2,550 Grafts from Dr. Cooley on 18 January 2006

[Hair Apparent]

Here We Go, Again.

 

To-day I had my second HT with Doctor Cooley.

 

2,550 grafts just in the placement I had desired--front loaded, leaving the front hairline low enough to form an advanced widow's peak, and the recessed temples filled in a touch. And the rest used to add density to the front and top. The blueprint Dr. Cooley sketched on my head left a little more of the crown untouched than I had hoped for, but he had sufficient grafts left over to add to the crown's circumference, "shrinking" it, as it were. And with the part of the 2,600 grafts I got the first time already there and growing, it's more than satisfactory.

 

I don't have to go into the details of the operation; it was identical to my experience the first time and mirrored the experiences of everyone else who has related his time in Dr. Cooley's chair.

 

This time, I was wise enough to take the proffered Valium in the afternoon as well as the morning so I felt no discomfort whatsoever, except for a brief episode of "restless legs" that erupted toward the end, from being so relaxed the whole time. There was also the benefit of "compressed time". I was in the chair for eleven hours, but it seemed like only three or four at the most.

 

Now the waiting drill begins. It won't be so bad this time, since I already have the results of the previous HT, and because I've already asked and got answers on all the niggling questions that come up. With the denser packing, I'm looking forward to a much better "bumper crop" this time, at least in the front and top. (According to Dr. Cooley, I still have about 1,000 viable grafts left in my donor hair. It will be quite some time before I can find my way clear to do anything with those.)

 

With me, Nashville Kat, Maximus, Prosipicience, tntiger, ifloss, and Robert, we have quite a fraternity of Cooley patients here,and we'll all be going through the growing phase together (except for Robert). Good luck to us all!

[Robert_]

Congrats on your sophomore surgery, Hair Apparent! It's true that Dr. Cooley has had quite a bit of patients posting on the forums lately. Just off the top of my head, I can list at least a couple of more in the last year or so: Brando, Briank, and Marcelo. All of those guys posted their experiences and photos but are off enjoying their hair now. Brando pops in from time to time.

 

-Robert

[Hair Apparent]

Thanks for the good wishes, Robert. I'm even more excited about this one than I was my first.

 

My first HT was, in many ways, an experiment. I had not learnt as much about number of grafts versus density as I have since the first one. My goals were modest and I wanted complete coverage to avoid a shiny bald spot in back. Because of those two desires, I gambled that, maybe, one would be enough.

 

And if it turned out that it wasn't, even with the modest goal I had in mind, I wasn't any worse off, since a second HT would take care of it.

 

At my age, I was going for a mature look along the lines of actor Robert Montgomery's hair (see photo)

 

 

This is the way Doctor Cooley designed my hairline on the first HT and now he's added the density to it that should give me the results I want, at least in the front and top.

 

I know for the younger fellows out there, this would hardly be satisfactory, but for me, it is perfect--and a hell of an improvement for a guy who had no hair in front or on top when it all began.

[Prospicience]

HA,

 

Sorry the timing didn't work out on the 18th, by the time I arrived to get my stitches out Dr. Cooley had already started with you. I asked Stacey about the possibility of meeting you but unfortunately it was a little too late. Stacey is blonde haired assistant (due in March I believe) who removed my sutures and did most of the clean up work a week earlier.

 

Post some shots when you can; congrats on the return trip and best of luck!

 

Regards,

Mike

[Hair Apparent]

No worries, Mike. I figured the lines had gotten crossed somehow.

 

I'm a little surprised that Stacey didn't ask Doctor Cooley to admit you (or maybe she did, and he had his reasons for not admitting you at that particular time) since during my first HT, Dr. Cooley asked if I minded if a potential patient come in to observe the procedure--and, of course, I had no problem with that.

 

Most likely, there was some hygenic reason why you couldn't be admitted at that particular time. Anyway, sorry I missed the chance to meet you.

