Hair Apparent

Steve, You can run a search on this site for me under "Hair Apparent" and find extensive comments on my HT's from Doctor Cooley. Like Brando said, nothing but positive.

ShouldIdoit, I was Dr. Cooley's patient and received three HT's from him. You can run "Hair Apparent" through this site's search engine for details about the procedures and experiences. To cut to the chase, they were all positive. You say your hair loss is stage 5. I wish I'd been so lucky. My initial hairloss level was Norwood VI and pushing VII in the back. With so much space to cover, I knew I wasn't going to look like Elvis at the end, and frankly, at my age, I didn't need to. Doctor Cooley and his staff pointed out my limited options. I opted to have him distribute the grafts from the first HT all over my balding area, rather than just using them in the front and top, to "frame the face", as they like to say. I underestimated the results in the crown area, but I am still happier to have even a faint dusting of hair back there. On my second HT with Dr. Cooley, I concentrated on the front and top. Dr. Cooley uses what he terms a "reverse hairline" approach for that. He places the greatest density forward and gradually fades it back to wherever the number of grafts ends at the crown. One of the things that pleased me the most about Dr. Cooley's skill (as a person, he is also top drawer. I've rarely known someone as genuinely decent and considerate and generous as he is) is his sense of artistry. In sketching out my frontal hairline, he took into account my age (in my 50's) and general shape of my face. One thing I noticed during my research of HT's is so many people, even those with as much hairloss as myself opted for a more rounded frontal hairline, filling in the the entire front. In my considerations, that always struck me as unnatural, particularly for one of my years. My preference was to build my hairline from the front centre of my forehead and widen it as it went back, leaving the temple sides receded. Before I could communicate this to Dr. Cooley, that was precisely the hairline he sketched out for me. My third and final HT was at Dr. Cooley's offer. He wanted to put some final touches on the second HT. It was only 500 grafts, but it made the front work look 100% better (and it looked good before). It was his eye for artistry that told him how he could get so much improvement out of such a low number of grafts. Bottom line: yeah, I still have a big, honkin' balding spot on the back of my head. I have enough grafts remaining for another HT, but another 2,000 grafts, I don't think, would make enough of a cosmetic difference in that balding spot--at least, not enough to drop a big chunk of $$$ to do--so I will just wait for future developments, such as hair cloning, to catch up. But from the front, and to a lesser extent, the sides, I still get thrilled when I look in the mirror. No, as I said, I'm not Elvis, but it is a natural hairline and the hair on top has a natural thickness for a man my age. I don't know how old you are, but it is perfect for a man in his 50's. In fact (I never made a secret of the fact that I had hair transplants), that is the most common compliment from my friends and associates: that is a realistic and natural appearance for my age. Sure, I would love to have a full head of hair, or at least have thicker hair--who wouldn't?--but with what he had to work with, Dr. Cooley got the maximum benefit in my appearance. And it's so nice no longer being "the bald guy" in the room. I don't have any direct knowledge of Doctor Wong. From all of the other positive comments here about him, I think it's a sure bet that you couldn't go wrong with him, either. My experiences with Dr. Cooley were so satisfying, however, that--if another HT for me was worthwhile and I had an unlimited wallet and my choice of any HT surgeon--I would still go with Dr. Cooley.

When I went under the knife for my first HT, I was completely upfront about it with my friends and colleagues. When I got back to work, I was glad to show off my scar in the back and answered any questions. There weren't that many questions, at the time. (I suspect people were reserving judgement until they saw how well it came out; now I get questions all the time from other "follically challenged" fellows.) I didn't receive a single negative remark or even a joke about it. My feeling was "in for a penny, in for a pound." I wasn't going to worry about public opinion or acceptance. And it paid off. If anything, I received support and encouragement. And when I went in for HT # 2 and # 3, I didn't have to worry about having to explain those, either.

