Slight Bleeding during very first shower wash 1 day post-op.

[Messi]

Question to anyone who has experienced this... 

During the very first hair wash (1 day post-op) saw some minor bleeding in the recipient area in one spot, after pouring warm water from the cup over the area.  Bleeding stopped shortly after, but am a bit concerned. Has anyone experienced similar?  Did I dislodge a graft?  

Thanks

[NARMAK]

Just now, Messi said:

Question to anyone who has experienced this... 

During the very first hair wash (1 day post-op) saw some minor bleeding in the recipient area in one spot, after pouring warm water from the cup over the area.  Bleeding stopped shortly after, but am a bit concerned. Has anyone experienced similar?  Did I dislodge a graft?  

Thanks

Why are you washing the recipient are 1 day post-op? 

Usually you are told to wait a week or 10 days. The only area you are usually washing before that is the donor area where the extractions were made from. 

There's a possibility you may have washed dried blood but unless you saw a graft, there's a chance you may have affected it but not guaranteed. 

Who did you go to that did not give you proper post-op instructions? 

[Messi]

Went to a very reputable surgeon. And the instructions were to gently pour water over the recipient area (from a 16oz cup filled with warm water and some suds), but just let it then "air dry" to keep the area clean.  

[mafpe]

if you have a pic, that would help. if the blood is sourced from one of the grafts, you might have dislodged one, but otherwise probably you just cracked a scab open and blood flowed a lil bit.

mine were cleaned pretty early too thats why most of the dr i went to have clean looking HT, the water applied is like having trickles of water through your head, very2 gently and slowly. try to have little to no pressure on them, especially for the first 3 days at least.

[NARMAK]

2 minutes ago, Messi said:

Went to a very reputable surgeon. And the instructions were to gently pour water over the recipient area (from a 16oz cup filled with warm water and some suds), but just let it then "air dry" to keep the area clean.  

It would be interesting to see you name who this surgeon is. There's one place that i have heard of similar, washing the recipient area practically the day after. 

Personally i would say its hard to know if you dislodged a graft unless you can see it, but generally the advice i got and most others is to wait 5-7 days minimum and use saline spray to keep the area as hydrated as possible until the grafts fully anchor in and then have the head wash. Taking over 2 days if necessary to wash all the scabs. 

[Messi]

1 minute ago, NARMAK said:

It would be interesting to see you name who this surgeon is. There's one place that i have heard of similar, washing the recipient area practically the day after. 

Personally i would say its hard to know if you dislodged a graft unless you can see it, but generally the advice i got and most others is to wait 5-7 days minimum and use saline spray to keep the area as hydrated as possible until the grafts fully anchor in and then have the head wash. Taking over 2 days if necessary to wash all the scabs. 

But if a graft has been dislodged, wouldn't it be washed out by the water?

[NARMAK]

7 minutes ago, Messi said:

But if a graft has been dislodged, wouldn't it be washed out by the water?

It can be washed away depending on how you are washing the hair and very likely not see it. 

So the only other way to tell imo is that you have to look at your high resolution post-op images and then compare to now to see if it looks the same or it looks like you have a difference. That's probably the only way to really know if a graft may have washed out. 

Again, this is why i think most doctors/clinics tell you to wait around a week before washing the recipient area to make sure the grafts are as secured as possible. 

[Madhur Vansil]

7 hours ago, Messi said:

Question to anyone who has experienced this... 

During the very first hair wash (1 day post-op) saw some minor bleeding in the recipient area in one spot, after pouring warm water from the cup over the area.  Bleeding stopped shortly after, but am a bit concerned. Has anyone experienced similar?  Did I dislodge a graft?  

Thanks

No matter who’s  your surgeon .The clinic is totally wrong here because the grafts take approx minimum 48-72 hours to get fix in the scalp after the surgery and that’s the reason it’s not advised to even touch them at all for first 3 days at minimum in most clinics .

 

Please post some images of the recipient area .

Edited October 12, 2022 by Madhur Vansil

[mafpe]

for my case though, the first day after the op, they sprayed my head with... saline solution probably? most likely same as the holding solution to "water down" the bleeding, leading to a cleaner head.

d+1, i went again to the clinic for evaluation, with very gentle / light cleaning of the head, using running water (trickle volume, very gentle touching, only slight patting no brushing / dragging).

d+3 and onward, i did the same, with lukewarm / slightly cold water + foamed shampoo to keep things clean + drying via cold setting hair dryer.