 

As I mentioned, there are at least a half-dozen of us who have all received HT's from Dr. Cooley in the last six weeks. We'll all be going through the growth phases together. It's like all of us are in the same graduating class. Maybe we could all work out some kind of "final result" reunion sometime next year.

 

Thanks for the kind thoughts, Mike--and good luck with your new hair.

[Prospicience]

HA,

 

I truly believe Stacey did ask but I think he was already working on your donor area - certainly no time be meeting and greeting then!

 

I was able to meet Nashville Kat during his procedure as it was late in the day and Dr. Cooley was more then halfway into the placements within the recipient area. On the day of your procedure, I was in there right around 8:00 AM - the beginning of the process as you well know.

 

This past weekend, I spoke with Maximus as he was driving home the day after his procedure. It was a great call; we talked for nearly two hours relating transplant stories, general experiences and opinions overall.

 

A "Cooley Reunion" of sorts would be a good thing!

 

Regards,

Mike

[Hair Apparent]

Yeah, I have to agree. At the time Doctor Cooley had my scalp flayed open to remove the donor strip was probably the time in the process when the chances for infexion are the greatest (let alone it probably being one of the most delicate phases of the operation).

 

Just a matter of unfortunate timing.

 

Incidentally, I took a look at your pics and the results look great. You have a higher fringe area of hair than I do so you got excellent coverage with your 3K grafts.

 

You saw the kind of hairline I wanted, and received from Dr. Cooley. With the 2,600 grafts from my first HT distributed across my entire bald area, it fit that hairline but was sparse all over. With this next 2,550 concentrated on the front and top (and some used to close the sparse spot at the crown) I feel confident that I will get oh-so-close to my goal.

 

But with what you're starting with, Mike, I think you are going to wind up with an outstanding result.

 

It's going to be fun to see what the next year brings to all of us.

[Hair Apparent]

Update 1 HT2 + 6

 

I gotta say, I'm loving this.

 

Obviously, there's not much in the way of developments to report after only a week, but I can speak to the experience, and so far, it's been great.

 

Following my first HT, everything was new. I didn't know what to look for, except in the most general of conditions. It was tough to know if what I saw looked good, adequate, or bad. I had to learn everything from comparison from photos and comments posted here by others and the answers from the fusillade of questions with which I bombarded Ailene Watts at Doctor Cooley's office (and to which, she was most patient, informative, and gracious).

 

Now I have the benefit of experience and with that, I have to say I'm tickled to death at what I see so far.

 

The transplanted hair from front to top is much denser than last time--because I went with the front loading this time (as opposed to an even distribution across all of my balding scalp last time). That's the 2,550 grafts I got this time plus half of the 2,600 from my first HT all in that area, giving it a much more impressive look this time than last, at least from the front.

 

For the first few days, there was some redness of the skin in the transplanted area, but nothing dramatic. Almost no scabbing and what there was was tiny. And, like last time, no swelling at all. I went ahead and buzzed down my naturally growing hair to match it as closely as I could to the length of the transplanted hair, just for symmetry's sake. The suture line shows, of course, but who cares? (And, in fact, the fresh suture line this time is less conspicuous than my first one was at the same time along in the process.)

 

In fact, the day after the HT, I visited my father-in-law's house (I had to, to take care of a family squabble) and stopped off at a grocery store on the way home, and went hatless. I got no undue stares or questions.

 

Since then, I've gone out in a public hatless a couple more times--I try not to do that too much, just to avoid any accidental bumping or trauma to my scalp--and haven't felt conspicuous in the least.

 

The best part has been seeing clearly, in any kind of reflexion, under any kind of light, the hairline which I had hoped to gain. No "washing out" of the hair under harsh lighting because of the sparse density.

