Transplant Procedure Info


Procedure 1
Dr. Cooley




latinlotus

latinlotus

Age: 46 | Bald Class: Bald Class 3v Email Me

Density achieved: 60 FU/cm2 at the hairline with the density decreasing moving back of the head. Average was around 40 FU/cm2. Grafts were placed at the frontal 25% of the head.Crown was not addressed since it is minor and i can cover it with Toppik.
Hair counts: Single = 717; double = 908; triple = 464; quadruple = 8
Total grafts = 2097;Total hairs = 3957
Donor density: 85 FU/cm
Strip was 20 cm X 1-1.4cm wide
Trichophytic closure, non dissolvable sutures
Platenet rich plasma (PRP) used
Doctor selection
After one year of diligence research and getting plenty of questions answered by many doctors and as well as trusted members of this forum, I decided to go for a HT with Dr. Cooley on November 20th, 2008.
Here are the reasons why I went with Dr. Cooley:
1-Coalition with HTN:
Dr. Cooley is part of the Coalition. Otherwise how would I know how evaluate a doctor’s work. With modified pictures, with online paid posters, with web sites deleting negative comments about some doctors, I have the comfort to know that Dr. Cooley’s work had been evaluated by Pat, the publisher of HTN, who only has patient's interest at heart. More importantly, I know that Dr. Cooley’s work had being made accountable by HTN online community.
2-Approach
The doctor should recommend an approach/hairline that corresponds with EXACTLY what I want. When I first meet with a doctor, I don’t provide him with any input. I just ask him what he thinks it is best for me. Some doctors recommended an aggressive approach, while others suggested something more conservative. Dr. Cooley recommended exactly what I want for my HT, in terms of hairline placement and density. I also like the fact that the yield and conserving donor grafts are the most important issues for him.
3-Hand-on doctor


Dr. Cooley is a hand-on doctor when dealing with the surgery. Contrary to some clinics, he participates extensively, both in doing the incisions and implanting of the grafts. Some clinics let the staff do all the implanting, which may be ok for some patients, but that is just not acceptable for me. Staff comes and goes while the doctor always stays. I understand a HT surgery is long and tedious and it is humanly impossible for the doctor to do everything himself. That being said, I want my doctor to do more than less, and I want him to be in the room as much as possible, and it is exactly what he did with me. Based on comments from some former patients, Dr. Cooley is a control freak…that is what exactly what I want to hear.
Similarly, Dr. Cooley works only on one patient a day. I want him to devote all his attention to my case. Again, I am not comfortable to go to a doctor who works on more than one patient a day. Now that I went through with the HT, I think the procedure is simply too complex to have a doctor dealing with two patients at the same time.
4-Perfectionist
Dr. Cooley is a perfectionist who does not accept the status quo. He is constantly try to improve his techniques in order to help his patients get better results. He was one of the first doctors who used the microscopes for HT, his involvement with Intercytex regarding hair multiplication and his introduction of PRP into HT surgery; make me believe that he is in a constant pursuit of perfection.
The fact that dr. Cooley is a dermatologist (as opposed to just a general practitioner) and that he won 2008 The Platinum Follicle Award given by the ISHRS for “Outstanding achievement in basic scientific or clinically-related research in hair pathophysiology or anatomy as it relates to hair restoration” also weighted a great deal in my decision.
5-Photos of consistent results of former patients
Although it is somewhat important, we all know that photos can be retouched and lighting can make a huge difference on the results. In addition, when a clinic is posting a picture, it is usually a home run result. Thus, online pictures should be taken with some reservation. Finally, some clinics have full time marketing consultants, therefore the number of pictures posted online does not necessary indicate the size of the patient base or the popularity of a particular doctor. I take the example of Dr. Bernstein who I believe is unknown to a large part of the online community. Yet he is one of the top HT doctors out there, and he is the granddaddy of the follicular units transplantation. He was on Oprah, he was on numerous TV shows and was voted best doctor in NY for many years. His marketing was just elsewhere.
That being said, Dr. Cooley’s patients pictures always seem so clean and that the results always look very good when compared with the number of grafts used. Planting 3K grafts on a Norwood 2 patient is nothing to be impressed.


