arussell

Transplanted hair works well in a scar. Just make sure you go to an experienced surgeon.

Guys this has been a topic of discussion for YEARS! And rightly so! It is important. But lets just say that it doesn't matter what term is used to identify the type of procedure. It matter what "fits" for the patient. The argument used to be about all the waste with FUE, but with time and better methods this has improved. The main issue that I see is that patients are not educated on the fact that regardless of FUE or FUSS/FUT there WILL be scars! One is long and narrow and the others are small and round but they are scars. Both have excellent benefits and both have drawbacks..... First go to an experienced surgeon........ money is important but you have to compare an apple to an apple...... and even then not a Granny Smith to a Red Delicious! You have to know what the clinic reputation is.... aside from physician results. What holding solutions, who makes incisions, who places.... and it does not have to be all the surgeon but it does matter about experience. Experience can also be subjective. A clinic that does 5 surgeries a day cannot be compared to one that does 1 or 2.... But how long someone has been in the field and their backround are important. Think about the big picture, future loss.... a transplant does move hair to a more desired location but it STAYS there... so thinking about the future is important because hair loss is progressive and a transplant does not stop hair loss. Medication inhibits loss but not everything works on everyone one so it is coming up with a plan with your surgeon that you are comfortable with. A strip procedure will yield more follicular units that have a lower chance of damage for less money. There will be a scar. If the scar is something that is less than what was hoped for, a small FUE can hide it well. The scar usually will not be apparent if post op instructions are followed. Most patients can still wear fairly short hair after healing. BUT you do have restrictions about exercise that can impact the scar. and you cannot shave your head without finding the scar. FUE generally requires shaving the donor area to do the harvesting but you don't have sutures. You do have scars, they are small white scars and this can impact future surgeries and these scars if less than what is hoped for you can't really fix. This can also diffusely thin the donor if larger procedures are done. With EITHER method you cannot SHAVE your head without seeing a type of scar......... 4000 grafts is a good size procedure. Please so your research and get more than one opinion...... RESEARCH!!!! TAKE YOUR TIME!!!!

Patrick1916. My pleasure. Don't get upset yet. Coincidentally we just posted a similar type situation. A patient had gone to another surgeon and done FUE with thinning of the donor. Go to the search bar and look for the video posted. We did a strip on this patient and did a PRP treatment on him. I am not saying a strip is your only option but it is a good option. As I mentioned, the scar is a thing that has gotten a lot of attention because years ago it was not a focus and lots of bad ones were created. Just like with FUE, FUSS has also evolved in the right hands.

Delacey I am not sure what you are asking in the question above " Out of curiosity, what yield can one expect from an FUE procedure at Dr. Cooley's clinic?", if you are asking how large a procedure we are able to do with FUE there are many facets to the answer. It will depend on the native donor density first of all. We do Both FUSS and FUE. Our surgeries just like most clinics range in size. Dr. Cooley always uses ACELL in all surgeries regardless of the harvesting method. I would say our average FUSS is 2500-3000 and FUE average is 2000. If you mean the percentage of waste, that is much more subjective. Dr. Cooley uses the the WAW or some refer to it as the flat punch which has decreased waste significantly. We still place all grafts under a scope and trim excess tissue. This step also gives us the ability to segregate the grafts so Dr. Cooley definitively knows a one hair follicle from a two! I hope this addressed the question.

Patrick1916, I am sorry you are having this issue. Both FUT and FUE are great procedures if the patient is well educated in what they can do and in the downside of either or both. FUE is not the newer procedure, it is a newer name for the old "plug" harvesting. In both harvesting methods a scar or scars are the result. In the FUT it is a long linear scar and if done well and healed well, the scar is many times extremely hard to find. In large FUE surgeries there are many small round scars that can give a "moth eaten or shot gun effect" with shorter hair styles. In neither can a patient expect to have the ability to shave without evidence of a surgery. With FUT if the incision is less than hoped for an FUE can be done to disguise it. With FUE little can be done because the donor area is difusely thinned. But there are other sources for more hair such as the beard!. The most efficient harvesting is done doing a strip first because more hair can be moved successfully with the least amount of waste and then use the FUE to finish it up if needed or desired. Both are good neither are perfect procedures. Many things also depend on the skill of the surgeon and clinic and what they use in surgery such as Acell which helps the body to heal with out as much chance of scarring. The benefit of FUE is less restrictions during the healing phase. It does not provide better or superior results. Be cautious about doing a second session without fully discussing your concerns about how it is now and how it is going to look if you do a second procedure.

