Preparing for DHI begins 2 to 4 weeks before surgery. The key steps include completing blood tests, stopping blood-thinning medications and supplements, quitting smoking and alcohol, and arranging your schedule for 7-10 days of recovery. Proper preparation directly affects graft survival rates and the smoothness of your recovery.
This article is for informational purposes only and does not constitute medical advice.
4-Week Preparation Timeline
4 Weeks Before Surgery
This is the ideal time to begin making lifestyle changes that support the best possible surgical outcome.
Stop smoking: Nicotine constricts blood vessels, reducing blood flow to the scalp. Poor blood flow means less oxygen and fewer nutrients reaching transplanted grafts during the critical healing period. Surgeons recommend quitting at least 2 weeks before surgery, but 4 weeks provides a stronger foundation.
Limit alcohol: Reduce alcohol consumption and plan to stop entirely 1 week before surgery. Alcohol thins the blood and increases bleeding during the procedure.
Start finasteride if recommended: If your surgeon has prescribed finasteride (1mg daily), starting it 3-6 months before surgery is ideal. However, if you are just beginning preparation, starting 4 weeks before still provides some benefit. Finasteride stabilizes hair loss and can strengthen existing miniaturized hairs.
Arrange time off work: Plan for 7-10 days away from the office. If you work remotely, you may be able to return to light computer work as early as day 3-5, though visible recovery signs persist for 7-14 days.
2 Weeks Before Surgery
Stop blood-thinning medications and supplements: The following should be discontinued 2 weeks before DHI (confirm with your surgeon, especially for prescribed medications):
| Category | Specific Items to Stop |
|---|---|
| Over-the-counter pain relievers | Aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve) |
| Supplements | Fish oil, vitamin E (high doses), ginkgo biloba, garlic supplements, turmeric/curcumin |
| Herbal remedies | St. John's wort, ginseng, green tea extract |
| Prescription blood thinners | Warfarin, clopidogrel (consult prescribing doctor first) |
Safe alternatives for pain relief: Acetaminophen (Tylenol) does not thin the blood and can be used during the preparation period.
Stop minoxidil: Discontinue topical minoxidil (Rogaine, 5% solution or foam) 1-2 weeks before surgery. Minoxidil increases scalp blood flow, which can cause excess bleeding during extraction and implantation. Your surgeon will advise when to resume it after the procedure (typically 2-4 weeks post-op).
Complete blood tests: If your clinic has not yet ordered blood work, schedule it now to ensure results are back before your procedure date.
1 Week Before Surgery
Stop alcohol completely: No alcohol for at least 7 days before surgery. Even moderate drinking increases bleeding risk and can interfere with anesthesia.
Confirm all logistics: If traveling for the procedure, book your accommodation, transportation, and confirm appointment details with the clinic. Pack comfortable, button-up or zip-up shirts (avoid pulling clothing over your head during recovery).
Prepare your recovery space at home:
- Extra pillows for sleeping elevated at 45 degrees
- A travel or neck pillow to prevent rolling in sleep
- Gentle, fragrance-free shampoo (or use the one your clinic provides)
- Spray bottle for saline misting
- Button-down shirts and loose hats for the recovery period
Night Before Surgery
- Wash your hair thoroughly with a gentle shampoo (no styling products)
- Eat a normal, balanced dinner
- Get a full night of sleep (7-8 hours minimum)
- Do not apply any products to your hair or scalp in the morning
- Wear a comfortable, button-down or zip-up shirt to the clinic
Blood Tests Required
Your clinic will specify which blood tests to complete. Standard pre-operative panels for DHI include:
| Test | Purpose |
|---|---|
| Complete Blood Count (CBC) | Checks red/white blood cells and platelets; identifies anemia or infection |
| Coagulation panel (PT/INR) | Assesses blood clotting ability; ensures normal clotting during surgery |
| Hepatitis B surface antigen | Screens for hepatitis B infection |
| Hepatitis C antibody | Screens for hepatitis C infection |
| HIV test | Screens for HIV |
| Blood glucose (fasting) | Identifies diabetes or pre-diabetes that could impair healing |
| Blood type (some clinics) | Standard surgical precaution |
Some clinics also request:
- Thyroid function (TSH, T3, T4) to rule out thyroid-related hair loss
- Hemoglobin A1c for patients with diabetes risk factors
- Liver function panel if there are medication concerns
Blood tests are typically performed 1-2 weeks before the procedure. International clinics often arrange blood work on the day before surgery during the in-person consultation.