 

it's best to leave your head alone for at least 3 days, so that the grafts are able to settle down and stick onto the made incision, but i don't think it's a deal breaker IF you know how to clean them very gently without damaging the grafts. 

like narmak said though, you might want to take a photo of the bleeding source, and check if the graft is still there. if it's still there, it might still survive, but if it's not there anymore, then probably you have lost a graft.

[Al - Moderator]

You should be waiting until 3 days post op to pour water from a cup on your hair. You can very lightly put some soap suds on it by very lightly patting the soap/shampoo on your head without rubbing. Do that on days 3, 4, and 5. Then on day 6 you can let the shower run on your hair normally, but be gentle with putting your hands through your hair.

 

[Fue3361]

Don't lots of clinics have a "cleaning" literally the day after surgery?  I know they gently washed my recipient area (gentle patting + pouring of water) the day after I had my procedure.  

[Messi]

[Messi]

Hi guys,

Here is the pic after my second day wash this morning.  Do you guys think it looks ok?

Any comments are greatly appreciated.  

[NARMAK]

8 hours ago, mafpe said:

for my case though, the first day after the op, they sprayed my head with... saline solution probably? most likely same as the holding solution to "water down" the bleeding, leading to a cleaner head.

d+1, i went again to the clinic for evaluation, with very gentle / light cleaning of the head, using running water (trickle volume, very gentle touching, only slight patting no brushing / dragging).

d+3 and onward, i did the same, with lukewarm / slightly cold water + foamed shampoo to keep things clean + drying via cold setting hair dryer.

 

it's best to leave your head alone for at least 3 days, so that the grafts are able to settle down and stick onto the made incision, but i don't think it's a deal breaker IF you know how to clean them very gently without damaging the grafts. 

like narmak said though, you might want to take a photo of the bleeding source, and check if the graft is still there. if it's still there, it might still survive, but if it's not there anymore, then probably you have lost a graft.

I went to the clinic for a donor wash, but i do not believe they do anything other than advise continuous spraying of saline water every 30-60 mins on the recipient area to keep it from badly scabbing over. The main proper head wash where you can apply a little more force to massage the scalp then is usually around 7-10p days post-op. 

1 hour ago, Messi said:

Hi guys,

Here is the pic after my second day wash this morning.  Do you guys think it looks ok?

Any comments are greatly appreciated.  

Not going to sugar coat it. There's several spots i can see where it looks like a red blood spot and no hair. I think you may very well have lost grafts there. 

Can you please name the surgeon and tell us what exact post-op instructions they gave you to follow for this washing of the recipient area? 

[Messi]

Hi Narkmak,

Thanks for your responses. I'd rather not name the surgeon at this time. But in their instructions they specifically said to pour very gently suds and warm water from a cup onto the grafts to keep that area clean post op on day 1-3.  

[NARMAK]

5 hours ago, Messi said:

Hi Narkmak,

Thanks for your responses. I'd rather not name the surgeon at this time. But in their instructions they specifically said to pour very gently suds and warm water from a cup onto the grafts to keep that area clean post op on day 1-3.  

Fair enough. That's obviously your choice, but i do think if it's a reputable surgeon, then they have an accountability to you to ensure you are given the maximum chance for your hair transplant to succeed including post op instructions. 

I do think personally the instruction to wash the recipient area post-op is a huge mistake. However, i do think saline spray regularly used would have helped you till the 7th day to keep the area as clean as possible till the hair fully anchored. 

OP, i wish you well though on your journey. Its not easy and hopefully this experience will not negatively affect your final results. 

[general-etwan]

Hard to say what I have to say but the truth that I observe is:

• Recipient area should not be touched until at least 72 hours after the procedure is finished, and no full washing the head until 7 days. Any clinic who instructs to touch or pour water and suds over the area 1 day after the procedure, I wholeheartedly disagree with on a scientific basis. The grafts need at least 3 days to fully secure in the scalp and to play it safe the scalp should not be touched at all for at least 3 days.
• The pattern of graft alignment I see here is not good. Except for the hairline, all in straight rows. No idea who this "reputable surgeon" you wish not to name at this time is, but this is not proper artistic design in my estimation and I do not understand why there are clinics out there doing this.

