The first week after a hair transplant is the most critical period for graft survival. Transplanted follicles are not yet anchored into their new blood supply and can be dislodged by physical contact, pressure, or improper care. With proper post-op protocol, FUE and FUT grafts achieve 90-95% survival rates.
Day 1: Immediate Post-Surgery
Most patients leave the clinic with a bandage covering the donor area (back and sides of the scalp). The recipient area where grafts were placed is typically left exposed. Here is what to expect on day 1:
- Swelling: Mild forehead swelling begins within hours. This is caused by the saline solution and local anesthetic injected during the procedure
- Numbness: The scalp feels numb from residual anesthesia, which can last 24 to 48 hours
- Mild oozing: Small amounts of blood or fluid around grafts is normal for the first 12 to 24 hours
- Pain level: Most patients rate pain at 2-4 out of 10. Prescribed pain medication typically manages this well
Your surgeon will provide a spray bottle with saline or a specialized misting solution. Use it to keep grafts moist according to their instructions, usually every 30 to 60 minutes while awake.
Days 2-3: Swelling Peaks
Swelling typically peaks between days 2 and 3, sometimes extending to the forehead and around the eyes. This is cosmetic, not dangerous, and resolves on its own within 5 to 7 days.
| Day | Swelling Level | Pain Level | Key Actions |
|---|---|---|---|
| Day 1 | Mild | 2-4/10 | Mist grafts hourly, sleep elevated |
| Day 2 | Moderate to peak | 2-3/10 | Continue misting, cold compress on forehead (not on grafts) |
| Day 3 | Peak, then declining | 1-3/10 | Begin gentle saline rinse if surgeon approves |
| Day 4 | Declining | 1-2/10 | Scabs forming around grafts |
| Day 5-7 | Minimal | 0-1/10 | Gentle washing begins per surgeon protocol |
Important: Do not apply ice or cold compresses directly to the transplanted area. Apply them to the forehead above the grafts if needed to reduce swelling.
Sleep Position: Days 1-7
Sleep position is one of the most important and underestimated factors in week 1 recovery. Sleeping flat or rolling onto your side can crush or dislodge newly placed grafts.
Recommended sleep setup:
- Sleep on your back at a 45-degree incline (recliner or stacked pillows)
- Use a travel neck pillow to prevent your head from rolling to the side
- Place a clean towel over your pillowcase each night, as mild oozing can occur during the first 2 to 3 nights
Most surgeons recommend maintaining the elevated sleep position for the full first week. After day 7, you can gradually return to your normal sleep position.
Graft Protection Protocol
During week 1, the transplanted grafts are sitting in tiny recipient sites that have not yet healed. The follicles are held in place primarily by dried blood and the body's initial clotting response, not by tissue integration.
What to avoid during week 1:
- Touching, rubbing, or scratching the recipient area
- Wearing hats, helmets, or headbands that contact the grafts (loose baseball caps worn backward may be acceptable after day 3 per some surgeons)
- Bending over with your head below your waist (increases blood pressure to the scalp)
- Heavy lifting, exercise, or any activity that raises blood pressure or causes sweating
- Direct sunlight on the scalp
- Smoking and alcohol (both impair blood flow and graft survival)
- Swimming pools, saunas, and steam rooms
Washing Your Hair: When and How
Most surgeons allow the first gentle hair wash between days 3 and 5. The standard protocol:
First Wash (Days 3-5)
- Fill a cup with lukewarm water mixed with a small amount of baby shampoo or surgeon-provided shampoo
- Pour the mixture gently over the scalp, letting it run over the grafts without rubbing
- Do not direct shower water at full pressure onto the grafts
- Pat dry gently with a soft towel. Do not rub
- Allow the scalp to air dry for the remaining moisture
Subsequent Washes (Days 5-7)
- You can begin using very light fingertip pressure on the donor area
- Continue pouring water over the recipient area rather than rubbing
- By day 7, most scabs should begin loosening naturally during washing
Scab removal is a normal part of the healing process. Forcing scabs off before they are ready can pull grafts out. Let them fall naturally during gentle washing.
FUE vs FUT: Week 1 Differences
Recovery during week 1 varies depending on the procedure type. For a detailed breakdown, see our FUE vs FUT comparison.
| Factor | FUE | FUT |
|---|---|---|
| Donor area pain | Mild, scattered sensation | Moderate, concentrated along incision line |
| Suture removal | None needed | Sutures or staples removed at days 10-14 |
| Donor bandage removal | Typically day 1-2 | Typically day 2-3 |
| Return to desk work | Day 3-5 | Day 5-7 |
| Donor washing | Day 2-3 | After bandage removal, day 3-5 |
FUE recovery time is 7-10 days. FUT recovery takes 10-14 days due to the linear incision in the donor area requiring suture healing.
What Is Normal vs What Is Not
During week 1, many patients experience anxiety about whether their recovery is on track. Here is a quick reference:
Normal during week 1:
- Forehead and eye swelling (days 2-5)
- Mild itching as healing begins (days 4-7)
- Tiny pinpoint bleeding spots in the first 24 hours
- Scab formation around each graft site
- Numbness in the donor and recipient areas
- A few grafts appearing to "pop out" (usually just the hair shaft, not the follicle)
Contact your surgeon if you notice:
- Significant bleeding that does not stop with gentle pressure
- Signs of infection: increasing redness, warmth, pus, or fever above 38C/100.4F
- Severe pain that worsens after day 3 instead of improving
- Excessive swelling that spreads beyond the forehead to the neck
- Any foul smell from the surgical sites
For a complete guide on warning signs, see our guide on when to contact your surgeon post-op.
Week 1 Recovery Checklist
Use this daily checklist to stay on track:
- Mist grafts with saline spray every 30-60 minutes while awake (days 1-3)
- Sleep elevated at 45 degrees on your back
- Take prescribed medications on schedule (antibiotics, anti-inflammatory, pain relief)
- Avoid bending, lifting, or strenuous activity
- No smoking or alcohol
- Begin gentle washing when surgeon approves (typically days 3-5)
- Keep the scalp out of direct sunlight
- Take standardized photos from consistent angles on days 1, 3, and 7
Week 1 sets the foundation for everything that follows. The next phase, weeks 2-4 healing phase guide, covers scab shedding, shock loss onset, and the transition from recovery mode to the waiting period before new growth begins.
Track your hair transplant recovery with standardized photo comparisons at myhairline.ai/analyze. Upload photos at consistent intervals to measure progress objectively.
This article is for informational purposes only and does not constitute medical advice. Always follow your surgeon's specific post-operative instructions, which may differ from the general guidelines described here.
FAQ
When will I see results after hair transplant?
Visible new growth typically begins between months 3 and 4 after surgery. By month 6, most patients see noticeable density improvement. Final results with full thickness and maturity are not apparent until 12 to 18 months post-procedure.
Is shock loss after hair transplant normal?
Yes, shock loss is a normal part of the hair transplant recovery process. It occurs in roughly 50 to 70% of patients between weeks 2 and 6 post-surgery. The transplanted hairs shed, but the follicles remain intact beneath the skin and re-enter the growth cycle within a few months.
How do I know if my hair transplant is working?
By month 4, you should see fine, thin hairs beginning to emerge from transplanted follicles. By month 6, these hairs should be gaining thickness and length. If you see zero new growth by month 5, consult your surgeon for a follow-up assessment.