It's been over three years since the first time I walked into Doctor Jerry Cooley's offices and investigated the possibility of having a hair transplant. Three HT's later, I find that it has been an education, full of illumination and discovery about the process of hair transplantation. In the interests of sharing what I have learnt, I submit this. I fully admit that some of it is subjective--there's no way to avoid that, since many of you won't share my initial level of baldness, or age, or other circumstances--but a great deal of it, I believe, is objective and reasonably universal. Thus, it may have value for those of you considering an HT or wondering what will be the result of yours. Self-Education is the Key. Of everything I have to say, this is first and foremost. I was at a great disadvantage because I did not discover this forum until after I had done all the research I could and had undergone my first HT with Dr. Cooley. But, in exploring the option of an HT, I spent literally days--not all at once, but at least one session of on-line research went for twelve hours straight--learning all I could about the mechanics of hair transplantation, what the current state-of-the art was in hair transplantation, and then what physician I should approach for further information. I read of the success stories and the butcherings. I committed to memory the various terms and what were considered the most modern techniques. And then, I went through the various physicians available to me. As I said, had I known of this forum, it would have saved me hours of effort. But fortunately, through my own careful analysis and study, I determined that Dr. Cooley was the surgeon I should opt to perform my HT. As is true with most evolutions of life, once I had my first HT performed, I discovered that my education on the process had only begun. If for no other reason than the fact of having an HT and personally undergoing the effects of it provided me with knowledge that I did not have before. Before undergoing an HT, the best I could do was acquire a general idea of what an HT could accomplish. But every patient is different, with different hair and scalp characteristics, different rates of healing, and different desires. The only way to learn how you will respond to an HT is to have one. That makes it tough to project one's own results. If I had known how my first would turn out, it might have affected the approach I used. I don't think so, but it might have, and it might affect yours, if you are considering one. It's a Catch-22; you can't know for sure how you want to approach the questions of density and coverage and placement of grafts until you've had an HT, but you can't have an HT until you've made decisions on all of these things. Toward breaking out of that circle, I recommend listening to your surgeon's recommendations and projections, and review the experiences of the folks who post here. You still won't know 100% how an HT will work on you, but you can get a decent idea, within a certain window of probability. It's Difficult to be Completely Realistic. I'm a practical man, and pretty good at setting aside personal biases for the sake of objectivity. And my goals for my final results were reasonable and modest. Even so, as time went by, and I observed the final results of my HT's--and compared them to results achieved by others on this forum--I realised that I had unknowingly suffered from some small self-deceptions. Not the kind where you know deep down you're fooling yourself; I mean small things which I never realised that I was keeping myself from noticing. In my case, it was mild mis-estimations of two things. First, my own degree of baldness. I was a Norwood VI, but truth to tell, I was actually knocking on the door of Norwood VII-hood. It wasn't that I was fooling myself on how much hair I did have; it was that I had resisted taking a real good look at how much hair I didn't have--until the results of my first HT started to reach fruition. At that point, I began taking a closer look at just how much area I had to cover, mainly because I was comparing my progress to others whom I thought had suffered baldness similar to mine. After so many close, unblinking looks, I began to realise just how much balding area I really had. The second thing; like I bet all of us have, I studied the before-and-after photographs of HT patients on the physicians' websites. I did those mental calculations: "O.K., this guy was this bald and he had this many grafts," and tried to calculate if I would have the same results. This is a reasonable thing to do, but until I got my first HT, I was looking at the photographs with an eye toward all the positives and few of the negatives. I doubt if any surgeon recommended here posts deliberately re-touched or enhanced photographs of previous patients. But there are things which affect how a patient's HT looks--the lighting, the positioning of his head, how he wore his hair before his HT(s). And obviously, a physician is going to advertise his most successful outcomes. Not that he didn't do as good a job on the patients whose pictures he doesn't show; that goes back to what I said above, some people, because of their physical characteristics, respond better to an HT than others. As I gained more experience from my own HT's, my eye grew more accurate in evaluating photographs. I learnt to adjust for such things as lighting or position. It's not that the shortcomings of a patient's HT (his results and number of grafts compared to his original level of baldness) weren't there to see; they were--it's just that before, I was looking more at the positives and not looking at the negatives. And, let me say, that in nearly every photo I looked at, even with a jaundiced eye, the patient's appearance was substantially improved by his HT; it's that, after my own operations, I was able to appraise them more realistically. With a More Realistic Perspective, I Realised What an Incredible Job My HT Surgeon Had Done. I don't mean to sound like a shill for Dr. Cooley, and there are enough testimonials by his other patients here that support what I say, that it won't sound like hyperbole. And nothing I say is meant to be a comparison to the other surgeons recommended here. I'm sure all of them are dedicated, talented professionals. I merely relate my experiences with Dr. Cooley. I knew going in that I would not be an easy patient. I had a lot of bald area and my scalp was covered with scarring from a youthful folly in hair replacement (not involving a hair transplant). At my consultation with Dr. Cooley and Ailene, I wasn't promised the moon and the stars. They gave me realistic projections and didn't candy-coat anything. In fact, this is what decided me on going with Dr. Cooley. Even though I had modest goals and modest expectations, I still had a tendency to expect more than what I reasonably would get. I didn't see this as a fault in Dr. Cooley's work--from the get-go, I thought his efforts exceptional. As I acquired a more objective perspective of just challenging a patient I was, and able to set aside my previous slightly over-optimistic expectations, I realised just how remarkable a job he has done on me. From the front, I am still stunned at how great I look. The hairline is absolutely perfect, appropriate for a man of my age, yet decently full. And all over my scalp, I have enough hair to mask the old scarring. I still have that big, honkin' bald spot in back. (Actually, "balding" is a better word; I have a light dusting of hair all over that. It still looks like a bald spot, but it doesn't have that shiny, pinkness that makes a bald spot really stand out.) And I would be lying if I didn't admit that bugs the heck out of me. But, now, I am more able to figuratively take a step back and look at Dr. Cooley's accomplishment as a whole--which is how everyone else looks at it--rather than component parts. And then I see just what a positive change he has made in my appearance. I may not have a head of hair like Elvis, but I am no longer "the bald guy" in the room. I read once of someone describing an HT for a Norwood VI or VII bald man as trying to paint a wall that needs two gallons of paint to cover it but having only one gallon of paint to do the job. It's an insightful metaphor, and accurate. That's what Dr. Cooley was facing with me, and I firmly believe that no other HT surgeon could have produced better results. Obviously, I am grateful to Dr. Cooley for his skill, knowledge, and generosity. But I also want to make a comment on him personally. Every once in a rare while, one meets a person who is just amazing in his dedication, compassion, and personal ethics. Dr. Cooley is one of these. I could name a dozen different instances where he has shown this with me. And if one reads the posts of his other patients on this forum, you will see that he is this way with each of his patients. I paid for his professional skill, but I will be spending the rest of my life trying to find a way to pay him back for his personal considerations. I don't want to leave out his staff, either. Ailene Russell is top-notch, both in her medical knowledge and in her approach to patients. His techs, the folks who do a lot of the grunt work and get little of the glory, are dedicated and skilled and patient-oriented. Again, I'm not saying that Dr. Cooley and his staff are all of these things and the other physicians' services recommended here are not. I've read enough posts of these other physicians' patients here to see those qualities are pretty universal. I'm only stating my experience with Dr. Cooley. For Those Considering Their First HT's, Do Your Legwork on HT Surgeons. Don't get swayed by fancy websites or promotions. Nor get too down in the weeds over cost. Yes, I know, an HT is not a cheap thing. But you will find that the quality surgeons all charge in the same ballpark of fees. If you get cited a fee that is significantly above or below their fees, then that should be a red flag. Use your brain. Research. Read what other patients have to say. Ask questions. As I mentioned, I didn't know of this forum when I did my research into HT surgeons. One of the things that struck me immediately was when I e-mailed my questions--and they were reasonably detailed--to the hair mills, like Bosley and MHR, I got a terse, impersonal "We can't tell you anything until you come in for a consultation." That, more than anything else, turned me away from them. Certainly, any e-mail discussions with an HT physician will have the caveat that he cannot answer with specificity until he can examine you personally. But they can and will provide some pertinent information based upon what you tell them. That's what makes this forum such a valuable tool. No poster here, even those few that decry HT's, wants you to have a bad experience. Read the posts, study their comments, evaluate them, and if you don't find an answer to your question already here someplace, ask it. I titled this post "Journey's End". That's because, financially, for the time being, I've sunk all into HT's that I feel I can without sacrificing the financial health of my wife and myself. Right now, there are other things more demanding. Beyond that, even though I have enough donor hair for one more HT, I think I may be better off waiting for medical science to catch up with my remaining baldness. If and when hair cloning becomes a viable resource, you bet I'll be jumping on that option. Fortunately, the "time for perfection of hair cloning-versus-me having the available funding" timelines work out just about the same. So I guess what I'm really saying is "Journey's End" is really "Journey Interrupted Indefinitely". I hope something I said here will be of help to those of you deciding on whether or not to have a hair transplant. It's one man's analysis, but reasonably objective, I think. Even so, it's just one more input. Don't stop with me. There are lots of posts here to learn from. Hair Apparent

