Hair Apparent

I've got to echo Robert's comments on Doctor Cooley. I've been impressed by his operation every step of the way. "?? By the way I got straight answers from Ailene during my virtual consultation and at my first visit to the office. I wasn't promised the sun and the moon and the sky, but got a realistic projection of what could be done for my level of baldness and condition of my remaining hair. "?? By the way Dr. Cooley, Ailene, Brandi, and the rest of the staff performed minute, painstaking work for almost twelve hours straight--not even a break for lunch. It was arduous for me, and all I had to do was lie there, so I can guess how demanding it was for them. Dr. Cooley was there the whole time, except for about fifteen minutes when something called him away. "?? By their post-op attention. They have been as indulgent with me after the work as they were before. I'm a fretter, and I've peppered Ailene with dozens of questions for the last six months, and she has answered them all with straight information and with good nature. "?? Speaking of indulgence--and I posted on this before--I walked in unannounced once (my dentist happens to have the offices next to theirs) just to see if they would like to take a quick look at my progress. I figured it would be a quick in-and-out, if they had time for me at all. Instead, I was ushered in and spent a good twenty-to-thirty minutes with Ailene and Dr. Cooley, while they took notes and studied my development closely. It was as if they had had nothing better to do--though they did--than to spend time with me. As I said before, when was the last time one saw a physician drop everything to visit with a walk-in patient for anything short of a life-threatening emergency? "?? All of the folks there are genuinely interested in their patients' post-op progress. They are genuinely glad when the patient is progressing well and are as thrilled as he is; and they are just as concerned when the patient isn't feeling things are going as they should. "?? The quality of the work performed by Dr. Cooley and his staff is top-drawer. I have read many posts about poorly healing scars from the donor area, enough to know that that is a real concern. But even though I had a pretty long scar--from ear to ear--it is virtually invisible now; just a razor's edge of a slightly brown line. The hair has grown back all around it and even I have trouble finding it, and I know where it was. The pattern of the hairline that Dr. Cooley devised is perfect for my age and shape of my head, and the transplantation of the hair was perfect. At this immature stage, it looks simply like the hairs remaining on the head of a balding man--and more are sprouting on a weekly basis. So far, the only negative aspect has been my concern that, after a strong initial development, my growth has slowed. I'm a week away from the six-month point, and I had expected to see a bit more than what I do. That's not a reflexion on Dr. Cooley's work; I have no doubt that he maximised my gain. But I have a sneaking fear that I was not as good a candidate as I hoped I would be, even with my modest expectations. The thing is, I don't know how much of my self-evaluation is emotionally based--from the natural impatience--and how much is logically based, from comparing my development with that of photos on line of others with similar degrees of baldness and a similar number of grafts. And I don't even know if my logic is accurate--this is one of those cases in which I don't know what I don't know. I brought up this concern to Ailene six weeks ago and she told me that most of their patients expressed the same doubts at the same time-frame in their HT's. She counselled me on the same thing I have counselled everyone here--patience and give it to at least the ninth month. Next week I have another dentist's appointment, and Ailene invited me in to their offices afterward, to have a look at my progress. I'm sure I'll get the straight scoop then. Let me add, to make things clear: I've experienced steady, increasing growth of the new hair all along, with new hairs continuing to sprout. I'm just beginning to wonder if the amount of baldness to cover and the quality of my hair was such that it won't make much of a difference. I wasn't looking for, nor did I expect to have an Elvis head of hair, but I was hoping for a significant change. Most likely, though, I am just over-worrying, as I am a worrier by nature. In any event, none of that reflects poorly on Doctor Cooley or his staff. His work is top-notch and his dedication and loyalty to his patients is even greater. And to go on record again, no, I am not associated with his office or compensated by him. My comments stem strictly from my experience with his office as a patient. There are many good HT surgeons out there, and I'm in no position to rate who's better than whom. But I do know, it would be difficult to find one better than Dr. Cooley.

Let me add my congratulations to the others, Kat. You received an excellent hairline for your age and you should be quite pleased. In fact, it's the same hairline Doctor Cooley reconstructed for me. We're close to the same age; I'm 48. And we received the same number of grafts. You have an advantage over me, though, as you have more hair on the sides and back than I did, so you're going to have a much better result on the first pass, and that's great! Your scar, at six weeks, looks exactly like mine did at that stage. If it stays that true to form, in a couple of months, it will be virtually invisible. The only way you will be able to find it is because you know where it was. I keep my hair much shorter than yours and my scar doesn't show at all. You're off to a great start and I'm glad for you. (Also, a little envious of all of you other Cooley patients, since you all started off with more hair than I did. I drew the low card in that hand of the gene pool.) Best.

