HairCenter

Hi Mick50, With either procedure, magnification allows the doctor to see what he's doing with incredible detail. With FUT the microscopes allow for full visualization of the grafts while with FUE the doctor has direct visualization during the extraction process while wearing his high power surgical loupes. With Dr. Cooley's FUE the grafts are put through two phases of examination for the number of hairs with the first phase being during extraction then the second phase during the examination and refinement under microscopes by the technicians. This helps to confirm if a two hair graft is a actually a two hair graft or a three hair graft with one of the hairs not visible at the surface. I hope this helps to clarify how the grafts are targeted for maximum cosmetic impact.

Thank you for the comments, everyone. We agree with you Andy. Shorter hair suits the patient well.

Thank you everyone for your comments. We've got more Ultra HD videos coming.

Happy Easter everyone! Today we have another video recorded in 4K Ultra HD for the most detail possible. This video showcases a patient that had undergone two procedures previously at a different clinic fifteen years ago. He came to Dr. Cooley to see about filling in the areas where his nature hair disappeared, which left his old transplants more exposed and gave him a much thinner appearance front to back. Dr. Cooley and the team placed 3149 grafts using FUT for the result you see here at one year post-op.

We presented this patient in a collection of photos in December, 2016 but he has returned for another followup and he allowed us to document his result with video. This patient is in his 30’s and wanted to restore frontal zone with FUE. We started him on finasteride and performed FUE with 1.0mm motorized punch, yielding a graft count of 1,825 (1-208, 2-441, 3-770, and 4-406). Given his fine hair, we wanted to capture as many 3 and 4’s as possible, hence the slightly larger punch used. We also performed PRP/ACell to thicken existing hair and promote healing of the FUE extraction sites. We find that PRP/ACell treatment after the extractions are complete enhances healing by reducing scar (fibrosis) formation and promoting regeneration of any transected follicles. He is shown one year post op. After photos are with dry and wet hair. The video is in full Ultra HD 4K resolution so a 4K capable monitor or television is recommended.

Thank you all for your kind comments. Mick50, When we say we can pre-select three and four hair grafts it means that Dr. Cooley is purposely seeking out these follicular units in the donor zone and targeting them for extraction. The idea is that with these sized multi-haired grafts, which are the largest we can expect to find with any regularity, they will give better coverage in the intended recipient zone, in this case the crown. Had only singles or doubles been used in this area the coverage would have been lower, potentially only half of what you see in these photos. I hope this answers your question.

Thank you, Dr. Lindsey, David and Hairthere for your comments.

PRP w/ACell can be very effective for thickening of miniaturized hairs and this is true also of the donor zone which is an underreported issue in the hair loss community. However each case is different and each clinic has not only various methods of creating and delivering PRP w/ACell but also various experiences. Dr. Cooley is one of the pioneers of this approach with regards to hair loss and he had worked with various systems to develop a consistent and reliable protocol. We'd be happy to review your particular case and give you an honest assessment. You can contact the clinic at Contact Us - The Hair Center.

This 40(ish) female patient came to us about her high hairline and thinning frontal core. She presented with hair loss due to several factors: 1-traction alopecia 2-CCCA 3-Hereditary recession She had an unusually good donor area and wanted to do as many grafts as possible. We performed strip FUSS which yielded 3,514 grafts (1-748, 2-2559, 3-207). We concentrated the grafts in a band along the front and into the frontal core as well. She returned at 18 months for a followup and was extremely pleased with the results.

Here is another Ultra HD 4K video presentation for your weekend. This patient came to see Dr. Cooley five years ago to see what could be done for his receding hairline and general thinning. Dr. Cooley and the patient agreed to do a strip procedure where 2000 grafts were harvested. Dr. Cooley also prescribed Propecia to help prevent further loss and to potentially enhance the patients native hair. The patient returned four years later to show Dr. Cooley is excellent result. It was at this time that the patient and Dr. Cooley began discussing a second procedure to add additional density to the hairline. Dr. Cooley and the patient agreed to perform a second procedure of 800 grafts via FUE with 700 grafts going into the frontal zone and hairline and 100 grafts going into the FUSS donor scar. The result is shown at one year after his procedure. As always, the video is best viewed on a 4K capable computer monitor or large screen television.