What Gorpy said . . . . In fact, everything he said. If anything, I was balder than you were, Glock, and with my first HT--especially since I had the grafts distributed all over instead of just on top and in front--my hair looked just as thin six months into it. That was 2,600 grafts. After my second HT--2,500 grafts, all put into the hairline and top--it looked a great deal better but still painfully thin. Fortunately, a slight application of Dermatch works wonders. Two weeks ago, Doctor Cooley did a touch-up of my hairline. He meant to only harvest and transplant 30-100 grafts, but ended up doing 500+. That will get me pretty close to what I was hoping for on top when I started this. I have to live with that big, honkin' balding spot in back, though. The hairs I transplanted back there don't do a whole lot cosmetically, but they do keep the spot from being shiny and they help the hair on top blend in when I comb it back. The point is, for Norwood VI guys like us, unless we are just fabulously lucky in terms of amount and quality of donor hair, we're never going to get past that thin-hair look. Supply just doesn't meet demand. Fortunately, this is one of the few areas where age is an asset. I'm in my fifties, so the thinness of my hair, especially with the hairline Dr. Cooley gave me, looks appropriate. Not optimal, but appropriate. At least, I can no longer be described as "that bald guy over there." The other good thing is that your new hair is going to look a lot more impressive to others than it does to you. I've gotten nothing but positive comments after both my first and second HT's. From what I can see in your photos, you are coming along just fine. I think you'll be positively thrilled after the next three or four months. And yes, the hair does grow at different rates and stages, so don't concern yourself with that, yet. In fact, even though one year is the general benchmark for evaluating the final results of an HT, there is usually some improvement after that. Up to several months after my first HT, I saw improvement, not in new growth, but in the individual hairs getting thicker and more manageable. It's been fourteen months since my second HT, and it's the same story this time. I'm looking forward to hearing about your results in the next six months or so. Best of luck!

Update 4 HT2 + I year, 49 days I let so much time elapse since my last update in order to provide the most accurate information possible. During my reporting of my first HT, occasionally I jumped the gun in outlaying the results, not having waited enough time to let things develop. For this one, I made sure I gave it enough time for a truly accurate account. Let me start with excerpts from an e-mail I sent my surgeon, Doctor Jerry Cooley, and his staff: ________________________________________________ As far as the dedication, skill, and efforts of all of you, I never stop singing your praises. In terms of technical surgical skill, obviously, Dr. Cooley, I am in no position, in education or experience, to grade you against the other surgeons listed in the Hair Restoration Co?¤lition--for my money, whatever differences there are in the skills of the Co?¤lition members are so thin as to be negligible. But from personal observation, I am convinced that no-one could find a better hair transplant surgeon than you. Speaking to your skill as a surgeon, I know this: my hair transplants have been undetectable. Now, I have not made a secret of the fact that I have had hair transplants and most of those in my circle are aware of that. But one thing that tickles me is that those who were not plugged into the grapevine immediately assume my new crop of hair is the result of Propecia or some other hair-restoration pharmacon. They are surprised to learn that it is the result of transplants, so natural does it look. Speaking to your sense of the ???¦sthetic, this is one area that I would unhestitatingly rate you the best of the best. The hairline you designed for me was perfect. Not only was it age-appropriate, it was precisely in keeping with what I had envisioned for myself. That is the aspect that tickles me the most about my HT's when I look in the mirror. Were I to have unlimited donor hair (and an unlimited wallet), I would not alter the hairline you designed for me one whit, only, naturally, thicken what you have already provided . . . . Speaking to the intangibles of you as a physician--character, ethics, personality, your "bedside manner"--this is another area where I would rate you as top of the line. I have never enjoyed a better experience with you or Ailene or the rest of your staff than with any other physician, military or civilian--and if you knew how favourably I compared military medicine to civilian, you'd know even more how highly I regard you. I have no doubt that, given the number of grafts and my degree of balding, no other surgeon could have given me better results than you, nor made the entire experience as enjoyable. You maximised my gain in all of the tangible and intangible aspects. If it sounds like I am laying it on thick, I am not. This is a candid appraisal of your work . . . . One of the things that first and most impressed me about you and Ailene is that you did not give me, either deliberately or inadvertently, any false expectations or overly optimistic prognoses. Your estimations of my probable results were dead-on. You gave me the straight scoop, and I appreciated that from the get-go. And don't think I am unaware of how uncomfortable it is for a medical person to offer a patient any predictions--there is the looming risk that an unreasonable patient will build those predictions into an overly optimistic expectation of results, and then, when the results fall short of that ideal, the patient blames the doctor and his staff. So I am aware of the courage that it took for you and Ailene to even advance a prediction in my case. I am thankful that you trusted me enough to do that, for that was the only way I could make an informed decision to go with hair transplantation . . . . In short, what you have done--and this is no small accomplishment, given what disadvantages you had to work with--was turn me from a "bald man" to a "balding man". Whatever is left to be accomplished, at least I can no longer be described as "the bald guy over there". You probably know what a tremendous boost in self-confidence even such a relative improvement is. (Self-confidence I feel 90% of the time, until I see some 80-year-old man with a head of hair so thick you couldn't get a comb through it. #%@%$#@#! gene pool.) Bottom line: I made the right decision to go ahead with hair transplants; and I made an even better decision in selecting you and your staff as the professionals to perform it. In fact, I couldn't have made a better one, there. There aren't enough ways for me to thank you for what you have achieved in my case. In report-card terms, you get "A's" in all subjects. Thank you, thank you all, for your hard work and dedication on my behalf. ________________________________________________ What I exorcised from the above were my comments about how difficult a patient I was, given my degree of baldness--I was a Norwood VI--and basically average in all of the characteristics that a HT patient has (density of donor hair, thickness of individuals hair, laxity of scalp). That meant I fell short of my original goal--and a modest one it was--even after two HT's. However, the culprit there is Nature. What Dr. Cooley achieved in the face of me being so short-changed is nothing short of remarkable. Viewed from the front, my goal was reached. The hairline Dr. Cooley designed for me was perfect for my age and desires, and that alone is a big moral booster. It is when viewed from the sides and the back that I fall short. Dermatch, lightly applied--just enough to reduce the contrast between hair and scalp--does an excellent job. I even have enough hair in the crown--thanks to my decision for my first HT to have the grafts distributed all over my balding area--for Dermatch to make a difference. No, it doesn't come close to concealing that big honkin' balding spot, but it helps blend my hair and the spot doesn't stick out like a sore thumb. The information I want to disseminate here goes mostly to you Norwood VI and VII fellows: unless you are lucky enough to be of those guys with absolute ideal characteristics in terms of available donor hair, no, you aren't going to regain everything. But what you do get back makes a tremendous difference. Especially when you consider the fact that no-one else really looks as hard at your hair, or lack of it, as you do--unless you are completely bald. Then, everyone notices. So, my experience has been, even a modest, incomplete gain has a big pay-off. (Of course, I'm 50, and the remaining balding areas are easier for me, and others, to accept. If you are 30 and a Norwood VI or VII, yeah, that's a tough row to hoe.) If, when you read my e-mail to him, you thought I was laying it on a bit too thick, believe me, I was not. Within five years, I will be able to go back for a third HT. In the meantime, I am determined to find some more tangible way to express my gratitude to him for his efforts and generosity on my behalf. And that's the way it is. Good luck to all of you, both my fellow HT veterans and those of you considering it. And for those of you considering it, I hope something I've said in my posts has been informative to you.