Nashville, Glad to hear everything went so well--though it doesn't surprise me. As you pointed out, that seems to be the case with each of Doctor Cooley's patients. Your experience certainly echos mine and exceeds it in some ways. Dr. Cooley really does seem to have a master's touch. My head was never that red, either, nor did I experience any swelling. And like Brando, my scar is virtually invisible. The only reason I can find it is because I know where it is, and even then, it usually takes me three or four efforts and a hard look to see it. Good luck with your new hair! Now comes the hard part--the wait.

Wantitback, I have often counselled patience to relatively recent HT patients here. As I have discovered, sometimes it is the "doctor" who should take his own "advice". One would think that it is in the first few months following an HT that one's patience would be the most strained. After all, he just spent a scad of money for the procedure and he still looks just as bald as he always did. I found out that isn't the worst time for impatience. I was lucky enough to see early growth; new hairs began to sprout on my head at about the 7-to-8 week point. I'm a few days shy of my 5-month point and I'm seeing hairs sprout all over the place, now. Here's the thing: standing in front of my mirror shaving, I can see the new hairs sprouting all over the place and it tickles me to death. But, if I take a couple of steps back from the mirror, or if I catch my reflexion under harsh, indistinct light--like in the kitchen window at night--all that new hair "disappears". Against all intellect, I couldn't help wondering if this was "it". That it was never going to get any better than this. I fired off an e-mail to Doctor Cooley's office, explaining my current state. His head nurse, Ailene, told me that they receive a great deal of similar questions from their patients right at this stage of their HT's--the 4.5-to-5 month point. She explained that, even at 5 months, most of the hair you see is still at the immature stage and hasn't reached its final thickness and growth. Moreover, there is still plenty of hair that hasn't "broken the surface" yet. It takes at least three cycles of growth, or approximately 9 months before an HT patient begins to see enough growth to estimate the final result, and as Robert said, it will be a year or even longer to actually see the final results. Bottom line: one needs to have patience for almost a year--and the waiting doesn't get any easier after the first couple of months. One has to get through the "Is it ever going to grow?" stage, and then through the "Is this all there is?" stage. Good luck with your HT, friend. It sounds like you're about to enter Stage 2. Just be patient.

Which reflects the situation I had to consider when I had my HT. As a Norwood VI, I was forced to decide where I wanted to concentrate the placement of the transplanted hair. Conventional wisdom insists that one in my position should concentrate the grafts on the hairline and forelock, to frame the face, and leave the crown and back bare, pending future HT's. By and large, this is sound advice, and it is, in fact, what Doctor Cooley originally recommended for me. My problem was this: I know myself well enough to know that, doing my HT according to that plan, even if I ended up with a satisfactorily full hairline and forelock, having that large bald spot in back would have bugged the hell out of me. And I'm not prepared to use any more of my disposable income for another HT for the next couple of years, at least. Knowing that, I came up with another plan. Instead, I felt that evenly distributing the grafts all over my balding area would work better for me. That meant I had to accept a couple of trade-offs. The overall density of the transplanted hair would be less, of course. To adjust for that, I would accept more recession at the temples than most HT patients settle for. As I have said, a photograph illustrates things much more clearly than all the verbal description in the world. What I had in mind was something along the lines of this hairline: I am approximately the same age as this man was when this photo was taken. Therefore, a more recessed hairline and an overall thinning would be age-appropriate for me. Once Dr. Cooley saw that I had reasoned out the whole thing and was willing to accept the trade-offs, he was on board with it, and in fact, designed a marvellous hairline precisely along the lines of what I had envisioned. As I see the hair now start to grow in my crown and back, even though it is at a slower rate than my top and front have been, I know I made the right decision--for me. I can also see that Propecia has already started to take effect; the diameter of the balding area in back has shrunk noticably. The only question remaining is will I be satisfied with the density of the transplanted hair. As I see it growing in now, allowing for the facts that there is still more hair to sprout and much of what hair I do see is still immature, I believe it will be--or at least very close. Which brings us back to the subject of cover-ups, like Dermmatch. Robert, you achieve remarkable results in using it, but I don't know if I have the patience to apply it with the attention to detail that you have. (Until the grafts grow in sufficiently to make finding a barber worthwhile, I still cut my own hair, and most of the time, I do such a slap-dash job of it, that it looks like a blind goat grazed on my hair.) The thrust of this is that, unless one is lucky enough to be balding low on the Norwood scale, one is not likely to get what would be cosmetically seen as "full density" on his first HT pass. He either is going to have a balding crown or back, or is going to have thinner density hair overall (if one does it like I did). I'm fortunate in the fact that age works in my behalf. It is normal for a man my age to have receding temples and an overall thin density. So I may be able to get away without using Dermmatch or some other cover-up (though I undoubtedly will give it a try). But for younger patients with balding noggins high on the Norwood scale, there probably isn't any way around using such cover-ups--except to have follow-on HT's.