Unfortunately there can be very vague pathology reports especially if the pathologist doesn't specialize in Dermatologic issue. I would get a second opinion for a Dermatologist who is a hair specialist. Using topical steroids correctly if you have this or other common skin issues does not cause shedding or problems. Generally it fixes the problem. Many of skin/ scalp problems are long term issues that require long term use of topicals. Many of these patients have totally successful transplants. They have to follow physician recommendations and be seen regularly. Remember a transplant does not cure anything. It simply moves hair to a more desired location. It is the medical program designed to address your diagnoses that will help you to be stable.

Dr. Cooley often tells a patient that the most efficient way to harvest is to do a strip, maybe two depending on the degree of loss and the goal and then if the patient wants to cut the back very low do a smaller FUE to address the "icing on the cake" and maybe a few to the scar. that was exactly this scenario. He was thrilled before the last and now feels complete!

Androgentic Alopecia or male pattern balding is genetic. Alopecia Universalis is an autoimmune issue and not at all the same thing. Genetics determine how much of the AGA gene you have inherited. And with Universalis it is a medical condition that does not respond to the same kinds of treatments. Universalis means the lack of all hair, anywhere on the body. AGA only impacts certain areas of the scalp. AGA deals with how bald on the Norwood scale for men you will go. Universalis is incurable but in some cases treatable condition that impacts all hair. Taking medication that inhibits the conversion of testosterone to DHT does inhibit loss of hair genetically marked to respond to DHT. It is not a cure it is a treatment for this non transplanted hair. It has no impact on transplanted hair. Transplanted hair comes for an area on the scalp that is resistant to DHT. This area can have some mild thinning in most situations and as the patient becomes older hair can thin. That lovely event is called Senile Alopecia! The word Alopecia simply means hair loss, not the root cause of the loss.

If you are close to your clinic, call them and ask if they can see you. Do they do a one week clean up? If you just started antibiotics it can take a little while to get them in your system. You might call them back and ask if you can do a "loading" dose. I am not a fan of baby shampoo. Ask the clinic if they can recommend something else. We provide a gentle cleanser but you can't buy it in the stores. Rinsing is a good thing. Keep in touch with your clinic!

Taking medication and doing a transplant are two separate questions but the answers overlap. A transplant moves hair to a location where you don't have any. It does not change your genetics or cure male pattern balding. Medication does not cure male pattern balding. Medication inhibits future loss of EXISTING native hair. You can do a transplant and never take anything but you take a risk of losing that non transplanted hair. Hair loss does not stop in the 40's or 50's. It is lifelong and totally dependent on the genetic code you inherited. PRP can play a role in rejuvenating miniaturized hair. besides oral meds there are topicals such as minoxidil that can stimulate growth but have no impact on DHT. Caffeine might help (not coffee mind you!) ketaconazole and perhaps some supplements. All of these are smaller parts of that equation.......

Are you taking an antibiotic? What are you using to wash with? This does not look normal. I would contact the clinic.

Take care of you! But know to those of us who do this because we genuinely want to help you are an asset. I personally wish you all the best. Positive thoughts and a fantastic holiday season.

If you got money to blow carry on as in 12/14 months you be back to baseline, that's only if your a good candidate / responder. Now saying that I do believe that PRP/Acell can be & has been a good tool for the purpose of healing of which been used for many years effectively & have shown patients recovery increased to a decent level. On Top, This is a treatment not a cure. But the photo's above are at about 12 month or more interval so no, you do not return to baseline that soon. It would depend on some of the "variables" that Dr. Cooley alludes to. We recently had a patient come back after 4 years and although he had lost some of his initial gain he still had not returned to baseline. This can augment medication and for those unable to take meds it can really be helpful. It is all in the prospective of the patient. We offer it but will evaluate and tell you if you would benefit from doing this or not.

PRP with Acell helps to rejuvenate existing native hair. It is like icing on the cake, the growth cycles are the same for a transplant or native hair so while his transplant was growing in his native hair was rejuvenating! The idea of "necessary" is a relative thing. The transplant moves hair but does nothing to enhance the miniaturizing native hair. This is a win win situation!

Congrats! I know you will be happy. I did want to clarify that Dr. Cooley is very involved in all aspects of the transplant surgery. He does not do dissection or trimming or separation of the follicles (1's, 2's, 3's etc.) but he does all the extraction in an FUE and works with our transplant Team Supervisor Brandi in placement. We use microscopes to separate and trim all grafts regardless of harvesting method so they can be implanted appropriately.

Transplanted hair would not feel like "straw" or have knots, I have to agree with Spanker that this sounds a lot like a hair piece. Some of these can be pretty good. There are usually "give aways" such as in the front a "piece" can't restore that temporal junction, leaving it a little out of balance. Many people have certain things that they are just sensitive about. I have had patients who didn't tell their spouse.... not sure how they accomplished this but they didn't tell..... and everyone thinks a little differently. Disclosure about something that gives a sense of less esteem or discomfort may not be something you want to push for them to disclose. Just my opinion!

