DHI Method

The hair transplant with the Dhi method leads to no or sometimes less swelling compared to other approaches. There is no need to inject a physiological saline solution in the Dhi hair transplant. Only some water is injected together with anesthesia. However, we do not find injecting water under the skin appropriate. The hair transplant with this method is already an easy procedure and it does not result in any swelling. Dr. Hakan Doganay has been practicing hair transplants with pen implanter for more than 10 years. Even if his surgeries cause swelling, it is at a low degree and passes fastly.

Additionally, a physiological saline solution is also applied to the donor hair area to swell it. The reason is to create a better tissue to extract the grafts simply and quickly. The swelling that occurred on the back of the head or in lower head areas does not bother a patient much. This is why there is no after surgery swelling treatment for the donor area.

Result

Even if the swelling after the hair transplant is a natural condition, yet, many candidates prefer to not have it. In most cases, the swelling passes by simple support (like ice), rarely, it requires medical treatment

Frequently Asked Questions

Which Sleeping Position is Appropriate After the Hair Transplant?

After the hair transplant, you will be given or advised a certain neck collar. It is actually a pillow used on the trips. You will sleep comfortably once you set it under your neck. Moreover, if possible, try to put two more pillows under your head to stay more sejant. The most important thing to remember is not to sleep facedown because it consequences swelling and moving of the roots from their places while contacting the pillow.

When Does the Pain in the 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 the Hair Transplant?

Necrosis is one of the least wanted complications after the 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 Swelling of the Nape Considered Normal After Hair Transplantation?

To extract the roots comfortably, fluid is injected into the skin after anesthesia. This 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 the 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

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