Medications and Supplements: What to Continue
Not everything needs to stop before surgery. The following are generally safe to continue (confirm with your surgeon):
| Medication | Continue or Stop | Notes |
|---|---|---|
| Finasteride (1mg daily) | Continue | Supports existing hair, does not affect bleeding |
| Blood pressure medication | Continue | Essential for health; inform your surgeon |
| Thyroid medication | Continue | Essential; inform your surgeon |
| Antidepressants (SSRIs) | Continue | Inform your surgeon about specific medication |
| Multivitamin (standard dose) | Stop 1 week before | Some contain vitamin E or blood-thinning ingredients |
| Biotin | Continue | No effect on bleeding; supports hair health |
| Acetaminophen (Tylenol) | Safe to use | Does not thin blood |
Always provide your surgeon with a complete list of all medications and supplements you take. Some interactions are specific to individual drugs and require personalized guidance.
Diet and Nutrition Before DHI
Week Before Surgery
A nutrient-rich diet supports healing and graft survival:
- Protein: Eggs, lean meats, fish, legumes. Protein is essential for tissue repair.
- Iron-rich foods: Spinach, red meat, lentils. Adequate iron supports oxygen delivery to healing tissue.
- Vitamin C: Citrus fruits, bell peppers, broccoli. Supports collagen production for wound healing.
- Water: Stay well-hydrated. Aim for 2-3 liters daily in the days before surgery.
Day of Surgery
- Eat a light breakfast 2-3 hours before your appointment (unless your clinic specifies fasting)
- Avoid heavy, greasy foods that may cause nausea if combined with anesthesia
- Good options: toast, fruit, oatmeal, eggs
- Bring snacks to the clinic for breaks during the procedure (granola bars, fruit, sandwiches)
- Bring a water bottle
What to Bring to the Clinic
| Essential | Optional |
|---|---|
| ID and procedure confirmation | Entertainment (phone, tablet, earbuds) |
| Complete medication list | Snacks and water |
| Button-down or zip-up shirt | Pillow for the ride home |
| Loose-fitting hat (for after) | Sunglasses (post-swelling eye comfort) |
| Comfortable pants | A companion to drive you home |
Mental Preparation
Setting Realistic Expectations
Review your treatment plan and hairline design with your surgeon during the pre-op consultation. Understand the graft count, the areas being treated, and the expected timeline for results (12-18 months for final density). Patients who go into surgery with clear, realistic expectations report higher satisfaction with their outcomes.
Understanding the Commitment
DHI is a long-term investment. The procedure day is just the beginning. The full results take over a year, and you will go through a shedding phase at weeks 2-4 that temporarily makes the area look thinner. Being mentally prepared for this timeline prevents unnecessary anxiety.
For a walkthrough of exactly what happens during the procedure, see the DHI step-by-step procedure. To understand the full recovery timeline after surgery, visit the DHI recovery timeline.
FAQ
What blood tests are needed before DHI?
Standard pre-DHI blood tests include a complete blood count (CBC), coagulation panel (PT/INR), hepatitis B and C screening, HIV test, and blood glucose level. Some clinics also test thyroid function and hemoglobin A1c. These tests confirm you are healthy enough for the procedure and identify any conditions that could affect healing or increase bleeding risk.
How long before DHI should I stop smoking?
Stop smoking at least 2 weeks before DHI surgery, ideally 4 weeks. Nicotine constricts blood vessels and reduces blood flow to the scalp, which directly affects graft survival and wound healing. Smoking after the procedure is equally harmful. Most surgeons recommend staying smoke-free for at least 2-4 weeks after DHI as well to give grafts the best chance of survival.
Can I take finasteride before DHI surgery?
Yes, finasteride (1mg daily) can typically be continued before and after DHI surgery. Many surgeons actually recommend starting finasteride 3-6 months before the procedure to stabilize hair loss and potentially thicken existing miniaturized hairs. Always confirm with your specific surgeon, as individual protocols vary. Minoxidil should usually be stopped 1-2 weeks before surgery to reduce bleeding risk.
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