 

As far as any discomfort: the first night, I had a bit of a headache--six or seven Tylenol took care of that--and some tightness at the suture line. Within a day or so, there was no more aching, although I still feel a bit of tightness at the back. Itching has not been a significant problem. The sutures itched more than anything else, and the itching creme that Doctor Cooley provided took care of that. As for itching in the area of the transplants, most of the time it has been so minor that it was easy enough to ignore. Sometimes, though, I just sprayed some of the "green stuff" on my scalp and that remedied the itch.

 

I've noticed this morning that some of the transplanted hairs have started to shed--as is to be expected. It's a bit sad, since it has been so much fun having them there, but at least I know that it's not "good-bye" to them, but rather "until we meet again" in a few months.

 

This is going to be a fun year!

[dhuge67]

How much of the transplanted hair usually sheds compared to how much stays? I always thought that whatever was transplanted would shed (all of it) and then start growing again in 3 months or so.

 

What's the deal?

[Hair Apparent]

Dhuge,

 

While it varies, naturally, from patient to patient, generally speaking, you are correct: all of the transplanted hairs fall out within the first days, as the follicles retreat into the telogen phase. Then, as you said, the hair will start to grow back in about three months.

 

However, occasionally, there are some hardy souls that do not fall out but remain. Following my first HT, I had maybe 5% of the transplanted hairs stick around for the long haul.

 

The transplanted hairs from this HT began to fall out--at least to the point I noticed--at about day five. To-day, I've noticed even more "jumping ship". No doubt the rest will follow soon, except if I have any stubborn ones, like last time.

[ifloss]

None of mine have fallen out as of day 14 - I hope they never do. I feel like I actually have hair again.

[Hair Apparent]

I've never read here of any HT patient retaining all of his transplanted hairs in the first few weeks post-op, but I would imagine it's certainly possible.

 

If you've managed to hold on to all of yours, then--good deal!

 

I still have quite a few of my transplanted hairs visible after the first week, but I can see that they are slowly abandoning ship. It's a bit difficult to tell, since this crop of grafts was planted more densely and some of it was the hair from my first HT, which I let Doctor Cooley buzz down to make the second procedure easier.

 

I can live with seeing them go away, because I know they'll be returning in a few months. I was an "early bloomer" the first time, and lots of the hairs came back within six weeks. Maybe I'll be lucky again this time.

 

Congratulations on what seems to be a good break for you though, Michael.

[Prospicience]

A lot of my new hairs stayed with me even after my suture removal (approximately 60+ percent still there two weeks after the procedure which was on 1/4/06). However, they are jumping ship quite quickly now - as expected all along.

 

Regards,

Mike

[ifloss]

Ditto on that. They have started abandoning ship as well. It's like losing a good friend, except he'll be back in a couple of months.

[Robert_]

Originally posted by Hair Apparent:

 

As I mentioned, there are at least a half-dozen of us who have all received HT's from Dr. Cooley in the last six weeks. We'll all be going through the growth phases together. It's like all of us are in the same graduating class. Maybe we could all work out some kind of "final result" reunion sometime next year.

 

 

 

Make that one more, Hair Apparent! That's right! I was back "in the chair" on Friday the 3rd for another round! Just like you said, we'll all be going through this together! Maybe we should all try to meet up at Pat's "Forum Appreciation Party" to swap stories?

 

-Robert

[Hair Apparent]

Make that one more, Hair Apparent! That's right! I was back "in the chair" on Friday the 3rd for another round! Just like you said, we'll all be going through this together!

 

Another near-miss! I was in Doctor Cooley's office the day before, having my sutures removed, and Ailene told me you would be in the next day. But I didn't know it was for another procedure, and I had neglected to ask her the time you would be there (not knowing it was for another procedure and that you would be there most of the day).

 

Unfortunately, I am currently dealing with some medical problems my wife has developed and the time was tough to spare. But if I had known that you were also resigning from your position as moderator, I would have made the time to drop by.

 

Your constant presence here will be sorely missed, my friend, and I regret not having the chance to drop by and meet you in person.

