HairCenter

We hope you all have been enjoying the holiday season. For our final PRP result to present for 2017 we'd like to share the following case. This patient was just 21 years old when he first came our clinic to discuss his options for saving his hairline. He had already been on finasteride for two years with success but this success was for maintaining his hair only with little regrowth. One session of PRP with ACell by Dr. Cooley and the miniaturized hairs of the hairline not only thickened but some of the original hairline shape has returned in the temple. PRP result shown is one year from treatment.

Dr. Cooley is one of the original pioneers of PRP with regards to hair loss and hair restoration. He has spent over a decade to come up with our current protocol used for our patients today. It is a constantly evolving protocol based on new technologies and developments in the field. Dr. Cooley is confident in the efficacy of PRP, especially when properly combined with ACell, to help patients that have been deemed good candidates for the treatment. PRP w/ACell is effective for thickening hair in patients with diffused hair loss and is especially helpful for patients that are otherwise poor surgical candidates due to either poor donor supply or not enough loss to justify surgery in the first place. With our approach we've seen some very good results. However, Dr. Cooley is becoming more concerned with the apparent explosion of PRP offerings in the marketplace as it seems that every medispa/ plastic surgeon/ dermatologist, etc. is offering the procedure, some with unrealistic claims. We at Carolina Dermatology Haircenter wish to help set the record straight about PRP. We'll be presenting numerous cases of PRP results with varying levels of improvements to show you what you can realistically expect or not expect. In our experience, PRP does not need to be administered two, three or four times a year to achieve optimal results. We typically administer one treatment with the expectation that this will be enough for at least one year of improvement. We see results manifest much like those of Propecia in that it generally takes three to six months to see the first signs of improvement and then the result can continue to improve for several months afterward. The longevity of these results does vary but we've seen some results stay strong for two and three years after only a single treatment. Per usual we find that PRP w/ACell works best when combined with other non-surgical treatments such as Propecia. Below is our first case to present and it represents a mild visual improvement but an overall improvement of 25% was measured with cross sectional tricometry 7 months after the one procedure we administered. Looking at the part line you can see how it not only narrowed but the hairs on either side of the part line are stronger. This was what the patient experienced throughout the top of his scalp and he noted that he could have more hair styles due to the increased density. The patient was 45 years of age at the time of the treatment and was not on Propecia before or after treatment. Case #2 In this presentation we have a 64 year old male that presented with general, moderate diffused thinning throughout the top off is scalp. Dr. Cooley administered one treatment of PRP with ACell. The patient had already been on finasteride consistently for ten years prior and he continues this medical regimen still. The patient returned after one year for a follow up visit and the improvements were noted. The hairs throughout the top of the scalp increased in terminal diameter and density improved as well. This is noted in the part line but also the crown. At this time it was discussed and agreed that a second treatment could be performed. The patient returned 18 months later with more improvements compared to the first procedure with an added increase in density and coverage. No other treatments were added and no alterations were made to his existing finasteride intake. Continuing our "Not All PRP is The Same" series, we have another example of PRP with ACell performed by Dr. Cooley and the team at Haircenter in Charlotte, NC. Case # 003 is a 21 year old male patient that presented with early onset male pattern hair loss with general thinning throughout the top of the scalp and miniaturization along the frontal hairline and into the temples. He was first started on Propecia but soon after we performed one procedure of PRP with ACell. The result is shown one year after the procedure was performed. The entire top of the scalp has thickened but of particular importance is how the hairline, particularly the temples, have thickened considerably. This is no doubt due to the synergy established by the combined use of Propecia and PRP. PRP Results Case # 004 Our next case presented as a 61 year old male with a well defined area of crown loss. He had already been on dutasteride for a number of years so the patient's loss had already been stable for a long time. In order to continue a non-surgical approach the patient and Dr. Cooley agreed on one treatment of PRP with ACell. The image on the far left is the "before" image before any treatment was administered. He had been on dutasteride already. The middle image is the result six months later. You can easily see a fairly significant improvement. The patient eventually returned four years after his initial visit, and single PRP with ACell treatment, and much of the original result has remained and the overall diameter of the balding area is still less than it was prior to treatment.

If you are not taking medication to fight your hair loss then it will only get worse so it would be advised to try medication for a year. With the amount of miniaturization seen in your crown you may see a strong turn around which would in turn mean you need less hair to get a satisfactory result.

Hi Gambler, I think you might be missing the point of this thread. Dr. Cooley feels that the narrative regarding PRP/ACell and what it can do is misleading because of false claims that PRP/ACell will regularly deliver what you asked for. PRP/ACell can and is a great treatment when performed correctly but it is not a miracle. Do cases like you ask for exist? Yes, but they are the exception, not the rule. The point of this is to show you what the average range of result are that can be expected from a high quality application of PRP/ACell. Keep in mind also that these examples are showing only one application of PRP/ACell (unless otherwise noted) as that is also what Dr. Cooley feels is another misrepresented aspect of PRP/ACell treatments, in that multiple treatments in a short span of time are necessary for success.