Outstanding! I'm pleased for you. It's a great job! Doctor Cooley's name doesn't get bandied about as much as some of the other HT surgeons', but I would put him in the top tier. I'm coming up fast on the five-month mark on my HT from Dr. Cooley. I had a lot more to replace than you did, and right now my scalp is covered with transplanted hair sprouting all over, front, top, crown, and back. It's still mostly baby-fine hair, but then it's still a little early. If all of this fills in like it appears it will, I should be extremely pleased. I won't have a head as impressive as yours, Brando, but as Robert put it about another poster, it will shift me from "bald" to "thinning a little", and that's good enough for me. Again, great results, friend!

Northern, I was going over some of my old posts and I discovered that I did have a brain fart when I indicated how often I take propecia. I actually take it every other day. I don't know what I was thinking when I not only said, but reiterated that I was taking it only twice a week. (Except that probably I got it confused with my hypertension meds and toss in some wooziness from working all night before I posted.) Sorry if I added to the confusion about taking meds. I know it's not a major point, but I wanted to square the matter. Hope everything is going great guns for you. You're past the two-month mark now; you should be seeing some sprouts pop up any week, now.

Obviously, I can speak only to my own experience with Dr. Cooley, who did my HT on 16 September of last year. You may have read my own account of the experience and my progress. And my remarks echo those of every other person on this board who received an HT from Dr. Cooley. For what it's worth, I made the determination to go to Dr. Cooley before I discovered this board, so my decision was based on the factors I had discovered during my own leg work. It was my assessment that his background, attitudes, and humanitarianism made him an excellent choice. If I had found this board before that, it would have made my work much easier, but my point is, it was my independent decision to go with Cooley, not a jumping-on-the-bandwagon sort of thing. Of course, now, I readily jump on the bandwagon. One thing I have noticed about the surgeries that those of us have received from Dr. Cooley is that we've tended to show visible growth of the transplanted hair earlier than the touted usual time for this of three months. Of course, that's no guarantee that you will experience early growth--every patient is unique--but it's a pretty good track record. You've selected a dedicated, skilled surgeon who genuinely cares about the welfare of his patients and who is genuinely as thrilled as his patients are to see successful results. He will cheer with you when things go well; and he will be as concerned as you if there is a problem or if you have a worry. The same goes for Ailene Watts and the rest of his staff. I didn't follow any pre-op directions, since my operation happened so soon after I made the commitment to do it--two days later, in fact. But follow his post-op instructions to the letter. It's easier if you can take two weeks off from work following the HT, just because its easier to minimise your activity and avoid accidentally dislodging any of the newly placed grafts. Again, speaking personally, I experienced no discomfort at all after the first night. That first night included some mild aching, akin to a minor headache, and the Valium he proscribed remedied that. After that, I never needed it, again. The only sensation I felt after that was some itching in the areas where the grafts were inserted. A few sprays of a water solution that Dr. Cooley will provide you took care of that. I never experienced any swelling, and the redness was gone in a day or two. The scar was always minimal, and now, four months later, even with my hair a half-inch long, I cannot see it. If I start parting my hair with my fingers to find it, I have a hard time, even though I know where it is. The most important post-op recommendation I would counsel--and I believe so would Robert or any of Cooley's other patients--is: patience. No matter how intellectually you know the way things are supposed to progress, your emotions will still screw with your mind. Especially in the early stages. You won't be able to resist the feelings of anticipation and impatience, even though you know better. I still feel that way often now, even four months later. So just try to be patient. Time will cure nearly any worry you might develop. And Dr. Cooley or Ailene will be right there to counsel you if you do have a concern. Best of luck to you next Wednesday and here's to incredible results for you.

No, that's correct--twice a week. It is Doctor Cooley's opinion that there is little-to-no added benefit by using it more often. He stated that I could certainly take it more often if I felt like doing so. Since he hasn't steered me wrong yet and I've enjoyed better-than-average results so far, I didn't see any reason to increase the doseage. Patience is the key, to be sure. A year from now all these worries about how much our hair has grown out and how much more will there be will be replaced by the headache of trying to find a good barber. I can live with that. Best.

