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BODY TREATMENT


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FACE TREATMENT // BOTOX
BOTOX INJECTIONS
The cosmetic form of botulinum toxin, often referred to by its product name Botox®, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crow’s feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes.

 


 

 

FACE TREATMENT // LIPOFILLING

By lipostructure or lipofilling, fat of the body, mostly from areas around the umbilicus (navel) or hips, is used to fill wrinkles and folds in the face or dents in other places of the body.
Because 40 to 60% of fat will disappear during the first two months, more fat than needed for the correction itself is injected.
Haematocele or bruising frequently occurs after the lipostructure, but these will disappear after 1 to 2 weeks.
The operation is performed under a local anesthetic and you can go home the same day.
After one month, the fat is completely built in the surrounding tissue. Therefore body fat can be considered as a tissue transplant.
Lipofilling is also the most natural way to fill out or smooth away wrinkles and it never leads to allergic reactions.

LIPOFILLING
Lipofilling is 'filling with own fat' and it is another term for lipostructure.

 

FACE TREATMENT // INJECTABLE FILLERS

As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow's feet or facial creases over the areas where this muscle movement occurs.
Soft-tissue fillers, most commonly injectable Hyaluronic Acid (H.A.) or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment or peeling, or a recontouring procedure, such as a facelift.
If you are considering a facial-rejuvenation treatment, this page will give you a basic understanding of the procedure – when injectables can help, how the procedure is performed, and what results you can expect. You should know though that a lot depends on your individual circumstances. Therefore, please make sure you ask your doctor if there is anything about the procedure that you don't understand.

KNOWING YOUR OPTIONS
Injected H.A. and fat are primarily used to improve the appearance of the skin's texture. They can help fill out deep facial wrinkles, creases and furrows, "sunken" cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips.
Injectables are usually not sufficient for severe surface wrinkles on the face, such as multiple vertical "lipstick lines" that sometimes form around the mouth. Instead, your plastic surgeon may suggest a resurfacing technique, such as chemical peel, dermabrasion or laser treatments. Rather than filling in facial lines, resurfacing methods strip away the outer layers of the skin to produce a smoother appearance.
Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or brow lift. Injectables are sometimes used in conjunction with facial surgery procedures; however, injectables alone cannot change facial contour the way surgery can.
Keep in mind that a plastic surgeon is a specialist who can offer you the full gamut of the most advanced treatments ranging from cosmetic surgery, refinishing techniques, laser therapy, injectables and the use of other fillers. You and Dr. Makram may determine that a single procedure or a combination of procedures is the best choice for you.

WHAT TO EXPECT FROM TREATMENT
The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery.
In some individuals, the results may last only a few weeks; in others, the results may be maintained indefinitely. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material's "staying power". However, the precise reason for the variation of results among patients has yet to be identified.

RISKS RELATED TO INJECTABLES
When injectables are administered by a qualified plastic surgeon, complications are infrequent and usually minor in nature. Still, individuals vary greatly in their anatomy, their physical reactions and their healing abilities. The outcome of treatment with injectables is never completely predictable.

PLANNING FOR TREATMENT
...FACIAL REJUVENATION IS VERY INDIVIDUALIZED
In your initial consultation, Dr. Makram evaluates your face – the skin, the muscles and the underlying bone – and discusses your goals for the surgery. He will help you select a treatment option based on your goals and concerns, your anatomy and your lifestyle.
Dr. Makram will ask you about your medical history and drug allergies. He will also check for conditions that could cause problems, such as active skin infections or non-healed sores from injuries.

...WHERE YOUR TREATMENT WILL BE PERFORMED
Injectables are usually administered in a surgeon's office-based facility. If, however, you are being hospitalized for a facelift, neck lift, brow lift, or any other procedure, your injections may be administered in the hospital as well.

...TYPES OF ANESTHESIA
Both the donor and recipient sites are numbed with local anesthesia. Sedation can be used as well. In this case though, you should make sure you arrange for a ride home after your treatment.

THE TREATMENTS
...TREATMENT WITH FAT INJECTIONS
In the medical world, the fat-injection procedure is known as autologous fat transplantation or microlipoinjection. It involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere and reinjecting them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips.

...THE PROCEDURE
After both the donor and recipient sites are cleansed and treated with a local anesthesia, the fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a suction device. The fat is then prepared and injected into the recipient site with a needle. Sometimes an adhesive bandage is applied over the injection site.
As with collagen, "overfilling" is necessary to allow for fat absorption in the weeks following treatment. When fat is used to fill sunken cheeks or to correct areas on the face other than lines, this overcorrection of newly injected fat may temporarily make the face appear abnormally puffed out or swollen.