 

Good luck on your third pass. With all the others, we comprise quite a "graduating class" of Cooley patients, indeed. We really must find a way to get together toward the end of our year's joint growth.

 

Best of luck!

[Robert_]

Oh man, I'm sorry to hear about your wife. I hope everything works out well.

 

I can totally understand that you didn't have the time to spare. If it's any consolation, I was out like a light almost the entire day. That's no exhaggeration; I snoozed almost the entire time. To call me a "lightweight" with sedatives is nothing short of an understatement so I most likely would have been unconscious anyway. Even if I would have woke up, I probably wouldn't have remembered our meeting.

 

Thanks for the good luck. This was only my second pass and the last for quite some time. Good luck on your second pass as well!

 

-Robert

[Hair Apparent]

Robert,

 

Thanks for the good wishes for my wife. Actually, it's serious enough that she goes under the knife this coming Monday; but if the surgery does what it is intended to do, then--once she recovers from the "controlled trauma" of the surgery itself--she will be restored to good health.

 

It's funny how the sedatives affect people differently. With me, I was simply nice and relaxed, and there was a sense of "time compression", but I don't recall drifting off. Then, again, there was nothing which forced my attention, either. Years of sleep deprivation at sea pretty much enables me to concentrate when I have to.

 

However, speaking of concentration, yes, I did know that this was your second HT. I must have had a brain neuron misfire when I said "third".

 

I'm glad everything went well for you last Friday, and you know the drill, now: "hurry up and wait".

[Maximus]

Hair Apparent,

 

Thanks for posting, it is encouraging and I am looking forward to hear how things progress. Sounds like several of us are in the hurry-up-and-wait stage.

 

I am almost at one month since the procedure. I've started a new job and it keeps me traveling so much that I still need to post pictures to a photo album. Twelve days after my procedure, I started work and they took my picture for the photo ID. It was cool because all my transplanted hair was still there and it turned out good.

 

Keep us posted.

[Hair Apparent]

Update 2 HT2 + 22 days

 

Nothing much to report at this stage. As expected, the transplanted hairs have continued to "jump ship". Most of them are gone now; however, some hardy souls are still there. It's difficult to estimate how many since they are masked by the hair from my first transplant which is now growing back after Doctor Cooley shaved it for my second HT.

 

But I see more hair in front and on top than I did before the second HT, so I know some of the hairs from the second HT are still with me.

 

The suture scar seems to be healing on schedule. The suture line itself felt a bit more raised to me than the first time (it's difficult to remember how the first one felt at the same stage last time), and I am attributing this to Dr. Cooley's use of the Trichophylic closure on me this time. In any event, the hair seems to be growing back and filling in the area, at least at the same stage it was the first time. So I expect no problems in that area.

 

Just for the record, I went back and documented the number of us posters on whom Dr. Cooley has performed HT's in the last two months:

 

08 Dec 05: Nashville Kat (second pass)

20 Dec 05: tntiger

04 Jan 06: Prospicience

12 Jan 06: Maximus

13 Jan 06: ifloss

18 Jan 06: me (second pass)

03 Feb 06: Robert (second pass)

08 Feb 06: daytrader

 

That's quite a number in such a small period of time. It's nice to have that many fellows going through this thing at the same stages that I am. (Although all of you guys started with more hair on your noggins than I had, so I'm going to be envious of your results.)

 

Good luck to us all!

[Prospicience]

H.A. & Edward,

 

HA - sounds like all is well and progressing as scheduled/expected. I risked a hair cut a week after suture removal. One thing I did not plan for, the area that Dr. Cooley shaved the hairs down near the donor strip popped out once the hair around it was cut. No scar show through but the shorter hairs were a "tell tale" sign to the "line" (can you say 2+2?).

 

Max,

 

Sorry I haven't called - I still have the number and will find the time! Sorry

 

Regards,

 

Mike

(As in Pro not Pri - just teasing HA)

[Hair Apparent]

Update 3 HT2 + 79 Days

 

 

Time to bring everyone up to speed on the progression of my second HT by Doctor Cooley.