This patient had initially had FUE to his crown and hairline at another clinic with disappointing results. We discussed FUE vs FUSS and he opted for the latter for his next procedure. He has very fine hair so he needed a good amount of hair to provide adequate coverage. We performed 4,197 grafts FUSS in the first procedure, mostly to the crown but also to reinforce the hairline. He returned at one year very pleased. The strip scar had healed very well and was almost invisible. He wanted a small fill in session to the crown so for the next procedure we performed non-shaven FUE of 414 grafts. This allowed us to selectively harvest 3 and 4 hair grafts for maximum effect. He is shown one year following this procedure. This is the placement for the 4197 FUSS grafts. Here is the placement for 414 non-shaven FUE grafts.

Bald36, A more accurate question would be, what would the result be like without medical treatment? This is because using PRP, in this case, acts like finasteride in that it reverses the miniaturization process, as Ailene said. The result would still be fantastic without PRP but the native hairs have thickened so of course it enhances the overall transformation.

Your recipient area should be OK and yes your hairs are "anchored" but you should leave it be as much as possible. The dryness and itchiness are normal but you should be consulting with your clinic for such post surgical issues.

Thank you Modernhair. Dr. Cooley really enjoys performing FUE as it allows him to flex his creative muscles even more due to the intricacies involved with FUE that are different from those found with strip surgery. We have more 4K FUE videos to share soon.

No arm twisting in our clinic! We tend to just present both options if they both apply to the case and let the patient decide. We like to educate about the pros and cons of each and while strip is still a very straight forward and reliable procedure we've seen FUE increase in reliability over the years as well. Dr. Cooley has been performing FUE on a regular basis for nearly seven years now so he's got the chops to do the job right. It's nice knowing that patients can be "Coolified" with FUE just like they have been for years with strip:) Regarding our FUE results, you can see some here, including the world's first 4K Ultra HD video of an FUE result. We've got a lot more coming now that we've started taking video seriously so stay tuned. We're just getting started:) http://www.hairrestorationnetwork.com/eve/183436-jerry-cooley-md-4k-video-800-fue-into-scar.html http://www.hairrestorationnetwork.com/eve/183053-ultra-hd-4k-video-1500-fue-jerry-cooley-md.html http://www.hairrestorationnetwork.com/eve/181626-fue-dr-cooley-1213-grafts-@-10-months.html Andy, The use of ACell in this particular case helped with the donor site recovery. As stated in the first post, ACell tends to help prevent fibrosis from forming as much as it would without ACell. It doesn't prevent fibrosis completely but it does promote healthy tissue regeneration. If any follicles have been transected in the donor zone it can help them to regenerate and grow. This helps to reduce potential follicular collateral damage. ACell also helps to strengthen any hairs that are miniaturized which is what we feel happened for this patient.

This patient is in his 30’s and wanted to restore frontal zone with FUE. We started him on finasteride and performed FUE with 1.0mm motorized punch, yielding a graft count of 1,825 (1-208, 2-441, 3-770, and 4-406). Given his fine hair, we wanted to capture as many 3 and 4’s as possible, hence the slightly larger punch used. We also performed PRP/ACell to thicken existing hair and promote healing of the FUE extraction sites. We find that PRP/ACell treatment after the extractions are complete enhances healing by reducing scar (fibrosis) formation and promoting regeneration of any transected follicles. He is shown one year post op. After photos are with dry and wet hair.

It is true, yes, but it is not always the case. It is best however to try and be patient because it may take longer than "3 or 4 months". It could take 6 to 8 months to see this improve.