Northern, I am pleased to hear of your progress! I had my HT done by Dr. Cooley 111 days ago. Our cases are very similar. The extent of my baldness was just about the same as yours (except I didn't have the benefit of your forelock). I had 2,600 grafts transplanted, and my regimen has been Propecia twice a week and washing my hair with Nioxin every other day. I was one of the lucky ones to see early growth--at about six weeks following the transplant--but as Smoothy points out, new growth in the crown always lags behind, roughly as much as three months, the growth on the top and the front. At HT + 50 days, you have a long, long way to go, friend, and I sympathise. At nearly four months, I see the growth of the transplanted hair beginning to burgeon, but it is barely cosmetically significant at this point. (The growth in my crown now looks like my top and hairline did at six weeks.) In a way, the wait is almost more difficult now than it was in the first few weeks when there was nothing but skin. Seeing the hair grow in confirms that the operation actually took place, but seeing how sparse it is now does tend to be daunting. Intellectually, I know that it will grow in thicker and more prolific in the coming months, especially in months six through nine. But emotionally, one can't help expecting it to grow in like one's beard does--all of it there at once. It's that dissonance between knowing how it will grow in and how your mind wants to fool you that can be discouraging. Don't let it get to you. You're right where you are supposed to be at this stage. Actually, a little ahead of the game, I think. You've got lots of growth ahead. Best of luck!

T. M., Dr. Cooley did my work. If you run his name through the search engine here, you will find nothing but sterling comments on his work and professionalism. I, too, intend to have a follow-up HT to increase density--I have about 3,000 grafts viable in my remaining donor hair. So I can, in essence, "double up". But that won't be for some time; I don't like dipping into my disposable income again so soon after my first HT. So I was hoping that the results of my first HT would be sufficiently satisfactory to let me live with it for a couple of years. From what your results show, it probably will be. Thanks, again.

Telephone Man, I am grateful to you for the pics you posted. Naturally, I am glad for you to see the great results of your HT. Like Robert said, you go from being noticeably bald to merely thinning a bit. But it also excites me because you are the first person to have been at my approximate state of baldness and to have received about the same number of grafts I did to post pics so far into the process--at ten months. It's the first reasonably good picture of what I can hope to expect in my case. I'm fourteen weeks into my HT and I have good early growth, but I've got a long way to go--and of course, I keep wondering what the final result will be. There were some differences between you and me. I was a Norwood VI--balder in the crown and less residual hair on top than you. On the other hand, I got slightly more grafts (2,600) and settled for more recessed temples at the hairline to accommodate putting more of the grafts into the crown. Nevertheless, allowing for those differences, your pics give me a good idea of what my result will be, and I thank you for that. If, in ten months, my hair looks anything like yours does now, I will be tickled to death. Thanks for the encouragement!

Outstanding results so far, friend. It makes me even more excited over what mine will look like in four more months. If there is one good thing about baldness, it's the fraternity we have here from all of us being in the same boat. I'm glad for you, shipmate.