[Messi]

To:  General-etwan

Thanks for your comments.  The surgeon is Dr. Bloxham.  Based on all the reviews I can't believe he would not know what he is talking about or not do a good job aligning grafts in the right way.  But based on your comments, I am now very worried. 

[FormerFutureKrillin]

2 hours ago, Messi said:

To:  General-etwan

Thanks for your comments.  The surgeon is Dr. Bloxham.  Based on all the reviews I can't believe he would not know what he is talking about or not do a good job aligning grafts in the right way.  But based on your comments, I am now very worried. 

@Messi a few things from a fellow Bloxham patient.

1. When you saw bleeding, was it a trickle of blood, or just fluid that slowly “oozed”? The former is more likely to indicate a lost graft. I had the latter and did not lose any grafts. This is no guarantee, but I could not tell from your post.

2. I had “red spots with no hair” as described above for a few days post-op. I had hair grow in each spot. The techs at one point during surgery mentioned that some of my grafts “sank” so they were not visible without magnification. I do not think this is any indication as to whether you lost a graft.

3. Each doctor has a different post-op  instructions. You should always follow YOUR doctor’s post-op instructions, no matter what people on the internet say. As to the “science” of when to wash, Dr. Bernstein, the doctor behind the graft anchoring study everyone cites, also recommends a wash one day post op. I’ll post those instructions below.

https://www.bernsteinmedical.com/downloads/BernsteinMedical_Post-op_Instructions_FUT.pdf

4. Even if you did lose a graft, a lost graft or two will not impact the overall result. A ton of people on the forum lost grafts and still had a great result. If you still have concerns, contact Dr. Bloxham.

5. As to rows, the implantation pattern does not mean the grafts are misangled or will look bad. Plus, you likely have some swelling accentuating the pattern. When my swelling subsided it did not look like a row pattern. Other top clinics (H&W) also have post-ops that look like row patterns behind the hairline (just search the forum) and their results look great. My personal opinion is that if the hairline is random and dense enough, it will not matter, but this is my opinion and others are free to disagree.

Again, if you still have concerns about any of the above, I’d recommend reaching out to Dr. Bloxham. Otherwise, continue to follow the post-op instructions and try to relax - stressing will not help.

[Messi]

To: FormerFutureKrillin

Thank you so much for your post.  I really appreciate it very much.  You are 100% right about trying to relax and not stressing out so much. I did reach out to Dr. Bloxham who assured that it looks fine and that there's no evidence of lost grafts. And yes, I also saw Dr. Bernstein's instructions to his patients to gently use water on their grafts right after the surgery.  I've been following Dr. Bloxham's instructions but some of those posts here from people had scared me a bit TBH.  A quick question for you, did you start washing your grafts (using finger tips and massaging them) on day 4? 

[Messi]

32 minutes ago, FormerFutureKrillin said:

@Messi a few things from a fellow Bloxham patient.

1. When you saw bleeding, was it a trickle of blood, or just fluid that slowly “oozed”? The former is more likely to indicate a lost graft. I had the latter and did not lose any grafts. This is no guarantee, but I could not tell from your post.

2. I had “red spots with no hair” as described above for a few days post-op. I had hair grow in each spot. The techs at one point during surgery mentioned that some of my grafts “sank” so they were not visible without magnification. I do not think this is any indication as to whether you lost a graft.

3. Each doctor has a different post-op  instructions. You should always follow YOUR doctor’s post-op instructions, no matter what people on the internet say. As to the “science” of when to wash, Dr. Bernstein, the doctor behind the graft anchoring study everyone cites, also recommends a wash one day post op. I’ll post those instructions below.

https://www.bernsteinmedical.com/downloads/BernsteinMedical_Post-op_Instructions_FUT.pdf

4. Even if you did lose a graft, a lost graft or two will not impact the overall result. A ton of people on the forum lost grafts and still had a great result. If you still have concerns, contact Dr. Bloxham.

