BJ47

A quick bathroom mirror pic as I’m at the DMV to get a replacement driver’s license. I’m a few weeks away from my one year mark.

Dr. Cooley in North Carolina. He books out about a year in advance, but he's known for natural hairlines.

Did they not remove your first scar during your second strip surgery?

Yes, I don’t see my new PCP until March so I went to an in-network walk in clinic.

Yep, had them removed at an urgent care tonight. The nurse said “it looks like he did embroidery on the back of your head!” 🤣

I heard back from my doc and he said all looks perfectly normal and that I should go ahead and have them removed. Thanks for the advice!

I did, will probably wait until I hear back. Should be just a couple days at most.

I’m almost 3 weeks in and should have my sutures removed on Wednesday. These pics are from a few days ago.

This was day 3 after my first in-home shampoo. The redness subsided and by day 7-8 the scabs had fallen off. It looked just like a buzz cut in the transplanted areas. I don’t have any photos of that.

Dr. Cooley recommended 2500, or +500 to address the crown with a “sprinkling”. As far as FUT vs FUE, I already had a scar from my first procedure so I didn’t see any reason to press for FUE. My understanding is that FUT tends to have a higher graft survival rate and FUE can cause a diffuse thinning in the donor area if a large number of grafts are removed.

I had an FUT procedure and I was told to keep the sutures in for 3 weeks. By that timeline I should have them removed in a couple days. The donor scar line is still a bit tender when light pressure is applied. Normal? Just want to be sure I’m healed enough for suture removal. Seems like from what I’ve read 3 weeks is a little on the longer side and should be fine.

Probably, but I have to ask anyway! It’s day 8 from my procedure and after my shower and drying my hair with a hair dryer on cool I noticed some white flakiness on the recipient area. I used gentle, circular motions with the pads of my fingers and some of the scabs easily came off into the sink. In some of them, there were hairs. I know the hairs will shed in 2-3 weeks and that the scabs should be coming off around now, I’m just wondering about the hairs in the scabs. Is this normal? Photo below.

I'm almost 7 days post op and wanted to share some pics. Planned on 3000 grafts with Dr. Cooley, 2500 frontal + 500 crown, and ended up with 3416. That was a happy surprise! 1 - 1042 2 - 1487 3 - 887 These pics are all from the day of the procedure. I posted another, lengthier post here if you're interested in more.

In the post op papers I received from my surgeon, he says "Remember that the grafts will usually enter a dormant stage around 2-3 weeks post op. Don't be alarmed if you see the hairs begin the shed. Sometimes a small amount of tissue can be attached. This is normal and what we expect to see." I don't know if this is what you're seeing, but I'd definitely check with your doc in person if you can.

Day 3, first home shampoo. Starting to get tingly and itchy in the recipient areas. Took my first home valium to get some sleep tonight and boy was it tasty.

Here's a thread I started last year with more info and photos. I ended up going for an in-person consult at Dr. Cooley's request November of 2021. He examined my scalp, reviewed my chart from the first procedure, and asked if I had any 1 year post op photos without any sort of concealer. I didn't, nor did I go in for a 1 year followup as he suggested at the time. He said most of the remaining hairs appear to be transplants with a bit of native hair still present in the middle tuft area. He said there had definitely been continued native hair loss and believed this was the primary culprit. I asked if the areas where there were *only* transplanted hair, like the hairline itself, was the sort of result he'd expect to see this many years later. He agreed no, said that there could have also been some thinning of the grafts diameter-wise, and that "these days we can get the grafts closer together." He also suggested I discontinue finasteride and begin a combo of dutatseride and oral minoxidil (which I've been on for a little more than a year). It's also worth noting that I have a severe anxiety disorder and that stress in general is not great for hair. I wonder how that may play into things as well.