Continuing our "Not All PRP is The Same" series, we have another example of PRP with ACell performed by Dr. Cooley and the team at Haircenter in Charlotte, NC. Case # 003 is a 21 year old male patient that presented with early onset male pattern hair loss with general thinning throughout the top of the scalp and miniaturization along the frontal hairline and into the temples. He was first started on Propecia but soon after we performed one procedure of PRP with ACell. The result is shown one year after the procedure was performed. The entire top of the scalp has thickened but of particular importance is how the hairline, particularly the temples, have thickened considerably. This is no doubt due to the synergy established by the combined use of Propecia and PRP.

PRP is a very misused and misrepresented treatment and your concerns about the number of procedures and how it is marketed is becoming a concern for Dr. Cooley. This is why we've started a series of posts to show the reality of PRP as it relates to multiple cases we are in the process of presenting. We've started a series of posts on the forums titled "The Truth About PRP" and we're showing that some cases can have a great result with dramatic improvements while others are moderate at best. PRP with ACell, properly administered, can and does have the same effect as Propecia and the same range of responses is also seen. Some respond great, some do not but one of the big issues that Dr. Cooley sees is the idea that one needs to have three or four treatments in a year. Dr. Cooley strongly believes that one procedure is usually enough and we'll be presenting cases that represent why he feels this way.

Click on the yellow bar at the top of the image and it will expand the image in a new window. If that is not enough you can visit our website at haircenter.com and view the new PRP gallery we're building. This will maybe give you a larger image to view.

In this presentation we have a 64 year old male that presented with general, moderate diffused thinning throughout the top off is scalp. Dr. Cooley administered one treatment of PRP with ACell. The patient had already been on finasteride consistently for ten years prior and he continues this medical regimen still. The patient returned after one year for a follow up visit and the improvements were noted. The hairs throughout the top of the scalp increased in terminal diameter and density improved as well. This is noted in the part line but also the crown. At this time it was discussed and agreed that a second treatment could be performed. The patient returned 18 months later with more improvements compared to the first procedure with an added increase in density and coverage. No other treatments were added and no alterations were made to his existing finasteride intake. The improvement is undeniable.

Dr. Cooley is one of the original pioneers of PRP with regards to hair loss and hair restoration. He has spent over a decade to come up with our current protocol used for our patients today. It is a constantly evolving protocol based on new technologies and developments in the field. Dr. Cooley is confident in the efficacy of PRP, especially when properly combined with ACell, to help patients that have been deemed good candidates for the treatment. PRP w/ACell is effective for thickening hair in patients with diffused hair loss and is especially helpful for patients that are otherwise poor surgical candidates due to either poor donor supply or not enough loss to justify surgery in the first place. With our approach we've seen some very good results. However, Dr. Cooley is becoming more concerned with the apparent explosion of PRP offerings in the marketplace as it seems that every medispa/ plastic surgeon/ dermatologist, etc. is offering the procedure, some with unrealistic claims. We at Carolina Dermatology Haircenter wish to help set the record straight about PRP. We'll be presenting numerous cases of PRP results with varying levels of improvements to show you what you can realistically expect or not expect. In our experience, PRP does not need to be administered two, three or four times a year to achieve optimal results. We typically administer one treatment with the expectation that this will be enough for at least one year of improvement. We see results manifest much like those of Propecia in that it generally takes three to six months to see the first signs of improvement and then the result can continue to improve for several months afterward. The longevity of these results does vary but we've seen some results stay strong for two and three years after only a single treatment. Per usual we find that PRP w/ACell works best when combined with other non-surgical treatments such as Propecia. Below is our first case to present and it represents a mild visual improvement but an overall improvement of 25% was measured with cross sectional tricometry 7 months after the one procedure we administered. Looking at the part line you can see how it not only narrowed but the hairs on either side of the part line are stronger. This was what the patient experienced throughout the top of his scalp and he noted that he could have more hair styles due to the increased density. The patient was 45 years of age at the time of the treatment and was not on Propecia before or after treatment.

This lady is in her mid 60’s and has been experiencing hair loss for many years. She did not find that topical minoxidil helped her. Our approach to women is very different than it is in men, especially in older women. They often have a very narrow band of good hair in their lower occipital (back) zone. Depending on how they style their hair, transplanting this hair to the front and part zone can make a substantial improvement in their situation. Covering the entire thinning area would create insufficient density given the number of grafts we expected to harvest. In this patient’s case, we were able to harvest 2,301 grafts by FUT and placed these grafts in the front and left part. We performed PRP/ACell to the entire scalp to provide some thickening as well. She is shown 11 months post op and she is very satisfied with the improvement.

