The first week after a hair transplant is the most critical period for graft survival. Every transplanted follicle is vulnerable during this window, and proper care directly impacts your final density outcome. What you do (and do not do) in the first 7 to 10 days determines whether the 90 to 95% graft survival rate holds or falls short.
This content is for informational purposes only and does not constitute medical advice. Always follow your surgeon's specific post-operative instructions.
Day-by-Day: What to Expect in Week 1
Day 1: Immediately After Surgery
The transplanted area will be red, swollen, and dotted with tiny incision sites where each graft was placed. Depending on your procedure type, here is what the recipient area looks like:
| Procedure | Day 1 Appearance |
|---|---|
| FUE | Small puncture wounds (0.7 to 1.0mm), pin-point bleeding, swelling |
| FUT | Linear incision in donor area, recipient sites similar to FUE |
| DHI | Minimal visible wounds due to Choi implanter pen technique |
Your surgeon will apply a bandage to the donor area. The recipient area is typically left uncovered. You will be given specific washing instructions and medications.
Day 2-3: Peak Swelling
Swelling typically peaks on days 2 to 3 and can travel from the scalp down to the forehead and around the eyes. This is caused by the tumescent fluid (saline and anesthetic) used during surgery.
- Swelling is more pronounced with higher graft counts (3,000+ grafts)
- Sleeping at a 45-degree angle helps reduce swelling
- Some surgeons prescribe a short course of oral steroids to manage it
- Cold compresses applied to the forehead (not the grafts) can help
Day 4-5: Scabbing and Crusting
Small scabs form around each graft site as the tiny wounds heal. These scabs are a normal part of recovery and protect the grafts beneath them.
- Do not pick or scratch at the scabs
- The scabs typically cover each graft opening with a small blood-and-plasma crust
- Itching may begin as healing progresses
- Gentle saline spray can relieve dryness and itching
Day 6-7: Early Resolution
By the end of week 1, swelling has decreased significantly. Redness begins to fade, and the initial soreness at both the donor and recipient sites reduces.
- Scabs are beginning to loosen but should not be forced off
- Most patients feel comfortable returning to sedentary work
- The donor area (FUE) shows small healing dots; FUT shows a healing linear incision
Week 1 Appearance by Graft Count
The visual impact of the procedure during week 1 varies based on how many grafts were placed.
800 to 1,500 Grafts (Norwood 2)
A smaller session produces less visible trauma. Swelling is mild, redness is limited to the temple area, and the overall appearance is relatively discreet. Many patients with lower graft counts can wear a loose hat and resume light activities within a few days.
1,500 to 3,000 Grafts (Norwood 3 to 4)
Moderate graft counts create a more visible post-operative appearance. The entire frontal zone will show redness and crusting. Swelling may be more noticeable and can extend to the forehead and eye area on days 2 to 3.
3,000 to 5,000 Grafts (Norwood 5 to 6)
Larger sessions produce more extensive redness and scabbing across a broader area. Swelling is more significant, and the donor area may feel tight or sore. Most patients take a full week off work for sessions in this range.
5,000+ Grafts (Norwood 6 to 7)
Mega sessions result in the most visible post-operative state. The entire top of the scalp will be covered in graft sites, with significant redness and swelling. Recovery from a mega session typically requires 7 to 10 full days before the appearance normalizes enough for public settings.
Critical Week 1 Care Instructions
Washing Protocol
Most surgeons recommend the following general approach (always follow your specific surgeon's instructions):
- Day 1: No washing; keep the area dry
- Day 2-3: Begin gentle washing with prescribed medicated shampoo
- Application method: Pour lukewarm water gently over the grafts; do not use direct shower pressure
- Technique: Pat, do not rub; use fingertips with zero pressure on the grafts
- Frequency: Once or twice daily as directed
Activities to Avoid During Week 1
| Activity | Risk | Resume When |
|---|---|---|
| Vigorous exercise | Increased blood pressure can dislodge grafts | After 2 to 3 weeks |
| Bending over | Blood rush to scalp increases swelling | After 1 week |
| Alcohol | Thins blood, increases bleeding risk | After 1 week |
| Smoking | Restricts blood flow, reduces graft survival | Ideally quit permanently |
| Swimming | Chlorine and bacteria exposure | After 4 weeks |
| Direct sun exposure | UV damage to healing skin | After 4 to 6 weeks |
| Tight hats or helmets | Pressure can dislodge grafts | After 2 weeks minimum |
Sleeping Position
Sleep on your back with your head elevated at 30 to 45 degrees for the first 5 to 7 nights. A travel neck pillow can prevent you from rolling onto the transplanted area. If you received grafts on the crown or vertex, avoid pressing the back of your head against the pillow.
Medications During Week 1
| Medication | Purpose | Typical Duration |
|---|---|---|
| Antibiotics | Prevent infection at graft sites | 5 to 7 days |
| Pain medication | Manage post-surgical discomfort | 3 to 5 days (as needed) |
| Anti-inflammatory | Reduce swelling | 3 to 5 days |
| Minoxidil | Usually paused week 1 | Resume at surgeon's direction (often week 2 to 4) |
| Finasteride | Continue if already prescribed | Ongoing |
Warning Signs to Report Immediately
Contact your surgeon if you experience any of the following during week 1:
- Excessive bleeding that does not stop with gentle pressure
- Pus or foul-smelling discharge from graft sites
- Fever above 100.4F (38C)
- Severe pain that worsens instead of improving after day 2
- Grafts visibly falling out or being displaced
- Large areas of swelling that do not respond to elevation
Looking Ahead
Week 1 is about protecting your investment. The grafts need time to anchor securely into the scalp before the next phase begins. For details on what happens next, explore the full transplant growth timeline or check density expectations by graft count for your specific graft range.
Know Your Stage Before Surgery
If you are researching transplant options, start by identifying your Norwood stage. The free AI tool at myhairline.ai/analyze classifies your hair loss from a single photo and provides a personalized graft estimate. No account needed, no data stored.
This article is for educational purposes only and does not replace professional medical advice. Consult a board-certified dermatologist or hair restoration surgeon for diagnosis and treatment recommendations.