...AFTER TREATMENT
Af a larger area was treated, you may be advised to curtail your activity for a brief time. However, many patients are able to resume normal activity immediately. You can expect some swelling, bruising or redness in both the donor and recipient sites. The severity of these symptoms depends on the size and location of the treated area. You should stay out of the sun until the redness and bruising subsides – usually about 48 hours. In the meantime, you may use makeup with sunblock protection to help conceal your condition.
The swelling and puffiness in the recipient site may last several weeks, especially if a large area was filled.

RESULTS
The duration of the fat injections varies significantly from one patient to another. Though some patients have reported results lasting a year or more, the majority of patients find that at least half of the injected fullness disappears within 3-6 months. Therefore, repeated injections may be necessary. Your doctor will advise you on how to maintain your results with repeat treatments.

YOUR NEW LOOK
If you're like most patients, you'll be very satisfied with the results of your injectable treatments. You may be surprised at the pleasing results that can be gained from this procedure.

FACE TREATMENT // NOSE SURGERY

Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.
If you're considering rhinoplasty, this page will provide you with a basic understanding of the procedure – when it can help, how it is performed, and what results you can expect. You should know though that a lot depends on the individual patient’s case and the surgeon. So, please make sure you ask Dr. Makram about anything you don't understand.

THE BEST CANDIDATES FOR RHINOPLASTY
Rhinoplasty can enhance your appearance and your self-confidence.
The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable and realistic in your expectations, you may be a good candidate.
Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes – to correct birth defects or breathing problems.
Age may also be a consideration. Many surgeons prefer not to operate on teenagers until after they've completed their growth spurt-around 16 years for girls and 18 years for boys. It's important to consider teenagers' social and emotional adjustment, too, and to make sure it's what they, and not their parents, really want.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
When rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, nosebleed, or a reaction to the anesthesia. You can reduce your risks by closely following Dr. Makram's instructions both before and after surgery.
After surgery, small burst blood vessels may appear as tiny red spots on the skin's surface; these are usually minor but may be permanent. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible.
In about one case out of ten, a second procedure may be required – for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons. The corrective surgery is usually minor.

PLANNING YOUR SURGERY
Good communication between you and your physician is essential. In your initial consultation, Dr. Makram asks you what you would like your nose to look like, evaluates the structure of your nose and face, and discusses the possibilities with you. He will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.
Dr. Makram will also explain the techniques and anesthesia he will be using, the type of facility where the surgery will be performed, the risks and costs involved and any options you may have. Most insurance policies do not cover purely cosmetic surgery.
Make sure you tell Dr. Makram if you have had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform Dr. Makram if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke.
Don't hesitate to ask your doctor any questions you may have, especially when it comes to your expectations and concerns about the results.

...PREPARING FOR YOUR SURGERY
Dr. Makram will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly.
While making preparations, be sure to arrange for someone to drive you home after your surgery and help you out for a few days if needed.

...WHERE YOUR SURGERY WILL BE PERFORMED
Rhinoplasty may be performed in an outpatient surgery center or a hospital. It is usually done on an outpatient basis, for cost containment and convenience. Complex procedures may require a short inpatient stay.

...TYPES OF ANESTHESIA
Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and on what you and Dr. Makram prefer.
With local anesthesia, you are usually lightly sedated, and your nose and the surrounding area are numbed; you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you sleep throughout the whole operation.

THE SURGERY
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and Dr. Makram's preferred technique. Finally, the skin is redraped over the new framework.
Many plastic surgeons perform rhinoplasty from within the nose, making their incision inside the nostrils. Others prefer an "open" procedure, especially in more complicated cases; they make a small incision across the columella, the vertical strip of tissue separating the nostrils.
When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.

AFTER YOUR SURGERY
After surgery – particularly during the first twenty-four hours – your face will feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with the pain medication prescribed by Dr. Makram. Make sure you stay in bed with your head elevated (except for going to the bathroom) for the first day.
You will notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you will feel a lot better than you look. Most of the swelling and bruising should disappear within one to two weeks or so. Some subtle swelling – unnoticeable to anyone but you and Dr. Makram – will remain for several months.
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Dr. Makram will probably ask you not to blow your nose for a week or so, while the tissues heal.
If you have nasal packing, it will be removed after a few days and you will feel much more comfortable. By the end of one or, occasionally, two weeks, all dressings, splints, and stitches should be removed.