Some factors that had no or little importance in my decision:
Price, location, whether the doctor can achieve high density or can do large sessions and whether the doctor and his staff are nice to me. That being said Dr. Cooley and his staff are top notch and are extremely caring. We know the charm and hospitality of southerners are unrivaled, and that is so true with Dr. Cooley’s staff.
My journey in Charlotte
I arrived in Charlotte in the morning the day before and went directly to Dr. Cooley’s office to go over the plan and hairline design. (Actually we already agreed on the design when he met with me in person last September). We agreed on the hairline and took some pictures. The plan calls for some sprinkle of hairs between the first and second line drew. The real density starts after the second line, with peaks and valleys which mimic a natural hairline. The last thing I wanted is a wall of hair which screams HT.
I decided to leave the hairline marks on my head for the rest of the day so that I can reflect on it. Needless to say, I stayed in the hotel the whole time in order to avoid funny looks. Beside, I wanted to get plenty of rest for the surgery early next morning.
The day of surgery, I arrived at the clinic at 7am sharp. With my hair clean, Dr. Cooley drew the same hairline again. The hairline he drew the day before did not require any change. He gave me a valium and some antibiotic and by the time I laid face down on the chair, I was already sleepy. He took some blood (about 50 cc) in order to extract the platelet rich plasma (PRP). PRP is concentrated growth factors contained in my own blood. It helps with healing AND increases grafts yield by about 10%-15% (according to Carlos Uebel MD in Brazil, the granddaddy of the mega session, who had been using PRP with HT for over 6 years). Grafts are bathed in the PRP before being implanted. PRP is also applied to the recipient sites and the donor scar. Dr. Cooley started to use PRP on some of his patients for about 10 months now. So far, the results are very good.
For more info on PRP, please check these threads:
http://hair-restoration-info.com/eve/forums/a/tpc/f/3466060861/m/4351091993?r=4441063993#4441063993
http://hair-restoration-info.com/eve/forums/a/tpc/f/3466060861/m/60610442?r=60610442#60610442


Dr. Cooley then numbed the donor and recipient sites with lidocaine. I would say that it is the most (and only) unpleasant part of the HT. With the effect of valium fully kicking in, the next thing I know, he already closed the scar with trichophytic closure. I now turned on the chair, and fell asleep almost immediately.
I woke up around noon and had a 30 minutes break for lunch. So far, about 400 grafts had been implanted. After lunch, I was given another valium and some antibiotics and then fell asleep again until about 4:30pm. There were about 200 grafts left to be implanted. I was awake for the last hour of the surgery and Dr. Cooley was there the whole time implanting the grafts himself with his assistant Brandi. Because I was asleep most of the time, Dr. Cooley told me he was in the room most of the time and had participated a great deal in my surgery. He has a hand-on approach about all of his surgeries…which is what I require from a doctor.
The donor strip generated an extra 100 grafts, but Dr. Cooley did not charge me for it. After cleaning up, and some post-op pictures were taken, his driver (Mr. Walker, by the way, is the nicest driver I ever met) drove me back to the hotel around 6 pm.
Dr. Cooley advised me to take a valium before going to bed, which I took, but I did not really think I needed it. At this point, I am still numb from the anesthesia. I went to bed around 10 pm, slept through the whole night and woke up at 8 am the next day.
The surgery lasted about 9 hours. Dr. Cooley said that he could have reduced by 2 hours if my hair was shaven or if he wanted to rush it. Before the surgery, I had no preference to shave or not, but Dr. Cooley opted not to shave because he did not want me to look like bozo the clown. Now that the surgery is done, I am really glad that my hair was not shaved because by day 3, most trace/redness of the HT (at the recipient and donor scar) was already gone. Also, adding the PRP to the surgery added an extra 45 minutes. This really shows his dedication to his patients as he is willing to incur more time (and cost) to help his patients achieve optimal result.
Recovery
At day 6, apart from the stubbles of the implanted grafts, I can confidently say that a stranger can not see that I had HT. Oh yeah, a very important point: NO PAIN WHATSOEVER since surgery day (either at the donor or the recipient sites), and no, I am not numb at the donor region. Compared to some results of other patients, I would say that my recovery was extremely quick. I am really puzzled because if a needle pierces through my skin, I would probably feel some pain for about 24 hours. Now imagine over 2000 piercing plus the donor scar, yet there is no pain. Who said no pain, no gain? I slept like a baby every night since. Is it due to the skill of Dr. Cooley and his staff, my own morphology, the size of my procedure or the addition of PRP to the surgery? Dr. Cooley was very candid about this and said there is a combination of factors, but he had found the PRP helpful and my recovery is a typical result when he uses PRP. He does admit that it is hard to prove this scientifically though.

