Welcome to the Quatela Center for Hair Restoration. We have prepared the following information and instructions that are necessary for a successful hair restoration.

After years of performing successful hair transplantation procedures, it's clear that the most important goal is a natural result. To achieve these results, we need to follow well-established principles of natural hair growth. The more you know about natural hair growth and your procedure, the better your result.

Therefore, we will first discuss the principles of natural hair growth and than we'll discuss specifics about your hair replacement procedure.

A single unit of hair is called a follicular unit. This follicular unit may contain one, two or three hair follicles. When we obtain, preserve and transplant hair honoring this naturally occurring follicular unit, we achieve a more natural result.

To obtain these follicular units, a strip of hair is obtained from the back or sides of the head where hair is plentiful. This hair will be segmented into grafts for placement on the top and sides of the scalp. The donor site in the back of the head will be closed and dissolvable sutures.

Next we create a variety of openings from 18 to 25 gauge in the top and sides of scalp, immediately followed by insertion of a follicular graft in each opening. It is crucial to place the grafts in a direction and orientation consistent with natural hair growth.

While we prepare your scalp for transplantation, other members of our team are busy slivering and grafting the strip of hair into the hundreds of individual follicular units for relocation to the top or front of your scalp. The preparation of each follicular unit is exacting, microscopic work.

Finally, we place hundreds of follicular units in the recipient sites. You are relaxed and rested as you leave for home following the day spent with us. You are relaxed and rested as you leave for home following the day spent with us.

Many clients notice tiny red dots in the scalp for about ten days. Approximately one month following hair transplantation, the transplanted hair falls out. New growth will appear at approximately four to six months following your procedure.

When hair transplantation is performed in a manner that is consistent with the natural hair growth- that is to say consistent with follicular unit growth- the outcome is a natural appearance. And best of all- it's your own hair- completely natural!

Now that we have learned about the science of hair growth, let's look at some specifics about your procedure. In order to obtain the best possible result, we have some special instructions we ask you to follow.

Now, let's go over some items that will be discussed during your preoperative consultation.

What do I do to prepare for hair restoration?

• Preparation for hair restoration starts about three weeks before the actual procedure. The written instructions outline all the steps necessary to follow to have a successful procedure. About three weeks before the procedure, we ask you to stop all medication, vitamins and supplements that would make you bleed during your transplant procedure. These would include prescription medications like Coumadin, over-the-counter products such as aspirin and ibuprofen-type products like Advil and Aleve. Many people aren't aware that vitamins such as vitamin E and supplements such as Ginko biloba, fish oil, garlic, Echinacea and anti-oxidants can make you bleed. All these vitamins and supplements should be stopped for three weeks before your procedure and two weeks following hair restoration. Tylenol or acetaminophen (generic Tylenol) is always ok.

Is there anything else to do to prepare for my procedure?

• Two weeks before your procedure you will receive a phone call from our patient care coordinator to review your instructions and answer any questions about the procedure. This telephone call will be scheduled the same as an office visit would be. At that time, we will remind you to start Vitamin C 1000 mg. three times a day for two weeks before and two weeks after hair transplantation to help with healing.

What do I need to do at one week before my procedure?

• At one week prior to the procedure, it is important to stop nicotine products and alcohol. It's also important that your scalp is not sunburned. You will receive a phone call from a member of our nursing staff to review your health history. This telephone call will be scheduled that same as an office visit would be.
• You will not need to take any special prescriptions before your procedure. However, there are three prescriptions to take after your procedure. One is an antibiotic to prevent infection. One is to have on hand in case you have any discomfort and one is for swelling. If you would like your postoperative prescriptions called in ahead of time, please have your pharmacy name and number available for the nurse when she calls. We will ask you to refrain from any form of exercise for three days prior to your procedure to minimize bleeding.

What about my daily medications?

• It is important to remain on your daily routine medications as prescribed by your primary care doctor. We will instruct you ahead of time which daily medications to take with just a sip of water and which medications to skip on the procedure day.
• If you use inhalers for breathing, it is important to use the inhalers on the morning of the procedure as directed and also bring the inhalers with you to the Quatela Center for Hair Restoration on the day of the procedure.

Do I avoid eating and drinking after midnight?

• Yes. After midnight the night before the procedure, nothing to eat or drink unless we tell you differently. This includes water and gum chewing. After your procedure has begun, we will provide breakfast and lunch for you so please let us know if you have any food allergies or special dietary requirements.

What time is my procedure?

• The BUSINESS DAY before your hair restoration, please telephone us at 244.1135 to find out what time to arrive for your surgery. Most hair restoration procedures start at 7:00 am.

Where do I check in for my procedure?

• You will park and come up the same walkway as you did for your initial consultation. The only difference is that you will enter the first door on the left, Suite 101.

What happens on procedure day?