GETTING BACK TO NORMAL
Most rhinoplasty patients are up and about within two days and able to return to school or sedentary work a week or so following surgery. It will be several weeks, however, before you are entirely up to speed.
Dr. Makram will give you more specific guidelines for gradually resuming your normal activities. They are likely to include these suggestions: avoid strenuous activity (jogging, swimming, bending and sexual relations – any activity that increases your blood pressure) for two to three weeks. Avoid hitting or rubbing your nose, or getting it sunburned, for eight weeks. Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it, but glasses are another story. Once the splint is off, they will have to be taped to your forehead or propped on your cheeks for another three months.
Dr. Makram will schedule frequent follow-up visits in the months after surgery to check on the progress of your healing. If you have any unusual symptoms between visits, or any questions about what you can and can't do, don't hesitate to call your doctor.

YOUR NEW LOOK
In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be looking better. In fact, many patients feel depressed for a while after plastic surgery – it's quite normal and understandable.
Rest assured that this stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within a week or two, you will no longer look as if you've just had surgery.
Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.
In the meantime, you might experience some unexpected reactions from family and friends. They may say they don't see a major difference in your nose. Or they may act resentful, especially if you've changed something they view as a family or ethnic trait. If that happens, try to keep in mind why you decided to have this surgery in the first place. If you've met your goals, then your surgery is a success.

FACE TREATMENT // HAIR REPLACEMENT

Hair loss is primarily caused by a combination of aging, a change in hormones, and a family history of baldness. As a rule, the earlier hair loss begins, the more severe the baldness will become. Hair loss can also be caused by burns or trauma, in which case hair replacement surgery is considered a reconstructive treatment.
If you're considering hair replacement surgery, this page will provide you with a basic understanding of the variety of procedures involved. You should know though that a lot depends on your individual circumstances. Therefore, make sure you consult your doctor if you have any questions that still need to be answered.

THE TRUTH ABOUT HAIR LOSS
Baldness is often blamed on poor circulation to the scalp, vitamin deficiencies, dandruff, and even excessive hat-wearing. All of these theories have been disproved. It is also untrue that hair loss can be determined by looking at your maternal grandfather or that 40-year-old men who haven't lost their hair will never lose it.

THE BEST CANDIDATES FOR HAIR REPLACEMENT
Hair replacement surgery can enhance your appearance and your self-confidence, but the results won't necessarily match your ideal. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Makram.
It is important to understand that all hair replacement techniques use your existing hair. The goal of surgery is to find the most efficient uses for existing hair.
Hair replacement candidates must have healthy hair growth at the back and sides of the head to serve as donor areas. Donor areas are the places on the head from which grafts and flaps are taken. Other factors, such as hair color, texture and waviness or curliness may also affect the cosmetic result. There are a number of techniques used in hair replacement surgery. Sometimes, two or more techniques are used to achieve the best results.
Transplant techniques, such as punch grafts, mini-grafts, micro-grafts, slit grafts, and strip grafts are generally performed on patients who desire a more modest change in hair fullness. Flaps, tissue-expansion and scalp-reduction are procedures that are usually more appropriate for patients who desire a more dramatic change.
Remember, there are limits to what surgery can accomplish. An individual with very little hair might not be advised to undergo hair replacement surgery.

HAIR LOSS IN WOMEN
Some doctors estimate that one in five women will experience some degree of hair loss usually caused by aging, illness, or hormonal changes after menopause. Women tend to experience a subtle thinning all over the scalp rather than losing hair in patches as is common in men. To correct the problem, some women choose to wear a wig or hair extensions. Others have had some success using a topical prescriptive drug. The effectiveness of such drugs varies in some patients and simply prevents further hair loss without stimulating any appreciable new growth. Hair replacement surgery may be the answer for those who feel uncomfortable with either of these options.
Because mini-grafts are usually the surgical treatment of choice for filling-in thinning areas, good candidates for this procedure should have dense hair growth at the back of the head. Mini-grafts are harvested from this dense area and replanted in thinning areas to create a fuller look. Occasionally, flap and tissue expansion procedures may be used if the individual is judged to be a good candidate.
If you're considering a hair replacement procedure, it's important to understand that you will never have the coverage you had prior to your hair loss, but surgery may camouflage the thin areas and give you more fullness.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
Hair replacement surgery is normally safe when performed by a qualified, experienced physician. Still, individuals vary greatly in their physical reactions and healing abilities, and the outcome is never completely predictable.
As in any surgical procedure, infection may occur. Excessive bleeding and/or wide scars, sometimes called "stretch-back" scars caused by tension may result from some scalp-reduction procedures.
In transplant procedures, there is a risk that some of the grafts won't "take." Although it is normal for the hair contained within the plugs to fall out before establishing re-growth in its new location, sometimes the skin plug dies and surgery must be repeated. At times, patients with plug grafts might notice small bumps on the scalp that form at the transplant sites. These areas can usually be camouflaged with surrounding hair.
When hair loss progresses after surgery, an unnatural, "patchy" look may result – especially if the newly-placed hair lies next to patches of hair that continue to thin out. If this happens, additional surgery may be required.