Kudos! This patient must be thrilled.

Concerns are justifiable! Ask about future loss and what can be done to protect and preserve the native hair. Most patients have between 6000 to 9000 viable donor follicles. Usually one transplant is not going to risk tapping out this source but inhibiting loss is an important part of this equation. Some things will depend on which surgeon you have chosen, they all vary a little in recommendations. Another part of the equation is the method of harvesting, FUT vs FUE. The method of harvesting can impact the number of donor follicle available. Talk to your clinic and explain your reservations! It is always in your best interest to have a long term plan in your back pocket! Best of luck!!!!

#10 Top Report Post Unread Today, 07:33 PM leindub's Avatar leindub leindub is online now Junior Member New Real Hair Club Member Join Date: Aug 2013 Posts: 15 Last Online: Today 08:35 PM Default I'm one of those peoole who recieved a nasty FUT scar about 15 years ago, I was sold a pencil thin one my barber would have problems locating. Aside from having FUE placed into it, would anyone know how successful a trichophytic repair closure is to try minimise it before going ahead with FUE? lEINDUB, i AM SORRY YOU HAD A BAD EXPERIENCE. It puts a bad taste in everyone's mouth and human nature is bad news travels faster than good news. First, can you let us know who the surgeon was? This is not to spread bad rumors about them but perhaps they have evolved and could do something to help you? Second if you would rather not see them, have you been to another transplant doctor who has a good reputation for scars and repairs? To answer your question, many times if the old tissue is removed the scalp retains a memory of the stretch and it just comes back, but have said that there are many variables. It will depend on the location of the scar (yes different surgeons can have different preferences), it also will be effected by the number of grafts you had done and the laxity you now have. My best advise is to visit a good clinic and get an opinion. Another question would be if you are doing additional grafts during this incision? I hope this helps.

This is a typical response to the diligence of a compliant patient! Dr. Cooley uses more post op spray than many and this is how we expect it to look if this is done. This actually helps with the healing process and the overall end results/

In my experience the hair in the back generally retains color longer than the top and sides. When you lose hair, it is not an even pattern of loss, it is the same with color, at least in the beginning of the loss of color or melanin in the hair. The grey's can be very random or they can be spread or or in patches. I think this is being over thought! And just for the record, grey and white hair is a little harder to color, it is resistant to it and needs to be "helped" more often!

I am not sure if you were instructed on what happens after a transplant regardless of the harvesting method. In most cases the implanted grafts will "sit" and passively absorb oxygen and food from the surrounding tissue. They adapt and take root usually over the first 6 to 7 days. Sometime around the 10 day time frame the hair shafts will extrude and shed. Because of the solutions used in numbing there can be a little swelling or a "sunburn" type effect to the recipient area and this skin can peel off. The bulbs are there, as noted above if they had been dislodged (and at 16 days this is very very unlikely) there would have been bleeding and it would have been enough to get your attention. Most of the hair will shed leaving you much as you were prior to your procedure. The grafts will have entered into the resting phase and will sit for 2 to 4 months before they begin to regrow. You are just beginning your journey! Good luck!

Yes, Muyor it was.

I have to agree that your donor area seems a little small. But most people have at least 6000 grafts in the donor area that can be harvested if done with discretion and good planning. There are some questions such as how old were you when your loss began and are you on medication to inhibit future loss? A lot of this depends on your ultimate goal. If you will be happy restoring the front and having the crown as it is that should be a doable transplant and one that can be very rejuvenating. But remember, the transplant doesn't stop loss and it appears you have some miniaturized hair as well, Please do lots of research! Good luck!

Oh My.... this sounds as if unrealistic expectations were set and perhaps the goal of the medications was not fully understood? I have found with some "Veterans" of older transplants that this can often be the case. As it has already been pointed out, the Merck study was not five years but 10 and the take away message is really if you look at the vast difference in the twin studies you see it does work, it just is not a CURE! And it does not totally STOP hair loss, nothing does at least not at this point! Older transplants with larger grafts may become isolated when existing hair continues to thin..... 7500 hairs??? on average there are usually 2 hairs or more per follicle so this would mean that less than 4000 follicles were "rehomed". If done with good technique even with Senile Alopcia they would remain natural in appearance. FUE is not new, it is just refined..... This has to be a procedure that is begun with the knowledge to make informed choices. And there are usually modifications that can be made to help those who started early and didn't preserve their native hair.