This is the usual recommendation by HT surgeons for graft placement, especially if the patient is in one of the higher Norwood classifications. The goal is to "frame the face" and break up that expanse of skin. The expectation is, if the patient so desires and if there is sufficient donor hair remaining, that a follow-on HT will address the crown. I was a Norwood VI and that was Dr. Cooley's initial recommendation. I had decided, though, that I couldn't live with a bald spot in the back, and opted to disburse the 2,500+ grafts of my first HT over my entire scalp. There are some trade-offs with this approach, of course. My frontal hairline was designed with more temporal recession than usual, and there will be thinner density overall. I understood this. I'm pushing 50, and at that age, a thinner look is perfectly natural looking and I saw that more tolerable than a denser front and a stark bald spot in back. My follow-on HT will then address overall density, rather than a specific location. That said though, there is nothing "wrong" about filling in the front with the first HT and filling in the back later. It's a matter of personal preference and age appropriateness. When Dr. Cooley knew that I understood the trade-offs involved, he was completely on board with my wishes and did a masterful job. Any good HT surgeon will work with the patient's desires, as long as the patient is realistic about what can be achieved. Most patients go the route you did, though, and that is perfectly fine. <BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>The anticipation is going to drive me crazy. How will it look? Ain't that the truth? The fact is, nobody can know for sure how his HT will look at the end, since each patient is different, and there are so many variables--quality and amount of the donor hair, the skill of the surgeon, vascularity of the scalp, and how well the patient heals. I do think that reasonable approximations can be foretold. Here again, there must be a keen level of understanding between patient and surgeon. Most HT surgeons will, naturally, be reluctant to pronounce how a patient's hair will look, out of concern that the patient will take that as a "guarantee". There are no guarantees. But if the doctor is satisfied that the patient has a firm grasp of the variables and is not looking for a guarantee, I think a reasonable estimation of how the new hair will look is not out of the question. That is one of the things that sold me on Dr. Cooley and his staff. Like all of us, I had scanned hundreds of photos of HT patients, and in the cases of patients with my Norwood classification and having received in the neighbourhood of the same number of grafts I was going to receive, I noticed wide discrepancies. Some had excellent results; others had acceptable ones; and still others showed results completely unacceptable to me. By that time, I established enough trust with Dr. Cooley and Ailene that I was able to ask for their best guess at what my own outcome would be, and they knew I wasn't asking for a guarantee, and I got a tangible answer. (That was one of the things that sold me on Dr. Cooley.) But, that's all it is--a best guess. So, like you, my anticipation is almost overwhelming. So I know exactly how you feel. All I can offer in the way of advice is--patience. I just went over the three-month mark since my HT, and I was lucky enough to experience early growth. My new hair started to grow in about seven weeks ago. Be prepared for some highs and lows. Even though I knew it would happen, after the hairs attached to grafts fell out and I was bald again, it was hard to get past the feeling of "What the hell did I spend all that money on?" Once I saw the new hair start sprouting, I was thrilled. But that bloom will come off the rose after a bit, too, after the first couple of weeks. The new growth isn't cosmetically significant yet, and you start thinking "Gee, I hope this isn't as good as it gets." Again, intellectually, I know better, but it's a human reaction. Just hang in there, friend, and try not to be too anxious. All of us, your fellow HT patients, are going through it, or have, so we know what you are going through. Best of luck on your new hair!

Marcelo, Congratulations on your successful HT! As a Cooley HT patient myself, I am not surprised at how great your experience was. Dr. Cooley is one of the hidden gems of the HT field. For whatever reason, his name doesn't get bandied about as often as some of the other highly recommended HT surgeons. Best of luck with your new hair! I'm sure you are going to be pleased at the outcome.

You might check out my topic "2,000+ Grafts from Dr. Cooley 16 Sep 04" under the thread "Hair Restoration Experiences". I detailed my experience with him, along with several updates, including follow-up visits. Robert (the Forum Moderator and Satisfied Patient) and Brando are others who have made similar posts regarding their experiences with Dr, Cooley.