PLANNING YOUR SURGERY
Hair replacement surgery is an individualized treatment. To make sure that every surgical option is available to you, find a doctor who has experience performing all types of replacement techniques – flaps and tissue expansion as well as transplants. Look elsewhere if your doctor tells you that he or she has perfected one technique that can "do it all."
In your initial consultation, Dr. Makram will evaluate your hair growth and loss, review your family history of hair loss, and find out if you've had any previous hair replacement surgery. Dr. Makram will also ask you about your lifestyle and discuss your expectations and goals for surgery.
Medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood-clotting problems, or the tendency to form excessive scars, will also be checked by him. Be sure to tell Dr. Makram if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
If you decide to have hair replacement surgery, Dr. Makram will explain the type of anesthesia that will be administered, the type of facility where the surgery will be performed, and the risks and costs involved. Don't hesitate to ask your doctor any questions.
Make sure you understand Dr. Makram's plan – which procedures will be used and how long each will take. Ask your doctor to give you an idea of what you will look like after the procedure or, in the case of grafts, after each stage of treatment.

...PREPARING FOR YOUR SURGERY
Dr. Makram will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking and avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it's especially important to stop at least a week or two before surgery; smoking inhibits blood flow to the skin, and can interfere with healing.
You should arrange for someone to drive you home after your surgery. Plan to take it easy for a day or two after the procedure and arrange for assistance if you think you will need it.

...WHERE YOUR SURGERY WILL BE PERFORMED
Hair replacement surgery is usually performed in an outpatient surgery center. Rarely does it require a hospital stay.

...TYPES OF ANESTHESIA
Hair replacement surgery, regardless of the technique used to perform it, is usually carried out using a local anesthesia along with sedation to make you relaxed and comfortable. Your scalp will be insensitive to pain, but you may be aware of some tugging or pressure.
General anesthesia may be used for more complex cases involving tissue expansion or flaps. If general anesthesia is used, you will sleep throughout the whole procedure.

THE SURGERY
Hair transplantation involves removing small pieces of hair-bearing scalp grafts from a donor site and relocating them to a bald or thinning area. Grafts differ by size and shape. Round-shaped punch grafts usually contain about 10-15 hairs. The much smaller mini-graft contains about two to four hairs; and the micro-graft, one to two hairs. Slit grafts, which are inserted into slits created in the scalp, contain about four to10 hairs each; strip grafts are long and thin and contain 30-40 hairs.
Generally, several surgical sessions may be needed to achieve satisfactory fullness – and a healing interval of several months is usually recommended between each session. It may take up to two years before you see the final result with a full transplant series. The amount of coverage you will need is partly dependent on the color and texture of your hair. Coarse, gray or light-colored hair affords better coverage than fine, dark-colored hair. The number of large plugs transplanted in the first session varies with each individual, but the average is about 50. For mini-grafts or micro-grafts, the number can be up to 700 per session.
Just before surgery, the "donor area" will be trimmed short so that the grafts can be easily accessed and removed. For punch grafts, your doctor may use a special tube-like instrument made of sharp carbon steel that punches the round graft out of the donor site so it can be replaced in the area to be covered – generally the frontal hairline. For other types of grafts, Dr. Makram will use a scalpel to remove small sections of hair-bearing scalp, which will be divided into tiny sections and transplanted into tiny holes or slits within the scalp. When grafts are taken, your doctor may periodically inject small amounts of saline solution into the scalp to maintain proper skin strength. The donor site holes may be closed with stitches – for punch grafts, a single stitch may close each punch site; for other types of grafts, a small, straight-line scar will result. The stitches are usually concealed with the surrounding hair.
To maintain healthy circulation in the scalp, the grafts are placed about one-eighth of an inch apart. In later sessions, the spaces between the plugs will be filled in with additional grafts. Your doctor will take great care in removing and placing grafts to ensure that the transplanted hair grows in a natural direction and that hair growth at the donor site is not adversely affected.
After the grafting session is complete, the scalp will be cleansed and covered with gauze. You may have to wear a pressure bandage for a day or two. However, some doctors allow their patients to recover bandage-free.
Plastic surgeons are the leaders in tissue expansion, a procedure commonly used in reconstructive surgery to repair burn wounds and injuries with significant skin loss. Its application in hair replacement surgery has yielded remarkable results – significant coverage in a relatively short amount of time.
In this technique, a balloon-like device called a tissue expander is inserted beneath hair-bearing scalp that lies next to a bald area. The device is gradually inflated with salt water over a period of weeks, causing the skin to expand and grow new skin cells. This causes a bulge beneath the hair-bearing scalp, especially after several weeks.
When the skin beneath the hair has stretched enough – usually about two months after the first operation – another procedure is performed to bring the expanded skin over to cover the adjacent bald area.

