This hair loss question was answered by Dr. Paul Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.
My hair transplant is booked for Dec 14th 2009. I was told not to engage in physical activity for at least 1 month post-op. Im not sure how to do this. I work out 4-5x/week. I take about 1 week a year off maximum. Exercise has been and is a form of stress relief/therapy. If there are any other exercise fanatics out there how have you dealt with this ?
Wounds heal in three stages:
The first stage is the inflammatory phase. In this phase the wound swells and the ingredients such as white blood cells, clotting factors, and fibrinogen for the adherence of the wound, prepare the wound for healing. This stage peaks at three to five days and the wound is very weak at this point. That is why it is very important to take it easy in the first week after surgical hair restoration if one wants to avoid a wide scar.
The second stage of healing is the collagen phase which starts at about one week after the hair transplant procedure. During this stage the collagen content increases and the wound strengthens. Sutures can be removed during this stage and we remove our sutures at 10 to 14 days. The second stage of healing last 2 to 4 weeks as the collagen content increases and the wound strengthens.
The third stage of healing is called the maturation or remodeling phase and may continue for several years, with concomitant improvements in wound appearance. As new collagen replaces the old collagen the wound gets softer and the scar is less conspicuous. That is why we need to wait at least one year to determine how a scar is going to look.
During the second stage of healing I tell patients they can go back to exercising but to use their common sense. If they do an activity that causes pain or a pulling sensation in the donor scar then they have done too much. When weight lifting, I recommend the patient goes down on the weights but increase his reps. It is important not to put too much stress on the upper neck and trapezius muscles during this stage.
As for running, it is ok to run at a pace that does not cause one to use the upper back muscles as accessory muscles to breathing. That pace differs for each patient and depends on one’s own fitness and also how one breathes when running. Sweat will not affect the surgery at the second stage of surgery because the outside of the wound should not have any scabbing and a skin barrier of epithelial tissue is already present.
In summary it is very important to take it easy for the first week after hair replacement surgery when the wound is in the first phase of healing. During the second phase of healing use your common sense. Try not to do activities that will put a lot of stress on the upper back and neck muscles. And if you do something and fell pulling in the donor area then you have overdone it and you are not ready for that activity. For example if you like to golf or play tennis, practice your swing and see how it fells. If you can feel some pulling in the area of the donor site then back off. During the third phase of surgery most exercise is fine. But I can still imagine someone who is into power lifting stretching the scar during this phase if they really push the weights.
I hope this is helpful.
Paul Shapiro, MD