Like many of the others have commented, it's personal choice, really--whatever you are most comfortable with. I can speak only to my own experience, of course. I underwent my first HT three years ago. (I've had two more since.) The day I had the surgery, I tossed away the hairpieces I'd worn for twenty years (not the same ones, of course LOL) and never looked back. I made no secret of the fact that I had undergone a hair transplant--I clearly told everyone at work why I was taking two weeks off. I decided that "in for a penny, in for a pound" was the way to go. I have to confess to a certain bit of trepidation that first day I walked into work after having the HT. (I was a Norwood VI and, of course, all of the new hairs had shed.) But I did not hear a single negative comment. In fact, I heard some positive ones from some who congratulated me on my boldness. Since then, while I don't advertise my HT's, I make no secret of them, either. And to anyone who expresses interest, I'm glad to discuss it. One thing I've noticed is that many folks still persist in holding onto the old "hair plugs" concept, and it's good to dispel that outdated thinking. Naturally, the bald guys are the ones who show the most interest, and here too, I have a chance to educate. One particular co-worker is worse off than I was--he's a definite Norwood VII--and is greatly interested in HT possibilities. Naturally, he needs to understand what is realistic for his degree of baldness (He's not going to look like Elvis, no matter how many HT's he gets) and how the procedure works and the costs--all of it. And that leads to one of the more satisfying benefits of "going public" with an HT: it's an opportunity to educate people, not only about the modern level of hair-replacement surgery, but to be able to steer them away from the hair mills, like Bosley and MHR. Since my hair has grown in, I've gotten plenty of compliments, which has been morale-boosting. (An HT patient tends to be more critical about his results than objective on-lookers.) The first time I heard a co-worker mention my new growth (after my first HT, which was barely the first step), she was complimentary, and I thanked her for being the only one to notice. She told me that, indeed, everyone did notice--she was just the first one to say anything. Of course, that was my experience. And since the second HT provided even more improvement (not quite enough for me--I still have that big honkin' balding spot in back--but nicely done in front and on top, especially with the aid of Dermatch), the whole thing is well received by my circle of friends and co-workers. Your situation sounds very similar to mine, and I'm glad to hear that. Objectively, I feel that taking the tack of not actively talking about your HT, but being frank about it, if asked, is the least burdensome way to go. Hope this helps.