• Before you come to the Quatela Center for Hair Restoration, shower and do your usual morning grooming routine. It's ok to brush your teeth but avoid any hair gel, hair spray, conditioners or make-up. Wear comfortable clothing that you will not have to pull over your head. Leave valuables, cell phones and beepers at home. If you need to make a phone call, we will be happy to provide a phone.
• When you arrive at Lindsay House, you will change into a comfortable gown. Next, the nurse will obtain your blood pressure and listen to your heart and lungs. I will also provide time for questions before your procedure.

Will I be awake for the procedure?

• It's up to you. Many clients watch their favorite videos or listen to relaxing music. You will be in a reclining position so reading or computer work is difficult. We recommend bringing your favorite VHS videos appropriate for mixed company or music CD's for entertainment. We also provide cable TV.
• Oral sedation is available for patients who are nervous or have difficult sitting still for a long period of time. If you chose to have oral sedation, you must have someone drive you home. For your safety, public transportation- such as a taxi- is not allowed.

How long does my hair restoration procedure take?

• It depends on the number of grafts but most procedures take about six hours with the total length of time about six to ten hours. As you know, this is an ambulatory procedure- which means you go home the same day as the procedure. You do not have to have someone stay at the Lindsay House while you have your procedure however someone must be available by telephone at all times while you are at the facility….OR
• We ask you to plan on spending the day with us. Any unusual bleeding or graft popping can prolong the procedure. This is why it is so important to follow the preoperative instructions. Bleeding during the procedure adds hours to the amount of time necessary to complete the procedure and also lessens the chance of the grafts to "take." So check with the pharmacist before using any over the counter medications or supplements we discussed or any cold, flu or allergy medications three weeks prior to the procedure.

Is hair transplantation painful?

• Your scalp is numb during the procedure so it's uncommon for our clients to complain of discomfort. Also, we have pain medication available for discomfort during the procedure. Just let us know so we can keep you comfortable. If we use the medication for pain during the procedure, you will need transportation following your procedure.
• After arriving home, most clients complain of discomfort more than pain and some experience a dull headache. Our clients tell us the prescription medication really helps with discomfort and aids in sleeping.

Do most clients need to arrange for a ride home after surgery?

• We recommend it. Transportation and a responsible adult overnight should be arranged prior to your procedure.

Will I have a dressing on my head?

• Most patients leave Lindsay House with a light surgical cap on and do not need a dressing. We ask you to keep this cap on for the first three nights. This cap reminds you not to touch the new grafts. You should expect to see little "crusts" at many of the graft sites which will typically fall off within 7 to 14 days. Please don't pick them off- you may disturb the newly planted grafts.

Tell me about the donor site.

• The wound at the back of the scalp where we obtained the grafts will be closed with clear, absorbable sutures that look like fishing line with a slightly yellow color. They dissolve in about 10 to 21 days and will most likely become loose at some point during shampoo. They don't require any special care.
• It is uncommon that we use staples to close a donor site. If we do, we will give you an appointment to return in one week to have the clips removed.

Does this procedure affect my ability to sleep?

• It is important to sleep with your head elevated on two to three pillows for one week after the procedure. It is not uncommon for clients to have some sleeplessness from this position change. This sleeplessness typically improves quickly.

What prescriptions are needed before or after surgery?

• You will not need any special prescriptions BEFORE the procedure except the Vitamin C 1000 mg times a day to promote healing as we discussed.
• The written instructions outline all the directions for the three prescriptions need AFTER the procedure.
• The first in an antibiotic (typically Keflex or the generic name of cephalexin). This is to prevent infection. You will start this when you arrive home after procedure and then one tab at bedtime. Then follow package directions.
• The second prescription is for discomfort (typically Vicodin or the generic name of hydrocodone). As a rule discomfort is very well managed following hair transplantation. A dull headache or ache at the donor site for two or three days is not uncommon. Please remember that alcohol should be avoided when taking pain medication, as should operating heavy equipment.
• The third is to prevent swelling and is called medrol dosepack. This comes in a little plastic box. Take three when you arrive home and three at bedtime. Then follow package directions.

When should I resume my daily medications?

• It is important to resume all routine daily medications on the day following your procedure unless you are instructed otherwise. Also, please continue to avoid aspirin, ibuprofen and the over-the-counter supplements we discussed for two weeks following your procedure.

I use Rogaine. When do I resume that?

• You may resume Rogaine or Propecia ten days following hair transplantation.

When is it ok to shampoo my new grafts?

• Four days after hair transplantation you may gently shampoo your hair.

When will I need to come back for follow-up?

• After watching the video, our schedulers will assist you in making postoperative appointments. You can use the privacy side entrance along the driveway if you wish. The location for this door is provided in your written instructions. If you have any questions about this, just ask our patient care coordinator show you this entrance when you are at the office for your pre-operative appointments.

I'm from out of town. How long do I need to stay in Rochester?

• It's a good idea to stay in Rochester overnight one night.

How long will I be out of work?

• That depends on the degree of privacy you are trying to maintain. Some clients are out of work about four days while others stay out of work two weeks until the pinkness is gone.

When can I work out?

• Remember that aerobic activity, heavy lifting, bending and straining is to be avoided for one week postoperatively. If you need a note for work or the gym, one will be provided for you upon request.