Update 6 HT + 90 days To-day is exactly three months since I had my HT performed by Dr. Cooley. According to the conventional wisdom, this is when the new growth is supposed to become visible. But I was one of the lucky ones; my new growth became visible about six weeks ago. Since then, those vestigial hairs I saw budding have gotten longer, thicker and acquired body, and I see more new growth coming in where I didn't see it last month. I was vaguely concerned about two tiny bald patches among the new growth--one right at the front hairline and another at the top, a bit left of centre. But now I can see the barest wisps of new hair growing in those spots, so that worry is relieved. First note for HT patients in the early stages: time resolves a great many of the concerns over the work that was done. Certainly, mistakes can be made or something may not develop as you expected. But try to resist the first impulse and see if the perceived problem resolves itself in a month or two. Within that first year, you can still expect to see new growth where you didn't see it (but it was supposed to be there) before. I'm also learning that there are certain "road signs"--or informal visual cues--that mark the stages of regrowth. The first one--and the toughest--is after all of the transplanted hairs shed and you are bald, again. After a few weeks of that, it's difficult to avoid the thought of "What the hell did I spend all of that money on?" The second is when the first new growth appears. It's vestigial and doesn't make a whit of cosmetic difference, but it's exciting, because now you know it's kicking in. For me, the last few weeks have been an interesting visceral experience because I'm feeling hair--either with my fingers or when the wind blows it--where I haven't felt hair in twenty years. It doesn't take long for that bloom to come off the rose, either, since it seems to take forever for the new hair one is seeing to start to grow. The next road sign is the stage at which I have arrived: the earliest hair is taking fullness and body and more can be seen coming in. Cosmetically, it still isn't much of a difference: you will be very aware that there is new hair on your head, but most other people won't notice it, unless they know you well or they are very observant. This will be especially true if you were one of the lower Norwood classifications, but even for me, who had a Norwood VI dome, no-one else has noticed it, yet. The fact of the matter is, most folks, even the ones you see every day, just don't pay that much attention to minor changes in your daily appearance. The other thing to remember about this stage is that new hair growth won't be visible at all under harsh, indistinct lighting, such as a window-pane reflexion or a security monitor. That can be vaguely demoralising. Every morning when I shave, I do a visual inventory of the new hair. But the other day, I happened to catch myself in the monitor of a convenience store's security camera, and with the harsh fluorescent lighting and low resolution, it looked like I was back to square-one. My counsel here is just--patience. The next stage--and the one I am looking forward to greatly--will be the point when the new hair has grown in sufficiently to be noticeable to others. I expect for me that will be within one-to-two months. As I mentioned, after my HT, I stopped wearing my hairpiece and got little-to-no reaction from my family, friends, and circle of acquaintences. What little I did get was actually positive. I didn't make a secret of my HT, but I didn't broadcast it, either. If asked, I was more than glad to talk about it, but almost no-one has asked. I expect most of them, for the large part, just assumed I decided to "go bald". So I am looking forward to their reactions when they see significant hair growth on my head. And I expect that the "road sign" after that will be when the new hair has grown in to the point when it no longer looks like "new hair growing in" and it takes on the appearance of having always been there. That's the point that we all are looking forward to. Also, conforming to conventional wisdom, the new hair in my crown has taken longer to sprout. Since my HT, there have always been a few strands of new hair visible back there--the hardy troopers that didn't "jump ship" after the HT--but now, new growth is apparent to the eye. It looks pretty much like the top of my head did six weeks ago, perhaps a bit less. As for the scar from the donor site: to all intents and purposes, it's gone. There is no area of hairlessness around it; my hair has grown back around and up to the incision line. I just went to look at it in the mirror before writing this paragraph, and I had to comb through my hair with my fingers three times before I could find it, even on the sides over my ears. And the incision line itself is literally hair thin. I keep my hair at about one-half-inch-length and to look at it, there is no sign of a scar at all. As I've said, certainly the final determination of how good my HT was will be how I look a year from now, but so far, everything has proceeded excellently. I know that with so much bald scalp, 2,500-2,600 grafts will only give me modest coverage--I expect I will have a follow-on HT at some point in the future; I have more than enough available donor hair remaining to "double up"--but at my age, I can get away with it. The thing is, it will make the difference between "bald" and "not bald". And that's what I was going for. The only problem I see looming on the horizon is, in a few months, I will have to start looking for a good barber--and that's a problem I don't mind tackling.

qvarnis makes an excellent suggestion, and one that doesn't get mentioned too often: take a photograph with you showing your desired goal. All the verbal description in the world won't convey what kind of hair you want as clearly as a photo will. If you don't have one of yourself with the hairline you are seeking--I didn't--use a photo of someone else who has the kind of hair you are hoping to regain. (In my case, I used photos of the actor Robert Montgomery when he was approximately the same age as myself; it represented the precise mature hairline that I hoped to get, given the limitations of my Norwood VI noggin.) Also note, using a photo to represent your goals is a different thing from studying photo samples of the HT surgeon's previous patients to evaluate his work. From that standpoint, photos are helpful but only to a point. The best way to evaluate the surgeon's skill is to examine his previous patients in person.

Congratulations, HBT. I'm thrilled for you as all of us who have gone through the same thing are. I like the pattern and distribution of your grafts, and the fast healing is a good sign, especially for what it imports for the healing of your suture at the donor site. We are especially kindred spirits because your pattern of balding was similar to mine. You had more hair on the top of your head to begin with, and I got slightly more grafts--2,500+--so we're just about neck-and-neck. I'll be rooting for good results for you even more than I do for all of us who have had HT's. That also makes it easier for me to envision your final results, and I agree with Cleanhead and Smoothy--it's gonna look great. Best of luck and keep us posted.