 

First, some old business from my first HT: As I have mentioned--probably ad nauseam--I was a Norwood VI and had the 2,500 grafts from my first HT evenly distributed over all of my balding area. My main purpose in that was that, in my case, I could not stand the idea of having a decent amount of hair up front and a big shiny bald spot in back. I had to have some hair in the back, even though I knew it would be sparse and hardly mask my baldness.

 

Of course, the cost was sparse hair all over, and as time progressed following the first HT, I realised just how much I had overestimated the results, in terms of density.

 

In the elapsed time since my second HT, I have taken away the following lessons from the first one, and they are all positive.

 

First, even after the end of the "golden period"--months seven, eight, and nine--when all of the transplanted hairs usually have sprouted, that is not the end of improvement in the transplanted hair. And that improvement, while not as thrilling as seeing even more new hair sprout, is significant.

 

After the "golden period", the transplanted hair will continue to thicken by individual shaft. Moreover, it will gradually lose that "Chia pet" look and begin to take on the aspects of hair that normally grows on the top of the head. When Dr. Cooley performed the second HT, it made the procedure easier to let him shave off the hair from the first HT. (In the front and top; for the second HT, I had the grafts transplanted in the more traditional fashion for men high on the Norwood scale: front-loading at the hairline and on top.)

 

By now, the hair from the first transplant has all grown back, and having it gone for a brief period enabled me to view the stark transition more readily. All of the hairs from the first HT have plenty of body and are much more manageable. A brush puts most of them in place, and they look robust, not like the dying-through-dwindling hairs of a balding man.

 

Certainly, there is still a lack of density and is too sparse to accept alone. And this is where there has been a neat turn-around in my spirits. Before my second HT, the sparseness of the hair was a disappointment--expected, but still a disappointment. However, now that I've had the second HT, I know that the hair from the first HT is there to provide an even fuller look after the hairs from the second HT begin to grow. It's kind of like having a leg up, as it were, and I'm very glad for what is there, even as sparse as it is. It's a nice turnaround in morale.

 

Lastly, there is no sign of any shock loss at all. I have all of the hair that was there before the second HT, and if anything, it looks healthier than before.

 

As for the hair transplanted to the crown and back in the first HT, it has continued to grow and thicken, as well. Certainly, that area is still going to look mostly bald, but having at least some hair there is a great morale booster for me. And, when the hair from the second HT grows in, it will be easier to blend in the back by having at least some hair there. At least, there won't be an abrupt stop from "hair" to "no hair".

 

On to new business: Naturally, at this stage, there is very little to report with regards to the growth of the second-transplant hair. Like the first time, a few hardy sprouts have appeared, but nothing that would make a cosmetic difference. If it follows the same pattern as last time, I won't begin to see any growth that makes a significant difference until somewhere between months three and four.

 

As to the strip scar, this has been a thing in which I have taken especial interest. The first time, I scarcely gave a thought to the scar. I finally took the time to notice it at about the third month, and I saw that all of my hair had grown back around it. I keep my hair at about 1/2-to-3/4 of an inch and my hair completely masked the scar. If I separated the hair, the scar was visible as a thin red line. However, within two-to-three months, that line had faded almost to invisibility. I can't even find the first scar now, and I know where it should be.

 

Between my first HT and my second, Dr. Cooley had gone to using the tricho-closure method. At first, I developed a few concerns about that. Where I had not even noticed or cared about the scar the first time, my attention seemed to be more focused on the second scar from the start.

 

Three things concerned me in the fourth week or so. First, the skin in the area of the scar seemed raised to my touch, and there even seemed to be a little "lip" of skin that wasn't there the first time. But I couldn't be 100% sure because I had paid so little attention to my first scar at the same stage. Also, it looked like my hair wasn't growing back around the scar, as it did the first time. But again, I couldn't be sure.