You're closer to a NW3v than you are a NW4 but you're really somewhere in between. Your temple recession has progressed to the point that the recession has met in the middle behind your forelock. I can't say that NW6 is inevitable but it should be considered a a potential end point. It also depends on your family history. I believe less than 4000 grafts are necessary as the front could be addressed easily with 1800 grafts and the crown could use roughly the same. The caveat is that your current density in the forelock looks to be quite high, as does the hair in the mid-scalp. This requires good density with the surgery in order to prevent your result from appearing too thin. It also depends on your hairline desires as the shape and placement can make the estimate swing higher.

The resolution you mentioned sounds implausible but photos would be necessary to see what the issue is. Consider that once an incision is made and a graft is placed the incision heals and the graft tissue becomes part of the tissue it is inserted into. Making a new incision to "twist" a graft into a different direction would require that the graft be scored with an incision made that would be large enough to facilitate this twisting you speak of. I think the potential damage to the tissue would be too great (compounded 500 to 700 times) not to mention the likelihood of transection from such an attempt.

Excessive bleeding during a hair transplant can cause difficulty in placing the grafts. The grafts can "pop" out and the bleeding can hide the incisions making it more difficult to see what to do. It also means that it can take longer for the incisions to close and start to heal. Scabbing takes longer and the grafts are more susceptible to damage through dislodging. This is why most clinics have a list of items to stay away from before surgery to avoid thinning the blood. These include alcohol, aspirin,etc.

This is referred to as "stick and place" and it has been in use for decades in North America. Many of the "old guard" in the industry used to utilize this practice and some clinics still do. The doctor removes the donor strip and that is the end of their involvement save for the occasional glance over a technician's shoulder as the technician makes incisions then places a graft immediately afterward. This can and is utilized for FUE as well but has gained much more attention due to the media that has been generated around the Turkish market.

Dr. Path is warning you about donor depletion. Asians having lower average density than Caucasians means that you have less hair to be transplanted, again on average. He is telling you that he has seen patients that have had 4000 grafts and the donor zone appeared to be thinner than what would be naturally seen with the same number of grafts taken from a Caucasian patient's donor. Regarding your patter of loss, 1500 to 2000 grafts would not be difficult to extract (based on numbers alone) but they would have to be spread over as large an area of your donor zone as possible in order to avoid thinning out any given area of your donor zone more than another. This too can cause the appearance of unnaturally low density. Forgive me if you mentioned it but if you are not taking preventative medications then any procedure at this point would be unwise. You are young and you have more loss to experience so with limited donor supply it makes sense to try and stop your loss with medical treatments before you decide to have surgery.

This patient is in his mid 30’s and had extensive hair loss in a diffused NW5A pattern. We performed FUSS of 3,210 follicular units along with PRP/ACell. He is shown at two years post-op with one reference photo showing his result at one year as well. He decided not to take any medication despite Dr. Cooley's recommendation. He understands that further loss will require more transplants, although we are hoping that periodic PRP treatments will help maintain his existing hair. Don't forget that if you have a 4K capable TV or monitor you can view the following video in ultra high definition to see the highest possible detail.

This patient had a serious form of skin cancer removed from his right temple several years prior; this was repaired using a skin graft, leaving a large, noticeable bald area. He had an unsuccessful transplant done elsewhere. Lifting the hair in the temple and temple point zone reveals the extent of the issue. Dr. Cooley performed a small FUSS procedure and transplanted 1353 follicular units in one procedure. The final improvement is obvious. The placement encompassed the entire scar which was a relatively small area overall. Despite this being almost all scar tissue the yield was very high. In fact, the patient was so pleased with the final outcome, he decided to return for a second procedure to address his crown, which was affected by androgenic alopecia. Dr. Cooley placed 1530 via a second FUSS procedure along with PRP/ACell and finasteride. This final result is 18 months after the second procedure.

Our patient came in for a check up and allowed us to shoot a new video to show his results four years after his initial procedure. We hope you like the added level of detail to the documentation of this result.