If I may, let me jump in with my Dermatch experience. I started using Dermatch about two months ago--the seventh month into my second HT. I apply it to my forelock and the rest of my hair in front and top. My crown, from about the imaginary line from the tops of my ears, has too little hair for Dermatch to be effective. After some trial and error, I've worked out the application amount and method that works for me. The instructions state to apply the Dermatch liberally with a damp applicator. "Liberally" is subject to interpretation, but for me, "liberally" does not mean to go hog wild. I did that the first time I tried it, and my scalp looked like I had spray painted it. After I dampen an applicator, I apply enough to thicken the hair and get a light painting of my scalp. (I try to do one small spot at a time, but if I accidentally overload the applicator with Dermatch, I'll spread it out over the entire area I want to cover.) I avoid letting any of the initial Dermatch coating get near my hairline. Immediately after the application, I take a dry applicator and use it to even out the application. This is also the time to smear some of the Dermatch out to the hairline. You need to be delicate here. Subtlety is the key. You don't want a "paint line" at the hairline; it's a dead giveaway. Ideally, at the hairline, you want just a hint of the Dermatch. An ever-so-slight amount to just diminish the contrast between hair and scalp slightly. I cannot overstress the need for real restraint at the hairline. Even a slight bit too much, and it looks like a smudge of dirt. That's the real purpose of me using a dry applicator--to "fuzz up" any obvious "paint lines" and to remove any excess Dermatch at the hairline. (If you overlook some spot that has too much Dermatch showing and discover it later, you can use a fingertip to remove the excess. Again, we're talking about a delicate touch, so you remove just the excess and leave just a tiny shade of the Dermatch in place. Rub it too hard, and you'll remove all the Dermatch.) After I hone and tweak the Dermatch application with the dry applicator, I run a brush through the whole thing. This evens out the application even further. This is not going to be the final styling; it's just meant to give you an idea of what the application is going to look like. This is where I do any final touch-ups--removing any remaining excess at the hairline, or adding a touch more, usually at the top, if I've missed a spot. After the Dermatch dries, then I brush and comb my hair for style. As I said, there was some trial and error, at first, while I experimented to see just how much Dermatch was right to apply in my case. At first, I tended to go too heavy, but learnt to back off. A couple of times, I got it too light (too light is always better than too much, though). But I finally got the right amount down. I've got the application process down to five minutes or so. If it's part of your daily grooming regimen, such as in getting ready for work, then you can start with the application, then shave and brush your teeth and so forth. By that time, the application will be dry and you can comb and style your hair. I've found that the only thing which really affects an application of Dermatch (besides soap and water to remove it) is friction. That means it is going to come out when you sleep, from contact with your pillow. (It hasn't seemed to noticeably soil my pillows, however. Probably because, when it's dry, it tends to flake off in minute particles.) Again, my experience has been, even after sleeping, one application will be good for the second day, but not after that. Again, people are different--different densities of hair, different areas of application, different sleeping habits. So you may find circumstances to be different for you. A few other random observations in my use of Dermatch . . . . I don't have the messy residue left on my sink, like Robert experienced (at least at first). I think this goes to the fact that I don't have to apply as much Dermatch as many do. I want the Dermatch damp, but not soaking wet, so very little of it (ideally, none) drips off the applicator onto the sink. One drawback I've found in Dermatch in my case is that I have salt-and-pepper hair. I asked the Dermatch people about this, and they recommended to blend the "parent" hair colour--in my case, dark brown--with white. I've done this, and it doesn't result in a salt-and-pepper application. It results in a faded version of the parent hair colour. It works, but I'd much rather be able to replicate true salt and pepper. I don't think any concealer can truly do that, though. In my opinion, using Dermatch sparingly is the key to the optimum result. If you discover you've used too little, you can always apply a second coating. But if you use too much, it's tough to bring it down. Even though it does thicken the individual hairs, what you are really going for is a reduction of the colour contrast between hair and scalp--especially, if like me, you are dark haired. It doesn't take that much to accomplish this. Probably because I am so discreet in my application, I've never had a "reveal" problem in sunlight. In fact, I've found that if I've applied it right, the brighter the light, the less noticeable it is. Occasionally, when I check in a mirror over the course of the day, I discover that I've left too solid of a line,such as at the hairline. As I mentioned, a quick smudge with a fingertip takes care of that. That's been my experience with the product. Of course, someone else's mileage may vary.

I was as open about my two HT's as Hoping. I had no compunction about stating that was the reason why I took two weeks off work both times and have been completely open about it. I know my new hair growth has been noticed. (I had a co-worker whom I see infrequently comment on how well the new growth was coming in; I replied that I was surprised that she noticed. She told me that lots of people did, but just didn't comment on it.) But I've gotten few questions about it. My feeling about it has always been--in for a penny, in for a pound. After my first HT, I did away with the hairpieces I had worn for twenty-five years and never looked back.

Bobbo, I can address the topic of grey hair, at least from my personal situation. First, continuing on with the skin tone/hair colour characteristics that the B Spot raised, the conventional wisdom also stipulates that fair skin and light hair colour creates a better illusion of fullness. Thus, if one's hair was all grey or all white, and his skin is fair, then it is to his advantage. In my case, I have salt-and-pepper hair--about 60% grey/40% dark brown--and my skin is fair. That creates--at least, in my case--curious problems with perception. Like most men greying naturally, the hair at the back of my scalp is the last to relinquish its natural colour--and, naturally, this is also the area from which the donor hairs are taken. This, in and of itself, does not create a cosmetic problem when transplanted; while the hairs harvested from that portion of my scalp are still more brown than grey, the difference wouldn't be enough to make it stand out when it grows in on the top of my head. The problems created by salt-and-pepper hair manifest during the growth period. And they are purely problems of perception. During the growth period of my first HT, I noticed that in bright, but indirect lighting or lighting from the side or back, the newly growing grey hairs tended to "wash out", making only the burgeoning dark hairs readily visible. Since the transplanted hairs hadn't yet matured, the dark hairs were not individually thick enough, nor collectively lush enough to provide contrast to the grey hairs. This, of course, created the illusion that less hair is growing than actually was, because I only readily saw the dark hairs. However, in bright direct lighting, particularly when overhead, such as on a sunny day, the light tended to reflect off the grey hairs and wash out the dark ones. Since I had fewer transplanted grey hairs than dark ones, this made it seem even sparser. The good news is, now that the hairs from my first HT have matured and the hair from my second HT are now, after four months, starting to fill in, the dark hairs are getting substantial enough to start providing contrast for the grey hairs, and the "wash out" effect is subsiding. I would imagine that when it comes to concealers, salt-and-pepper hair would be a problem, as well. Concealers only address one hair colour at a time, and I would think that one whose hair was greying would have to opt for either covering the grey with a concealer of his original hair colour or "go grey" using a grey-coloured concealer. I don't use concealers as a rule, but I have experimented with them, to test the results. Using a concealer of my original dark brown colour is less satisfying. I look a bit younger by getting rid of the grey, but it doesn't provide that much of an illusion of more thickness. (It's still too soon for me to be to expect a serious improvement with concealers, anyway.) When I apply a grey concealer (actually "white") to my hair, my appearance ages a bit (but at the age of 50, not enough to make a serious impact), but it does a better job of making my hair seem more robust--again, because of the low contrast between my fair skin and the light hair. And we're talking relatively, here. Even "going grey", no-one is going to look at me and say "Wow! Look at that full head of hair!"