EXPANSION
Creating New Skin from Old.

FLAP SURGERY
Flap surgery on the scalp has been performed successfully for more than 20 years. This procedure is capable of quickly covering large areas of baldness and is customized for each individual patient. The size of the flap and its placement are largely dependent upon the patient's goals and needs. One flap can do the work of 350 or more punch grafts.
A section of bald scalp is cut out and a flap of hair-bearing skin is lifted off the surface while still attached at one end. The hair-bearing flap is brought into its new position and sewn into place, while remaining "tethered" to its original blood supply.
As you heal, you will notice that the scar is camouflaged – or at least obscured – by relocated hair, which grows to the very edge of the incision.
In recent years, plastic surgeons have made significant advances in flap techniques, combining flap surgery and scalp reduction for better coverage of the crown; or with tissue expansion, to provide better frontal coverage and a more natural hairline.

...SCALP REDUCTION
This technique is sometimes referred to as advancement flap surgery because sections of hair-bearing scalp are pulled forward or "advanced" to fill in a bald crown.
Scalp reduction is for coverage of bald areas at the top and back of the head. It's not effective for covering of the frontal hairline. After the scalp is injected with a local anesthetic, a segment of bald scalp is removed. The pattern of the section of removed scalp varies widely, depending on the patient's goals. If a large amount of coverage is needed, doctors commonly remove a segment of scalp in an inverted Y-shape. Excisions may also be shaped like a U, a pointed oval, or some other figure.
The skin surrounding the cut-out area is loosened and pulled, so that the sections of hair-bearing scalp can be brought together and closed with stitches. It's likely that you feel strong tugging at this point and occasional pain.

AFTER YOUR SURGERY
How you feel after surgery depends on the extent and complexity of the procedure. Any aching, excessive tightness or throbbing can be controlled with pain medication prescribed by your physician.
If bandages are used, they will be usually removed one day later. You may gently wash your hair within two days following surgery. Any stitches will be removed in a week to 10 days. Make sure you discuss the possibility of swelling, bruising, and drainage with Dr. Makram.
Because strenuous activity increases blood flow to the scalp and may cause your transplants or incisions to bleed, you may be instructed to avoid vigorous exercise and contact sports for at least three weeks. Some doctors also advise that sexual activity be avoided for at least 10 days after surgery.
To make sure that your incisions are healing properly, your doctor will probably want to see you several times during the first month after surgery. It is important that you carefully follow any advice you receive at these follow-up visits.

GETTING BACK TO NORMAL
How soon you resume your normal routine depends on the length, complexity and type of surgery you've had. You may feel well enough to go back to work and resume normal, light activity after several days.
Many patients who have had transplants (plugs or other grafts) are dismayed to find that their "new" hair falls out within six weeks after surgery. Remember, this condition is normal and almost always temporary. After hair falls out, it will take another five to six weeks before hair growth resumes. You can expect about a half-inch of growth per month.

FOLLOW-UP PROCEDURES
You may need a surgical "touch-up" procedure to create more natural-looking results after your incisions have healed. Sometimes, this involves blending, a filling-in of the hairline using a combination of mini-grafts, micro-grafts, or slit grafts. Or, if you've had a flap procedure, a small bump called a "dog ear" may remain visible on the scalp. Your doctor can surgically remove this after complete healing has occurred.
In general, it is best to anticipate a touch-up procedure. Dr. Makram can usually predict how extensive your follow-up surgery is likely to be.