Using dynaplast as an effective and convenient method to reduce postoperative swelling after follicular unit excision method of hair transplant

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The follicular unit excision (FUE) method of hair transplant has become the preferred method of hair transplant over the years owing to its less invasive nature and avoidance of a linear scar on the donor area. However, general surgical complications of any surgery should always be kept in account. Hair restoration surgeries, including FUE, are also not free of complications.

Post-operative edema is a common consequence of hair transplant that can persist for 3–5 days after the surgery. It can involve the forehead, eyes, and sometimes the nose. In some cases, it may be so severe that the patient may not be able to open their eyes. Post-operative facial edema may be temporary but may cause significant aesthetic concerns to the patient, leading to anxiousness and absence from work.

Many factors are implicated in causing post-operative facial edema, like using large amounts of tumescence during surgery, the response of skin to trauma, lax skin, gravity pull, and mega and giga sessions in a day.^[1]Several measures have been mentioned in the literature to prevent eyelid and forehead edema after a hair transplant. Using a mixture of triamcinolone and tumescent solution in the recipient area in hair transplantation is one of the effective methods of preventing post-operative edema. Post-operative oral steroids have also been used to tackle this situation. Physical methods like vertical positioning of the head and using adhesive tapes on the forehead are also effective methods to reduce postoperative edema.^[2]An effective method of reducing postoperative edema is using dynaplast adhesive tape (Johnson and Johnson Ltd., Mumbai) on the forehead intraoperatively after injecting tumescent anesthesia.

Dynaplast is a flexible compression bandage mostly used for orthopedic indications and skin graft surgeries. In this method, a strip of dynaplast measuring around 15 cm * 2.5 cm is cut and applied on the forehead from one side of the temporal area, stretching across the forehead just above the eyebrows and extending to the other side of the temporal area. The Dynaplast adhesive tape is secured, ensuring that no hairy area is involved [Figure 1 and Video 1]. The Dynaplast adds a constant, firm pressure on the forehead without adding further discomfort to the patient, thus making it an effective method to prevent post-operative edema. The Dynaplast is applied before injecting the tumescent anesthesia, which is secured till the end of surgery. Post-surgery, the dynaplast is left in place and removed on day 3 of the surgery.

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Figure 1:

Image showing dynaplast application over the forehead just before tumescent anesthesia. The blue lines are the hairline design marked by Gentian violet.

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Apart from regular hair transplants of the hairline, the authors have also been using this technique in eyebrow hair transplants as well [Figure 2]. In an eyebrow hair transplant, using dynaplast has been effective in reducing eyelid edema. In the author’s experience, this simple measure has been an effective and cost-effective method of reducing post-operative edema in hair transplants. In addition to this, massaging over the eyebrows with three fingers after surgery and using an injection of triamcinolone acetonide in the tumescence has also been effective in reducing the complication.

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Figure 2:

Image showing dynaplast application over eyelid in eyebrow transplant.

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