I am just waiting for the growth result now. Dr. Cooley already booked an appointment for me for sutures removal with a HT doctor in Montreal next week.
For more updates/progress, please check my journal entries.


Non-Surgical Treatments:

Propecia started Nov 2007. Actually it is Proscar (5 mg finasteride) 1/4 daily skip the fifth day. Not much difference for the first 12 months. No noticeable hair loss or growth, no side effects either, not that I expect any anyway. However, at the 14 month mark of usage of Proscar, I can see a definite improvement at the crown, and maybe some regrowth at the temples. Please see my entry/photo related to use of Proscar.

I highly recommend to take Propecia for at least 12 months before jumping for HT. I saw a few times where a patient got a homerun result from HT, but it turns out that a big part of it was the result of medication. If he would have waited, maybe he would not need a HT after all... talking about waste of money AND grafts.

My Hair Loss Story

I never had lots of hair in the temple areas. I have been slowly losing hair since my mid-20's. However, I noticed a bit more hair lost in the temple areas about 3 years ago. Although I am an appearance conscious person, it never really bother me until early this year (2007), when I looked at a reflection of the top of my head in an elevator mirror. It is the first time that i notice that i am losing hair at the crown area as well. From that moment, i started to think i should do something about it.

How has my hair loss affected me?

Gradual loss of confidence, more reluctance in being in photos, although I am (used to be) very photogenic.

What hair loss treatments have worked best for me?

Hair transplant by Dr. Cooley REALLY improved my appearance. I would say that i turn back the clock on my age by at least 5 years. Finasteride helped also in reducing my hair loss while thickening and perhaps help with regrowth at the crown.

Am I happy with my hair transplant experience and the results?

Very happy with my experience and results, although I would like to have a bit thicker look at the temples. This can be corrected with a touch up, but i may not need it since i don't believe my final result is achieved yet. I will give it another six months. Even if there is no improvement from now on, I am still very happy with my result and would highly recommend Dr. Cooley.

What hair loss treatments would I recommend?

Take finasteride (Proscar) for at least a year, before considering hair transplant.  I have seen some great results from finasteride, including my own (at the crown only).

How has hair restoration surgery changed my life?

I hardly think about my hair loss anymore (which is one of the main goals that Dr. Cooley has for his patients). My confidence is up. Enjoy more being in photos. Get more attention from the ladies :) even though i don't need it as i am happy with my wife... But a bit of extra attention from the opposite sex always help...

My general advice and suggestions.

Do lots of research (internet research, meet doctors, see patients in person)...for at least 6 months. Get a good doctor from the Coalition. Have a healthy dose of skepticism. Do lots of work out: a bald with great muscles always looks better than a fat man (or skinny man) with a full head of hair.