5. As to rows, the implantation pattern does not mean the grafts are misangled or will look bad. Plus, you likely have some swelling accentuating the pattern. When my swelling subsided it did not look like a row pattern. Other top clinics (H&W) also have post-ops that look like row patterns behind the hairline (just search the forum) and their results look great. My personal opinion is that if the hairline is random and dense enough, it will not matter, but this is my opinion and others are free to disagree.

Again, if you still have concerns about any of the above, I’d recommend reaching out to Dr. Bloxham. Otherwise, continue to follow the post-op instructions and try to relax - stressing will not help.

Thank you so much for your post.  I really appreciate it very much.  You are 100% right about trying to relax and not stressing out so much. I did reach out to Dr. Bloxham who assured that it looks fine and that there's no evidence of lost grafts. And yes, I also saw Dr. Bernstein's instructions to his patients to gently use water on their grafts right after the surgery.  I've been following Dr. Bloxham's instructions but some of those posts here from people had scared me a bit TBH.  A quick question for you, did you start washing your grafts (using finger tips and massaging them) on day 4? 

[FormerFutureKrillin]

4 hours ago, Messi said:

Thank you so much for your post.  I really appreciate it very much.  You are 100% right about trying to relax and not stressing out so much. I did reach out to Dr. Bloxham who assured that it looks fine and that there's no evidence of lost grafts. And yes, I also saw Dr. Bernstein's instructions to his patients to gently use water on their grafts right after the surgery.  I've been following Dr. Bloxham's instructions but some of those posts here from people had scared me a bit TBH.  A quick question for you, did you start washing your grafts (using finger tips and massaging them) on day 4? 

I did, but I was extremely gentle at the start (probably too gentle) and gradually increased the pressure/massaging each day. I also used conditioner (Melvin has done a video on how to do this) on days 9 and 10.

I will also say that the scabs should come off fairly easily once they are ready - try not to force them. I was a little too rough on day 9 and removed a couple scabs before they were quite ready. Does not appear to have impacted the hair (and Dr Bloxham said it would not) but those areas did rescab and are still more red than everywhere else, which is annoying.

[Messi]

5 minutes ago, FormerFutureKrillin said:

I did, but I was extremely gentle at the start (probably too gentle) and gradually increased the pressure/massaging each day. I also used conditioner (Melvin has done a video on how to do this) on days 9 and 10.

I will also say that the scabs should come off fairly easily once they are ready - try not to force them. I was a little too rough on day 9 and removed a couple scabs before they were quite ready. Does not appear to have impacted the hair (and Dr Bloxham said it would not) but those areas did rescab and are still more red than everywhere else, which is annoying.

Thanks again for your quick response. What I am a bit puzzled about is why doesn't the doctor provide any other post-op instructions regarding using a conditioner or anything else besides just washing and massaging the grafts and the donor.

[NARMAK]

8 hours ago, Messi said:

To:  General-etwan

Thanks for your comments.  The surgeon is Dr. Bloxham.  Based on all the reviews I can't believe he would not know what he is talking about or not do a good job aligning grafts in the right way.  But based on your comments, I am now very worried. 

Thank you for feeling comfortable to name the doctor. If it's Dr Blake Bloxham, there's a few guys here who have been i believe to him recently however, and i do say this with all respect, i do find it strange to recommend a recipient area wash one day post-op at least if it's been told to you to do in the way it was done. 

I think it's personally better to err on the side of caution. Whilst i do strongly believe in following your doctors post-op instructions, if the vast majority aren't advocating full head washes before say days 5-7, i would have to be even significantly more careful because i genuinely do believe the hair isn't anchored enough only one day post-op. 

[Messi]

10 minutes ago, NARMAK said:

Thank you for feeling comfortable to name the doctor. If it's Dr Blake Bloxham, there's a few guys here who have been i believe to him recently however, and i do say this with all respect, i do find it strange to recommend a recipient area wash one day post-op at least if it's been told to you to do in the way it was done. 

I think it's personally better to err on the side of caution. Whilst i do strongly believe in following your doctors post-op instructions, if the vast majority aren't advocating full head washes before say days 5-7, i would have to be even significantly more careful because i genuinely do believe the hair isn't anchored enough only one day post-op. 

Thanks for your message again.   In addition to Dr. Bloxham, Dr. Bernstein also advocates for washing your head the first day post-op.  But I do see your point about being very cautious the first few days.