Update 5 HT + 67 days I felt I should make an entry here, since it goes to the professionalism of Dr. Cooley and his staff. Last week--on 16 November--I had a dentist's appointment, and co????ncidentally, my dentist's office is next door to Dr. Cooley's offices. Following my dental work, I thought I might take a shot at popping over to Dr. Cooley's office and see if they would like to take a gander at the early sprouting of the transplanted hair. I really expected to be in and out of there pretty quickly, if I was able to see Dr. Cooley or Ailene at all. One of the things I learnt since my Navy retirement is that medical care works differently in the civilian world. Where a Navy commander gets bumped to the front in a military dispensary, he's just one more patient in civilian medicine--and it's tough enough to get in to see a doctor even with an appointment, let alone drop in unannounced. As I was waiting for the receptionist to finish a phone call, Ailene happened to walk by, saw me, and said hello. I had already e-mailed them about my early growth and I told her that I just dropped by to see if they would like to take a quick look at it. She said "Sure" and I figured she would step out into the waiting room and give it a brief inspexion. The next thing I knew, she was inviting me into the consultation room, had my chart out, and had a million questions about how I was feeling and how I was adjusting. I was feeling a little self-conscious, since I hadn't intended to take up that much of their time, but she acted like I was the only person on their schedule that day. She made several notes in my chart, then examined my new growth. Then Doctor Cooley came in and he examined it. They were both tickled to death to see the early growth; you would have thought I had come in bringing them the Rosetta Stone. Dr. Cooley was pleased specifically about two aspects of the early growth. First, he was afraid that the old scarring of my scalp from when I wore a hairpiece attached with sutures would inhibit the vascularity of my scalp. The early growth shows that the circulation of the blood up there is just fine. Second, early growth is usually an indicator that the patient will wind up with the maximum benefit in terms of final thickness and density of the transplanted hair. (It's nice to hear that the odds are on my side for once; it's usually the other way 'round.) Dr. Cooley had several questions for me. He also made some recommendations for fixing the couple of scars that won't be covered by my new hair when it grows in. And then asked if there was anything I needed. As morale-boosting and pleasant all of that was, the thing that strikes me most is that he and Ailene interrupted their work day and devoted at least twenty minutes to me alone just because I walked through the door. Imagine any other physician doing that for anything short of a life-threatening emergency. The "final proof of the pudding" will be in what my hair looks like in ten months or so, of course. But at every stage of the process so far, my experience with Dr. Cooley, Ailene, and his staff has been nothing short of outstanding.

Update 4 This is quite remarkable. Forty-nine days after my HT, and I had settled back to wait out the "hibernation", after finally getting accustomed to seeing my bald head look back at me in the mirror. In fact, being the pessimist I am, I rather expected I would turn out to be one of those "late bloomers", whose hair doesn't begin to grow out for four, five, or six months. But, somewhat startling to me, some of the transplanted hair has already begun to sprout. Actually, I noticed it about ten days ago, but on the chance it was just wishful thinking, I withheld opinion. But now there's no doubt. The small dark spots I saw last week have erupted into thin, tiny hairs, and other small dark spots are appearing--and some even on the crown, where I really didn't expect to see anything for several months. It's nothing robust, and certainly all of the transplanted hair isn't coming in, yet. I don't think it even makes a real cosmetic difference, but I'm seeing a vague "shadow" in the area of the hairline and top where the grafts were transplanted. As far as my donor scar is concerned, it is almost completely faded. Except for one small spot (which may be the consequence of my impatient clipping of my own hair) hair has regrown almost completely. My hair right now is currently at about a half-inch or less, and it completely covers any sign of the scar. And if I lift the hair away from the area, all one can see is the incision line. And there's barely anything to be felt at all; the only way my fingers can detect it is because I know where the incision was made. That the scar is next to nothing doesn't surprise me all that much; I've always been a fast and good healer. But to see new hair growing already--that just Wow!

"One thing to remember/think about-- say your crown baldness is 10 cm now-- you get it filled in-- then in 10 yrs natural hairloss takes your crown loss to 15-20 cm??? Then you have a problem with an "eight ball look" and limited donor. Just keep that in mind and if you choose crown work, do not go very dense your first pass-- I would say 15-20 fu per cm first pass to play it save for future progression." An excellent point by Smoothy, and one I should have addressed. In my case, at my age, my baldness has almost certainly stabilised--another point in favour of my decision to fill in my crown. A younger person, however, whose balding still has a course to run, could very well find himself with that "eight-ball" display, should any crown balding advance. Another factor to take into account--and a good catch by Smoothy in bringing it up.