Hi all, It's been a whirlwind couple of days, and I don't have the clinic photos and final graft counts in hand yet, but I wanted to put down some thoughts about my procedure with Dr. Cooley on Wednesday, December 14, 2022. Dr. Cooley did my first procedure back in 2008, and when I felt it was time for a second go-around I didn't need to do any research. I always knew I'd go back to see him. Just as a frame of reference, he had over 10 years of experience with hair transplantation back in 2008, so add 14 more years to that and, yeah...the man and his team are absolute rockstars. My first procedure in 2008 was 2100-ish grafts to the hairline and frontal 1/3. It grew in, matured, and all was well. Like a dummy I stopped taking Propecia for a couple years and, of course, my hair loss progressed slowly. For this second procedure, I reached out for a consultation in August of 2021, had a call with Lollie in October 2021, flew to Charlotte for an in-person consult in November of 2021, and scheduled an appointment for my surgery for mid-December of 2022. Yep, about a year and a half from first inquiry to sitting back in Dr. Cooley's chair. Was it worth the wait? 100%. You're going to be enjoying your new hair for the rest of your life so you might as well go with a decorated surgeon with a track record for excellent results even if you have to stand in line for a bit. Two days ago, on the morning of the procedure, I arrived as requested at 7 am. I met with Angie, signed some paperwork, confirmed the number of grafts, and downed an antibiotic and a Valium before choosing some movies from a big binder. I joked that I hoped to sleep through the procedure and probably wouldn't watch the movies and Angie mentioned that they like having movies on in the background while they work. I said I would try to pick some movies they hadn't seen a million times and she said "Nothing Bourne!" Too funny. Dr. Cooley joined us and reviewed my chart and we talked about the game plan. 2500 grafts to the frontal 2/3 and 500 grafts to the crown (a "sprinking", he said). Best to not be super aggressive with crown coverage just yet. I use Toppik concealer and at least these 500 crown grafts would give those fibers something to cling to. He drew a suggested hairline and it was spot on what I was expecting. He took some "before" photos, which I hope to be able to share soon. Spoiler alert: they harvested approximately 3300 grafts so I think my crown coverage is a bit more than we were anticipating. Unlike some clinics that will charge you to transplant "extra" grafts they end up with, Dr. Cooley lets nothing go to waste and transplants every extra one at no additional charge. As one of the technicians quoted Dr. Cooley saying, "I took them out, so I'm going to put them all back in." That's a good man right there. The thing I was most nervous about was the donor strip removal. I laid face down on what looked like one of those sitting massage chairs and was injected with Versed to help relax me. Dr. Cooley then numbed me up in the donor area. He used one of those vibrating buzzy things with each injection of numbing med and I couldn't barely feel more than a tiny pinch each time. I burn off sedatives relatively quickly and remained alert for the entire strip removal and suturing. When it was over, Dr. Cooley asked "So the Versed didn't do anything for you?" I responded "Well, I was awake for all of that, but it just didn't seem like a big deal." Mission accomplished! Apparently I bleed more than the average person, and Dr. Cooley adapted by using a different suturing technique that gives the same clean scar results he's known for but also helps control the bleeding better. He explained what he was doing at each step to one of the other folks that was assisting him. Way to pivot! The doc made all the sites for the grafts while the technicians began dissecting the grafts from my donor strip. Lunch break! Dr. Cooley catered for the entire staff, and Dori was super helpful in taking my order and bringing me a plate with a chicken salad sandwich, the most amazing side salad, and a chocolate cookie for dessert. I snuck out of the exam room to go brush my teeth right after. Best not to have stanky breath with Dr. Cooley and helpers hovering inches from your face! haha After lunch the implanting of the grafts began. Another shot of Versed (by my request) and I was in and out the rest of the day. Super comfortable. Shoes off, blanket pulled up to my chin. Easy peasy. Everything wrapped up about 5:30 pm. Most of the staff had left much earlier but Dr. Cooley stayed behind to double and triple check all the graft placement, make tiny adjustments, and send me off with my post op care instructions. I didn't get a lot of sleep that night since I was up every 2 hours to spray the grafts and it was difficult to find a comfortable sleeping position. I took some ibuprofen to try to get ahead of any pain; Dr. Cooley gave me a few extra injections of the numbing meds in the donor area at the end of the procedure and that helped greatly. The next morning I had some breakfast, took the antibiotic and steroid pills I was given, and headed back into the office to get cleaned up. My donor area was a bit tender so I took a pain pill. Took another about 6 hours later. They made me nauseous, a common side effect, so I've discontinued and have been just taking the occasional ibuprofens as needed. I had the most amazing shampoo ever, after which the technician combed through very delicately looking for any grafts that may have popped out during the washing and drying process. He found a few and Dr. Cooley came in and put them back where they belonged. 3 popped grafts out of 3300. That's impressive numbers. The doc then gave everything an inspection one last time, asked if I had any questions, and encouraged me to contact him with any questions or concerns. Here are some photos taken when I got back home this evening after a day of air travel. This is after the shampoo at the office and with constant spraying throughout the day. All the longer hair are native and 2008 transplants, all the short stubbly hairs were transplanted yesterday. I'll share the pre and immediately post-op photos when I get them as well as final graft counts.

I recently scheduled my second HT (13 years later) and on the call to set up the date, the surgeon's office asked "You have dark hair right? You don't dye it do you?" Any idea why they'd ask that? It's a FUT procedure. Just wondering about the relevance.

Also, been digging through old photos and came across this 6 month post-op comparison. Not sure if it's helpful.

I appreciate everyone's thoughts very much. I put together this comparison and sent it over to Dr. Cooley's office for thoughts.

I took some time after showering tonight to comb through my hair and inspect after studying my post-op photos for graft placement from 13 years ago. I can tell that part of that front "tuft" is still there, probably the middle 1/3 or so. From the pics it doesn't look like many/any grafts were placed in this area and today it's noticeably thicker than the right and left sides of it. The hairline is still in place and I can make out the shape of my hairline now as compared to the post-op photos. There may have been some thinning of the transplanted hairs themselves, but the majority of the grafts appear to be there and still growing. I think this is mostly a case of my original hairs continuing to thin and recede. Sure, graft thinning could come into play as well but I don't think it's as significant as the former. @asterix0 I was off finasteride for about 2 years. I feel like it was a slow and gradual thinning over the last 13 years rather than a rapid loss scenario. I wonder what it would look like now if I had 2200 grafts, with that placement, on a slick bald head? @JDEE0 I don't know if it's fair to compare to a procedure that some are calling a "unicorn" and "YouTube worthy." LOL My results never looked as good as his. I wouldn't have considered my results at their best to be super dense but they provided coverage I was happy with for a time. @bostonguyI didn't ask Lollie what she thought about my current day photos. I didn't think anything was going on beyond original hairs continuing to fall out. Should I follow up with any specific questions? Some of you have mentioned having my scalp checked out or tested. In what way? Who could do that for me, and what would they be looking for?

Here's what I came up with in the way of post-op, no Toppik photos. I realize these aren't the greatest quality. Some inside, some in the sun. These are mostly a couple years post-op.

And day 1 post-op. Back home.

And here are the post-op photos (I also included one of the hairline that Dr. Cooley drew right before the procedure).

I managed to find the drive that has my photos from the day of the procedure. Here are the pre-op photos that Dr. Cooley took. I'll do another comment below this one with post-op photos to show graft placement.