"How you appoach the shaved head is a personal choice." Zerro, Hairbank summed it up with what he said above. Just to offer you my take on it, for what it's worth, when I decided to take the plunge with my first HT, back in September of 2004, I decided "in for a penny, in for a pound". In other words, I wasn't going to waltz around with trying to hide what I was doing or worry about people's reactions to it. When I took the time off--both times--for my first and second HT's, I told my bosses exactly why I was taking it. I got rid of my hairpiece. Both times, I buzzed my natural hair down so I wouldn't have to worry about cutting it for awhile, even though that meant my suture scar would show for several weeks, until it healed. With regard to having the hair from my first HT shaved down for my second HT with Doctor Cooley, I didn't even think about it. For that matter, I wasn't even aware of the information from Doctor Hasson that Pat posted here. I went ahead and had it shaved down. To me, it just stood to reason that, if shaving the hair from my first HT would make Dr. Cooley's efforts on the second HT easier, then he could do a better job of it. In my case, I suffered no shock loss in the hair I received from my first HT. It hasn't been quite three months since my second HT and I'm only now beginning to sprout some of the new hairs, but my first-HT hair grew back in a matter of weeks and, if anything, it looks healthier and more manageable than it did before it was shaved. But, again, that was just my preference. I fully understand that others may be more sensitive about "going public" with their HT's or, perhaps, are in an occupation where it is not as desireable to have the tops of their heads shaved. I do believe that it is better, on the whole, for the recipient area to be shaved down, but at the same time, not shaving it wouldn't have any fatal results. Like Hairbank said, it boils down to what works for you. And best of luck with your HT!

HairHope, Thanks for the good word. I think you will find it easier, with the second pass, to undergo the waiting. Living through the first HT is demystifying. The first time, you wonder what the final result will look like. You wonder, at the various stages, if your hair growth is progressing as it should. You wonder why some grafts seem to be growing just fine, but other grafts right next to them don't show any growth at all. Now, after living through it, most of those questions are non-issues; you know the answers. I was fortunate, during my first HT to have Doctor Cooley's head nurse, Ailene Watts, available to answer all of my questions. She had the patience of a saint. I must have asked everything under the sun, and every time I thought I had asked my last question, I'd think of one or two more the next day. And she answered each one patiently and accurately. This time around, except for one time, with regard to my concern over the irritation in my scar (due to the sebaceous cyst), I haven't had a single question I need answered. So, barring something completely unexpected, you will experience a lot less anxiety over the course of the second HT's growth.

Doc, The conventional wisdom is that growth of transplanted hair in the crown and the back lags behind the growth rate of the hair on top and in front, and that was my experience. To be specific, it helps to separate the crown from the back of my head. The hair growth on the back of my head lagged behind the growth on the top and front by about two months. At the crown, it was even slower. Only in the last few months has any hair grown out in the crown that made a real cosmetic difference. In the back, near the bottom of the balding area, the hairs are now thick--individually, not in terms of density--and do a decent job of "closing up" the balding area, oh perhaps, a little less than an inch. In fact, that seems to be the case all the way around the crown and back. The hairs near the fringe area of my non-transplanted hair seem to be fuller than those in the centre. But now it's clear that there is hair all over the balding area in the crown and back. As I said, it's not enough to disguise the baldness, but it's a real psychological lift to feel the hair back there. And when the hair from the second transplant grows in and gets long enough, I will be able to comb it back and get something of a gradiated blend, rather than a stark shift from hair to baldness. So, the bottom line, at least from my experience, is that, when dealing with the crown and back, it's best to add two-to-four months to the usual milestones in the time line for hair growth following an HT. Hope this helps.