Dr. Cooley and the team at Hair Center in Charlotte, North Carolina transplanted 2024 grafts in one procedure using FUSS (follicular unit strip surgery) for the result you see below. The video was shot two years after the procedure and the patient reports he is satisfied with the final result.*

This diffused NW5a patient is in his late 30’s and wanted frontal hair restoration. We prescribed finasteride to address the mid-scalp and the crown. Due to his inability to shave, and the need to be back at work in one week, we opted for non-shaven FUT. His hair was ultra-fine so we dense packed the grafts in the frontal third of his scalp, and relied on finasteride and PRP/ACell to thicken the back of his scalp. We transplanted 3,375 grafts using strip and we performed a procedure of PRP w/ACell as well. He returned two years later for his check and was very pleased with the natural looking results.

Yes. He's only eight months but while he has obviously had the majority of the grafts come through at this point he is expected to have more thickening but also maturation. You can see how the frontal hairs look slightly fuzzy? They will look healthier in a few more months with a smoother texture like the rest of his hair along with more shine. Thank you for your comment and question. Thank you, Mick50. Your comments are appreciated.

This patient is 23 and has noticed significant recession in his hairline and temples over the preceding few years. We discussed the pros and cons of surgical hair restoration at a young age. Initially, we performed a PRP/ACell treatment and started him on oral finasteride. Several months later he returned and noted that he was doing well on finasteride with no side effects and he stated he was starting to see thickening from the therapies. At this time, he wanted to pursue hair transplantation. Normally, I would encourage a young man to be patient and defer this decision for another year or two. In this case, he understood all the potential drawbacks of getting a hair transplant at a young age, but given his plans to pursue a career in acting, he strongly believed the benefits outweighed the risks. We performed strip surgery (2,626 FU’s: 1-469, 2-1084, 3-680, 4-393). He returned at eight months for a check and was ecstatic with the results. He understands the need for life long hair maintenance and is fully committed to this.

This patient is in his 40’s and wanted thickening of his mid-scalp and to restore his hairline. Given his occupation, he had to be back to work in less than a week and could not shave. We started him on finasteride and performed non-shaven FUT of 2407 grafts. By "unshaven" we do not shave the recipient area where grafts are placed. For the strip removal, a narrow strip of hair is shaved as per the normal FUT process. PRP with ACell was also applied to the mid-scalp. The result is 18 months post surgery. Graft breakdown: 1-638 2-1133 3-573 4-66

Hello Utley7, Yes, Dr. Cooley has spent a lot of time working with FUE and has transitioned to using the latest WAW motorized FUE system for graft scoring and extraction. If you give us a call at the clinic we can discuss Dr. Cooley's FUE approach and we can try to put you int touch with one of our FUE patients so you can perhaps coordinate a call or even a meeting if you live nearby.

Thanks for the comments everyone. I agree that the Harvey Keitel reference fits:)

Jerry Cooley MD and Carolina Dermatology HairCenter present another Ultra HD 4K video for your review. This 60 year old woman came to see Dr. Cooley about her receding hairline. After long discussions with the patient Dr. Cooley suggested a 3000 graft strip procedure to address her receded temples and her higher than desired hairline. 3231 follicular units were dense packed in one procedure. Dr. Cooley also administered PRP with ACell as well as prescribed finasteride (post-menapausal) and minoxidil. The result shown is at one year post surgery.

This gentleman is in his mid-60’s and wanted a natural restoration with a conservative hairline. He was looking for a ‘fill-in’ that would make him look better without it being obvious that anything was done. He was started on finasteride and had FUT of 3,877 grafts. He is shown one year later. He stated that this was exactly what he had in mind and was therefore very pleased.

Obviously, you should quit altogether and since you only smoke 1 to 2 a day it may not be very difficult. Any doctor will tell you however that you should stop before you have your procedure as this is medically proven to restrict the blood flow in your body and when you need optimal blood flow to deliver nutrients to your new grafts (once the new blood vessels form) then it is not a good idea to resume anytime soon after your procedure. If you absolutely have to resume give it two weeks minimum and while you should stick to your primary physician's recommendation I'm certain they would agree that that less you smoke the better your result will be.

Hi Spanker. Dr. Cooley feels that PRP is a great option for patients that do not wish to take, or cannot take, finasteride. The candidates for both that should expect a reasonable cosmetic improvement are similar in that the more hairs that are present with obvious miniaturization will see the largest potential benefits with thickening. Nothing grows new hair from scratch and every medical treatment we have will only thicken hairs that are being miniaturized. The same goes for PRP. What's different however is that PRP, when applied correctly using the proper protocols, CAN, not necessarily will, last for over a year. In fact, Dr. Cooley has more than one patient that have gone as long as two years without a visible cosmetic decline. This type of outcome is completely unpredictable however but the point is that it can and is a good option for long term maintenance when performed and administered correctly.

Thank you, Dr. Bloxham.

Thank you all for your great comments. Temple point work is absolutely critical for proper hairline reconstruction in many cases. Some just can't have temple point work because of the coarse nature of their donor hair but when it can be done, it has to be done just right or else it can contribute to and even be the sole reason for why a patient may feel their result is a failure. The goal for any transplant procedure should be naturalness, above all else.

Thank you again, everyone.

Thank you everyone. This is one of those cases that is more difficult to work with but the results are well worth the effort.