 

One thing I was sure of was that I was suffering from some sort of inflammation on one side of the scar. I went in to see Dr. Cooley at about the fifth week, and he discovered that the source of that irritation was a sebaceous cyst that had formed under the skin at that part of the scar. I have naturally oily skin and, it develops, that such a skin type lends itself to such cysts. Dr. Cooley removed the cyst and the irritation was gone.

 

Since then, all the hair has grown back and the scar is not noticeable at all, even when I ruffle the hair. I have to part my hair to find it. When I do that, it is still recognisable as a scar, but much less conspicuous than in the first few weeks. I'm not sure if it is healing at the same rate as my first, but the most important thing is that it is well-hidden by even my short hair, and that's what matters most to me.

 

At the same time, the slight raising of the skin that I felt in the first few weeks has gone away. Running my hand casually through my hair in back does not detect anything. It seems most of my worries there were premature.

 

Time will tell if the second scar winds up as invisible as the first one, but in any event, I'm no longer worried about it.

 

And that is where things stand at present. The one lesson to take away from all this has been to re????nforce what I have said all along about the experience of having an HT: Patience--patience--patience. Even after all of the grafts have sprouted, there is still a great deal of improvement to follow. Not as dynamic, perhaps, as seeing all those new hairs grow in, but there is still some improvement coming, even more than a year later.

 

Good luck to all of us going through the same thing!

[Doc Patient]

Hair Apparent,

 

Nice to read your recent update. I'm at HT2 + 87 days. Yes, we are most of the way through the dormant period at least now.

Question: when you had your first procedure (that did the entire scalp with low density), what time difference did you note between early sprouting in the front vs. midscalp and crown? My second procedure was done for midscalp and crown primarily - I've heard these areas progress more slowly. Just wondering what your experience was.

Like you I did not want to do hair transplantion only to the front 1/3 leaving a big bald area behind, so I did my second procedure at 5 1/2 months after the first (first did frontal 1/3). The front is looking great, and hopefully the bald areas behind will start filling in soon.

[HairHope]

Hi Hair Apparent!

 

Congratulations on your second pass, I have had only one pass, but clearly need a second one in the next year or so to improve density. I will certainly be asking questions about your 2nd HT experience, thanks for sharing.

 

You are moving into the fun period now. Good luck!

HH

[Hair Apparent]

Originally posted by Doc Patient:

Question: when you had your first procedure (that did the entire scalp with low density), what time difference did you note between early sprouting in the front vs. midscalp and crown? My second procedure was done for midscalp and crown primarily - I've heard these areas progress more slowly. Just wondering what your experience was.

Doc,

 

The conventional wisdom is that growth of transplanted hair in the crown and the back lags behind the growth rate of the hair on top and in front, and that was my experience.

 

To be specific, it helps to separate the crown from the back of my head.

 

The hair growth on the back of my head lagged behind the growth on the top and front by about two months. At the crown, it was even slower.

 

Only in the last few months has any hair grown out in the crown that made a real cosmetic difference. In the back, near the bottom of the balding area, the hairs are now thick--individually, not in terms of density--and do a decent job of "closing up" the balding area, oh perhaps, a little less than an inch.

 

In fact, that seems to be the case all the way around the crown and back. The hairs near the fringe area of my non-transplanted hair seem to be fuller than those in the centre. But now it's clear that there is hair all over the balding area in the crown and back.

 

As I said, it's not enough to disguise the baldness, but it's a real psychological lift to feel the hair back there. And when the hair from the second transplant grows in and gets long enough, I will be able to comb it back and get something of a gradiated blend, rather than a stark shift from hair to baldness.

 

So, the bottom line, at least from my experience, is that, when dealing with the crown and back, it's best to add two-to-four months to the usual milestones in the time line for hair growth following an HT.

 

Hope this helps.