Thank you for your question.
You submitted your question without a photo. And you seem to be in a situation where you
are trying to figure out when is a safe time to work out after a hair transplant. Your
doctor apparently is recommending waiting 2 months while you see that the general consensus
is 21 days. And you can be sure that there’s going to be some variability in opinions.
So I can certainly share with you how I explain to my patients when would be the right time
to work out.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a
system we developed to help non-surgically men and women with genetic pattern hair loss
as well as other conditions who come to us from around the world and it has been something
we have been doing and really have established a category of intervention for hair loss and
it has evolved from hair transplant surgery.
So in understanding the question of when is a good time to work out, as a cosmetic surgeon,
where I do a lot of procedures, I do a lot of eyelid surgery, I do a lot of facelift
surgery, I do a lot of other procedures, injectables and lasers. And when it comes to some general
principles in surgery, the goal is when you talk about limiting working out, the way I
look at it, is I generally want to minimize the risk for bleeding. And so when is that
risk highest?
Well, again in general terms, regardless of the technique of surgery, the first few days
are really the highest risk. And there are several phases of wound healing that are applicable
to all surgeries. There’s the: hemostatic phase, inflammatory phase, the proliferative
phase and then the wound remodeling phase.
Now that being said, very often my conversations with patients are about what kind of working
out and that can be quite variable because everyone defines working out differently.
Now for example, we are in New York City, one of the things that’s very popular is
hot yoga. Now one of the things about elevating body temperature, putting aside just working
out is something called vasodilation, that can be an issue and that can be an issue in
terms of swelling.
So when it comes to lifting and you mentioned about losing muscle mass, I can certainly
appreciate your concern. Generally speaking, amongst the fitness community, not working
out for about two weeks, you’re not going to lose that much muscle mass. But when it
comes to two months, I think it’s important to ask your doctor why is two months the reason
to not work out.
You know, when people get transplant, let’s say you do a strip technique, well there’s
suturing at the back of the scalp. Well, once the sutures are removed, unless there’s
any pulling of the skin, the wound healing is going to be pretty much unaffected by what
you do. When you have grafts in place, those grafts are pretty much stable and therefore
once you get past the first week, then essentially, it’s a matter of just looking at how much
of a risk of swelling there is.
You know, when patients come to us for Hair Regeneration, particularly when they’ve
had previous hair transplant surgery, they’re often ready to have a speech about not working
out. But because we’re doing something non-surgical, we are using Acellular matrix and platelet-rich
plasma (PRP) and injecting it under the skin and we’re not really making any kind of
open wound. It’s all just entry points with the skin, then working out is again something
I discuss but you can certainly do that a lot sooner than you would with surgery.
So that being said, I think that, from my hair transplant practice, I would say that
I would tell patients like I do with other surgeries, after the first week, it’s usually
okay to do something light. And then after the second week, use your judgement and work
out to the point where you’re not going to get yourself to incredibly high levels
of exertion or increase your body temperature, blood pressure, heart rate to an extremely
high level. But I would say, with each subsequent week, it gets safer and safer to be able to
get closer to what you normally do.
So instead of having a lot of people maybe second guess what your doctor is doing, I
think they don't have a clear justification. If you are somebody who works out with some
regularity and you are pretty intuitive about your body, then you can probably just use
your judgment once you get beyond let’s say the 21 days or 3 weeks, that is generally
accepted as time when you can work out more aggressively.
Again, in the context of just surgery alone, you know with the wide range of surgeries
that I do with a large group of patients who are very physically active and fit, I think
asking anybody not to work out for two months would be kind of unreasonable unless there
was a clear justification. There are other body surgeries such as tummy tucks where that’s
of course a very different discussion. But when it comes to hair transplant, I can’t
see clearly exactly what the justification would be. I think it’s best to have your
doctor explain it to you so that you can understand the thinking and then maybe you’ll be able
to come to an agreement as to the level of working out so that your doctor isn't concerned
that you would be doing harm to the outcome of your procedure.
So I hope that was helpful, I wish you the best of luck and thank you for your question.