I can only give an opinion for myself. Most definitely, nearly every HT surgeon will recommend filling in the front and the top first and leaving the crown for a second procedure. You are already aware of the advantages of this. I chose not to go that way. During my HT consult, Dr. Cooley also, initially, made the recommendation to fill the front and leave the crown bare. My problem with that was this: even following a successful HT on the front and top, I would be too self-conscious of the bald spot in back. To my point of view, a man whose hair is diffuse but present all over is less noticible as balding; all too often, I have seen people comment on a man who still has a healthy crop of hair in the front and top, but a shiny bare spot in back as "Look, he's going bald!" I stress: this is my opinion and feeling on the matter; you and others certainly might see it differently. There is no "right" or "wrong" on this; it's a matter of personal preference. Dr. Cooley recognised that, too. Once I told him of my preferences, he shifted his "plan of attack" accordingly. Understand, I had to settle for trade-offs. I was a Norwood VI and my HT consisted of 2,600 grafts. And Dr. Cooley spent most of my ten-hour operation on the crown. That meant I had to settle for a less-complete, less-typical hairline. Instead of filling in the hairline in a usual manner, I accepted a "sharper V", something akin to an advanced widow's peak. And no temple work. (Fortunately, being nearly fifty, that's not an unnatural look for my age.) Moreover, the denseness of the transplanted hair will be more diffuse. Lastly, typically, the hair transplanted to the crown takes longer to mature than the hair on the top and front; therefore, it will be longer before I see the final results of my surgery. I understood that these would be necessary compromises, and Dr. Cooley realised that I understood that--an aspect of HT surgery that I cannot overstress. To a great extent, it's a team of patient and doctor. If the patient has reasonable expectations and shows an understanding of what his condition of balding permits and won't permit, then the HT physician will use all of his skill to meet the patient's goals. (It's only been six weeks since my HT. In this early stage, it's difficult to estimate the final result. But based on how much time Dr. Cooley spent on my head [ten hours is much longer than I've seen anyone else describe the length of his operation, and Cooley was there the whole time, except for head calls and one ten-minute diversion] and the distribution of the hair as I saw it right after the operation, before it fell out, I think that the results will be better than I am expecting. [And I am a cynic by nature.]) So, the essential answer to the question of whether it's better or not to concentrate on the hairline and top and leave the crown bare is--it's a matter of personal preference and what you are comfortable living with. I also want to add, even if one plans on a follow-up HT--and those of us higher up on the Norwood scale do--one needs to look at it from the perspective of living with the results of the first procedure. Things happen. Financial crises erupt. Jobs can be lost. And someone might find himself living with the results of his first HT longer than he anticipated. So it's best if the results of the first are something one can live with. Bottom line: go with what you are comfortable with. Hair Apparent

Marcelo, I'm thirty-six days past my HT from Dr. Cooley. I've already posted the details of my surgery which, as Robert pointed out, you can find by using the "search" function, although my experience was no different than those of Robert, Brando, or the other Cooley patients he mentioned. In that aspect, the experience was all positive. This short a time into the procedure, obviously, I have no new hair growth to show, but I can talk about the scar. I buzzed my hair down right after the first two-week settling period for the grafts, so it was visible, but not pronounced at all. Now, over a month later, hair has grown back in around the donor site and my hair, even only an inch or less long, covers the scar excellently. Also, the scar is almost undetectable by touch. There is the slightest bit of raising at one or two points, but that has been fading steadily. Robert and the others can provide better info since they are further along in the process. Hair Apparent

Good deal! If your regrowth stopped now--which it won't, of course--you would still have tremendous improvement. The next few months should be even more gratifying. Obviously, since I had my HT done by Dr. Cooley, as well, I have more than just a kindred-spirit interest in your case. I just passed the four-week mark three days ago, and as is normal, I haven't got much yet to show for it. Remarkably, about fifty of the transplanted hairs refused to give up the ghost; those game little troopers are still there and growing. I actually needed that. Otherwise, it would be too easy to get dejected. This is the stage, when there are no signs of growth, when it's easy to let oneself think "What did I pay all that money for?" Besides just my desire to have my hair back, I have to confess I am also curious to see the outcome of Dr. Cooley's efforts. I know the hairline he drew for me and it was exactly what I wanted (within the limits of my Norwood VI noggin), and now I am impatient to gauge his results. Everything I have read about Dr. Cooley--from you, Robert, and other Cooley patients--attest to his remarkable artistry. He and his staff spent eleven hours on my head without a break; that's longer than most others have reported their procedures taking. Since he spoke of no significant problems with the surgery, I can only guess that he took that much time to ensure that he did everything exactly right and to achieve the maximum cosmetic effect. His attitude was extremely positive at both the conclusion of the surgery and at my follow-up visit. And now I'm dying to see if his work on me turns out to be a real masterpiece. I'll be thrilled if my head turns out as good as yours has, Robert. I have months and months to go, alas. One day at a time. Hair Apparent