Update 3 HT2 + 79 Days Time to bring everyone up to speed on the progression of my second HT by Doctor Cooley. First, some old business from my first HT: As I have mentioned--probably ad nauseam--I was a Norwood VI and had the 2,500 grafts from my first HT evenly distributed over all of my balding area. My main purpose in that was that, in my case, I could not stand the idea of having a decent amount of hair up front and a big shiny bald spot in back. I had to have some hair in the back, even though I knew it would be sparse and hardly mask my baldness. Of course, the cost was sparse hair all over, and as time progressed following the first HT, I realised just how much I had overestimated the results, in terms of density. In the elapsed time since my second HT, I have taken away the following lessons from the first one, and they are all positive. First, even after the end of the "golden period"--months seven, eight, and nine--when all of the transplanted hairs usually have sprouted, that is not the end of improvement in the transplanted hair. And that improvement, while not as thrilling as seeing even more new hair sprout, is significant. After the "golden period", the transplanted hair will continue to thicken by individual shaft. Moreover, it will gradually lose that "Chia pet" look and begin to take on the aspects of hair that normally grows on the top of the head. When Dr. Cooley performed the second HT, it made the procedure easier to let him shave off the hair from the first HT. (In the front and top; for the second HT, I had the grafts transplanted in the more traditional fashion for men high on the Norwood scale: front-loading at the hairline and on top.) By now, the hair from the first transplant has all grown back, and having it gone for a brief period enabled me to view the stark transition more readily. All of the hairs from the first HT have plenty of body and are much more manageable. A brush puts most of them in place, and they look robust, not like the dying-through-dwindling hairs of a balding man. Certainly, there is still a lack of density and is too sparse to accept alone. And this is where there has been a neat turn-around in my spirits. Before my second HT, the sparseness of the hair was a disappointment--expected, but still a disappointment. However, now that I've had the second HT, I know that the hair from the first HT is there to provide an even fuller look after the hairs from the second HT begin to grow. It's kind of like having a leg up, as it were, and I'm very glad for what is there, even as sparse as it is. It's a nice turnaround in morale. Lastly, there is no sign of any shock loss at all. I have all of the hair that was there before the second HT, and if anything, it looks healthier than before. As for the hair transplanted to the crown and back in the first HT, it has continued to grow and thicken, as well. Certainly, that area is still going to look mostly bald, but having at least some hair there is a great morale booster for me. And, when the hair from the second HT grows in, it will be easier to blend in the back by having at least some hair there. At least, there won't be an abrupt stop from "hair" to "no hair". On to new business: Naturally, at this stage, there is very little to report with regards to the growth of the second-transplant hair. Like the first time, a few hardy sprouts have appeared, but nothing that would make a cosmetic difference. If it follows the same pattern as last time, I won't begin to see any growth that makes a significant difference until somewhere between months three and four. As to the strip scar, this has been a thing in which I have taken especial interest. The first time, I scarcely gave a thought to the scar. I finally took the time to notice it at about the third month, and I saw that all of my hair had grown back around it. I keep my hair at about 1/2-to-3/4 of an inch and my hair completely masked the scar. If I separated the hair, the scar was visible as a thin red line. However, within two-to-three months, that line had faded almost to invisibility. I can't even find the first scar now, and I know where it should be. Between my first HT and my second, Dr. Cooley had gone to using the tricho-closure method. At first, I developed a few concerns about that. Where I had not even noticed or cared about the scar the first time, my attention seemed to be more focused on the second scar from the start. Three things concerned me in the fourth week or so. First, the skin in the area of the scar seemed raised to my touch, and there even seemed to be a little "lip" of skin that wasn't there the first time. But I couldn't be 100% sure because I had paid so little attention to my first scar at the same stage. Also, it looked like my hair wasn't growing back around the scar, as it did the first time. But again, I couldn't be sure. One thing I was sure of was that I was suffering from some sort of inflammation on one side of the scar. I went in to see Dr. Cooley at about the fifth week, and he discovered that the source of that irritation was a sebaceous cyst that had formed under the skin at that part of the scar. I have naturally oily skin and, it develops, that such a skin type lends itself to such cysts. Dr. Cooley removed the cyst and the irritation was gone. Since then, all the hair has grown back and the scar is not noticeable at all, even when I ruffle the hair. I have to part my hair to find it. When I do that, it is still recognisable as a scar, but much less conspicuous than in the first few weeks. I'm not sure if it is healing at the same rate as my first, but the most important thing is that it is well-hidden by even my short hair, and that's what matters most to me. At the same time, the slight raising of the skin that I felt in the first few weeks has gone away. Running my hand casually through my hair in back does not detect anything. It seems most of my worries there were premature. Time will tell if the second scar winds up as invisible as the first one, but in any event, I'm no longer worried about it. And that is where things stand at present. The one lesson to take away from all this has been to re????nforce what I have said all along about the experience of having an HT: Patience--patience--patience. Even after all of the grafts have sprouted, there is still a great deal of improvement to follow. Not as dynamic, perhaps, as seeing all those new hairs grow in, but there is still some improvement coming, even more than a year later. Good luck to all of us going through the same thing!

For you, ragz, and Island Girl and Captain 123 and what else . . . and any other female lurkers on this board: I can well imagine that hairloss is more embarrassing for females than it is for men--as much as we balding guys hate it, at least, society sees nothing unusual about men who lose their hair (and that's probably the only bone society tosses bald guys). But one of the chief functions of this board--besides trying to get out the best information possible--is to serve as a forum of mutual support. No-one who comes here, either male or female, will find anything but sympathy and support. Even those few posters here who decry hair transplants completely are attempting to help and not demean. Yeah, we're primarily a "men's club" here, but that's because nature has decreed that most hairloss sufferers be men. But, if there's any place that a female losing her hair can come to for information and support without fear of stigma or embarrassment, this is it. Good luck to you all on combatting your hair loss!

You might have your HT surgeon take a look at it. Even though it was 'way too early to be able to guess at the final result, a few weeks ago, I thought I detected a problem with the healing of my scar from my HT on 16 January this year, and asked Doctor Cooley to take a look at it. As it turned out, I had developed a sebaceous cyst in the scar. Dr. Cooley was able to remove it right then and there. Obviously, I have no way of knowing if you have the same sort of thing, but it's certainly worth having your HT surgeon take a look at it.

Setting aside the question of whether or not body hair would (eventually) blend in with one's scalp hair, is there any reason why an HT surgeon couldn't use the strip method for harvesting body-hair grafts for transplantation to the scalp? Granted, one would realise less donor hair from a strip taken from the body (although with my abundant chest hair, I'm not certain it would always be that much less). But on the plus side, more, and longer, strips could be taken, and, though I cannot speak for others, I would be far less concerned about the resultant scar(s) on my body than on the back of my head.

Thinkingaboutit, As I said in my post to ifloss, all patients are different,so there are no guarantees. But if you are the typical patient, you should be able to return to work after two weeks with no trace of your HT visible. I went back to work after two weeks following both of my HT's and there was nothing visible to tell anyone that I had had them. (Not that it mattered in my case; I was quite open about the fact that I had had HT's performed.) The ocean-water thing is a new one on me, so I am not qualified to tell you if it sounds ridiculous or not. But, as long as it does no harm, there's no reason not to give it a whirl. Good luck with your HT with Doctor Cooley. You couldn't be in better hands.

Ifloss, It doesn't surprise me that you have experienced early growth. After my first HT with Doctor Cooley, I saw the first burgeoning new hairs sprout at six weeks. Certainly nothing that made a cosmetic difference, but it was enheartening. After a few weeks of seeing nothing--even though one knows intellectually that he won't--it's hard to shake off the feeling of "What the @*%#@#! did I spend all that money for?" I'm at the seven-week point of my second HT from Dr. Cooley, and again, I'm beginning to see the same trace new growth, and again, it's a moral boost. One thing I should note, though: early growth does not imply consistency of growth. In other words, the new hairs you developed now may be the only ones you see for several weeks, before the next bunch of hairs push through the surface. Even for us "early sprouters", the conventional wisdom remains true: the growth really won't take off until months seven through nine. I am particularly interested in following your case, ifloss. Of all of Dr. Cooley's recent patients (some of us in for a second pass), your original degree of baldness most closely mirrors mine. In my first HT, I had the 2,500 grafts dispersed over my entire balding area. It gave me sparse but healthy growth all over. For my second HT, I got 2,550 grafts placed in roughly the same pattern as you did. The only difference is, I opted for more recession at the "sides" of the frontal hairline, giving me more of an advanced widow's peak. I'm 50, and that seemed more appropriate for me, and it freed up more grafts for density on top. I've got a bit of an advantage since I have 1,000-to-1,200 grafts from my first HT in that area already, so I'm hoping for a real cosmetic improvement. But I'm using your hair growth as something of a benchmark for me (although each patient is different, so it's not guaranteed we'll have the same results), so you better believe I'm rooting for you to have great results! Glad to see your early growth, and good luck with the rest of the crop!

Update 2 HT2 + 22 days Nothing much to report at this stage. As expected, the transplanted hairs have continued to "jump ship". Most of them are gone now; however, some hardy souls are still there. It's difficult to estimate how many since they are masked by the hair from my first transplant which is now growing back after Doctor Cooley shaved it for my second HT. But I see more hair in front and on top than I did before the second HT, so I know some of the hairs from the second HT are still with me. The suture scar seems to be healing on schedule. The suture line itself felt a bit more raised to me than the first time (it's difficult to remember how the first one felt at the same stage last time), and I am attributing this to Dr. Cooley's use of the Trichophylic closure on me this time. In any event, the hair seems to be growing back and filling in the area, at least at the same stage it was the first time. So I expect no problems in that area. Just for the record, I went back and documented the number of us posters on whom Dr. Cooley has performed HT's in the last two months: 08 Dec 05: Nashville Kat (second pass) 20 Dec 05: tntiger 04 Jan 06: Prospicience 12 Jan 06: Maximus 13 Jan 06: ifloss 18 Jan 06: me (second pass) 03 Feb 06: Robert (second pass) 08 Feb 06: daytrader That's quite a number in such a small period of time. It's nice to have that many fellows going through this thing at the same stages that I am. (Although all of you guys started with more hair on your noggins than I had, so I'm going to be envious of your results.) Good luck to us all!

Robert, Thanks for the good wishes for my wife. Actually, it's serious enough that she goes under the knife this coming Monday; but if the surgery does what it is intended to do, then--once she recovers from the "controlled trauma" of the surgery itself--she will be restored to good health. It's funny how the sedatives affect people differently. With me, I was simply nice and relaxed, and there was a sense of "time compression", but I don't recall drifting off. Then, again, there was nothing which forced my attention, either. Years of sleep deprivation at sea pretty much enables me to concentrate when I have to. However, speaking of concentration, yes, I did know that this was your second HT. I must have had a brain neuron misfire when I said "third". I'm glad everything went well for you last Friday, and you know the drill, now: "hurry up and wait".

Make that one more, Hair Apparent! That's right! I was back "in the chair" on Friday the 3rd for another round! Just like you said, we'll all be going through this together! Another near-miss! I was in Doctor Cooley's office the day before, having my sutures removed, and Ailene told me you would be in the next day. But I didn't know it was for another procedure, and I had neglected to ask her the time you would be there (not knowing it was for another procedure and that you would be there most of the day). Unfortunately, I am currently dealing with some medical problems my wife has developed and the time was tough to spare. But if I had known that you were also resigning from your position as moderator, I would have made the time to drop by. Your constant presence here will be sorely missed, my friend, and I regret not having the chance to drop by and meet you in person. Good luck on your third pass. With all the others, we comprise quite a "graduating class" of Cooley patients, indeed. We really must find a way to get together toward the end of our year's joint growth. Best of luck!

That reminds me of a bit I saw on The Tonight Show about thirty years ago, when Johnny Carson ruled the late-night hours. One of his guests was a comedian who, during his time in the chair next to Johnny, was relating a story of being at his hotel swimming pool and trying to make time with a beautiful girl. The comedian stated that he couldn't get to first base with this girl and grumbled that the girl must have had her eye on someone else, "probably some good-looking Italian guy who had just come out of the pool, his muscled body dripping and his hair slicked back by the water." Carson's very next guest was former baseball major-leaguer and sports-broadcaster Joe Garagiola--who had a scalp well into the Norwood VI classification. However, when Garagiola came out on stage, his face was dripping wet and what fringe hair he had was slicked back with water. Garagiola sits down and says "I just wanted to show [the comedian] was an Italian guy looks like when he just comes out of the pool." I must have laughed non-stop for fifteen minutes.

I've never read here of any HT patient retaining all of his transplanted hairs in the first few weeks post-op, but I would imagine it's certainly possible. If you've managed to hold on to all of yours, then--good deal! I still have quite a few of my transplanted hairs visible after the first week, but I can see that they are slowly abandoning ship. It's a bit difficult to tell, since this crop of grafts was planted more densely and some of it was the hair from my first HT, which I let Doctor Cooley buzz down to make the second procedure easier. I can live with seeing them go away, because I know they'll be returning in a few months. I was an "early bloomer" the first time, and lots of the hairs came back within six weeks. Maybe I'll be lucky again this time. Congratulations on what seems to be a good break for you though, Michael.

Dhuge, While it varies, naturally, from patient to patient, generally speaking, you are correct: all of the transplanted hairs fall out within the first days, as the follicles retreat into the telogen phase. Then, as you said, the hair will start to grow back in about three months. However, occasionally, there are some hardy souls that do not fall out but remain. Following my first HT, I had maybe 5% of the transplanted hairs stick around for the long haul. The transplanted hairs from this HT began to fall out--at least to the point I noticed--at about day five. To-day, I've noticed even more "jumping ship". No doubt the rest will follow soon, except if I have any stubborn ones, like last time.