Journey's End

[Hair Apparent]

It's been over three years since the first time I walked into Doctor Jerry Cooley's offices and investigated the possibility of having a hair transplant.

 

Three HT's later, I find that it has been an education, full of illumination and discovery about the process of hair transplantation. In the interests of sharing what I have learnt, I submit this. I fully admit that some of it is subjective--there's no way to avoid that, since many of you won't share my initial level of baldness, or age, or other circumstances--but a great deal of it, I believe, is objective and reasonably universal. Thus, it may have value for those of you considering an HT or wondering what will be the result of yours.

 

Self-Education is the Key. Of everything I have to say, this is first and foremost. I was at a great disadvantage because I did not discover this forum until after I had done all the research I could and had undergone my first HT with Dr. Cooley. But, in exploring the option of an HT, I spent literally days--not all at once, but at least one session of on-line research went for twelve hours straight--learning all I could about the mechanics of hair transplantation, what the current state-of-the art was in hair transplantation, and then what physician I should approach for further information. I read of the success stories and the butcherings. I committed to memory the various terms and what were considered the most modern techniques. And then, I went through the various physicians available to me.

 

As I said, had I known of this forum, it would have saved me hours of effort. But fortunately, through my own careful analysis and study, I determined that Dr. Cooley was the surgeon I should opt to perform my HT.

 

As is true with most evolutions of life, once I had my first HT performed, I discovered that my education on the process had only begun. If for no other reason than the fact of having an HT and personally undergoing the effects of it provided me with knowledge that I did not have before. Before undergoing an HT, the best I could do was acquire a general idea of what an HT could accomplish. But every patient is different, with different hair and scalp characteristics, different rates of healing, and different desires. The only way to learn how you will respond to an HT is to have one.

 

That makes it tough to project one's own results. If I had known how my first would turn out, it might have affected the approach I used. I don't think so, but it might have, and it might affect yours, if you are considering one. It's a Catch-22; you can't know for sure how you want to approach the questions of density and coverage and placement of grafts until you've had an HT, but you can't have an HT until you've made decisions on all of these things. Toward breaking out of that circle, I recommend listening to your surgeon's recommendations and projections, and review the experiences of the folks who post here. You still won't know 100% how an HT will work on you, but you can get a decent idea, within a certain window of probability.

 

It's Difficult to be Completely Realistic. I'm a practical man, and pretty good at setting aside personal biases for the sake of objectivity. And my goals for my final results were reasonable and modest. Even so, as time went by, and I observed the final results of my HT's--and compared them to results achieved by others on this forum--I realised that I had unknowingly suffered from some small self-deceptions. Not the kind where you know deep down you're fooling yourself; I mean small things which I never realised that I was keeping myself from noticing.

 

In my case, it was mild mis-estimations of two things. First, my own degree of baldness. I was a Norwood VI, but truth to tell, I was actually knocking on the door of Norwood VII-hood. It wasn't that I was fooling myself on how much hair I did have; it was that I had resisted taking a real good look at how much hair I didn't have--until the results of my first HT started to reach fruition. At that point, I began taking a closer look at just how much area I had to cover, mainly because I was comparing my progress to others whom I thought had suffered baldness similar to mine. After so many close, unblinking looks, I began to realise just how much balding area I really had.

 

The second thing; like I bet all of us have, I studied the before-and-after photographs of HT patients on the physicians' websites. I did those mental calculations: "O.K., this guy was this bald and he had this many grafts," and tried to calculate if I would have the same results. This is a reasonable thing to do, but until I got my first HT, I was looking at the photographs with an eye toward all the positives and few of the negatives.

 

I doubt if any surgeon recommended here posts deliberately re-touched or enhanced photographs of previous patients. But there are things which affect how a patient's HT looks--the lighting, the positioning of his head, how he wore his hair before his HT(s). And obviously, a physician is going to advertise his most successful outcomes. Not that he didn't do as good a job on the patients whose pictures he doesn't show; that goes back to what I said above, some people, because of their physical characteristics, respond better to an HT than others.

 

As I gained more experience from my own HT's, my eye grew more accurate in evaluating photographs. I learnt to adjust for such things as lighting or position. It's not that the shortcomings of a patient's HT (his results and number of grafts compared to his original level of baldness) weren't there to see; they were--it's just that before, I was looking more at the positives and not looking at the negatives.

 

And, let me say, that in nearly every photo I looked at, even with a jaundiced eye, the patient's appearance was substantially improved by his HT; it's that, after my own operations, I was able to appraise them more realistically.

 

With a More Realistic Perspective, I Realised What an Incredible Job My HT Surgeon Had Done. I don't mean to sound like a shill for Dr. Cooley, and there are enough testimonials by his other patients here that support what I say, that it won't sound like hyperbole. And nothing I say is meant to be a comparison to the other surgeons recommended here. I'm sure all of them are dedicated, talented professionals. I merely relate my experiences with Dr. Cooley.

 

I knew going in that I would not be an easy patient. I had a lot of bald area and my scalp was covered with scarring from a youthful folly in hair replacement (not involving a hair transplant). At my consultation with Dr. Cooley and Ailene, I wasn't promised the moon and the stars. They gave me realistic projections and didn't candy-coat anything. In fact, this is what decided me on going with Dr. Cooley.

 

Even though I had modest goals and modest expectations, I still had a tendency to expect more than what I reasonably would get. I didn't see this as a fault in Dr. Cooley's work--from the get-go, I thought his efforts exceptional. As I acquired a more objective perspective of just challenging a patient I was, and able to set aside my previous slightly over-optimistic expectations, I realised just how remarkable a job he has done on me.

 

From the front, I am still stunned at how great I look. The hairline is absolutely perfect, appropriate for a man of my age, yet decently full. And all over my scalp, I have enough hair to mask the old scarring. I still have that big, honkin' bald spot in back. (Actually, "balding" is a better word; I have a light dusting of hair all over that. It still looks like a bald spot, but it doesn't have that shiny, pinkness that makes a bald spot really stand out.) And I would be lying if I didn't admit that bugs the heck out of me.

 

But, now, I am more able to figuratively take a step back and look at Dr. Cooley's accomplishment as a whole--which is how everyone else looks at it--rather than component parts. And then I see just what a positive change he has made in my appearance. I may not have a head of hair like Elvis, but I am no longer "the bald guy" in the room.

 

I read once of someone describing an HT for a Norwood VI or VII bald man as trying to paint a wall that needs two gallons of paint to cover it but having only one gallon of paint to do the job. It's an insightful metaphor, and accurate. That's what Dr. Cooley was facing with me, and I firmly believe that no other HT surgeon could have produced better results.

 

Obviously, I am grateful to Dr. Cooley for his skill, knowledge, and generosity. But I also want to make a comment on him personally. Every once in a rare while, one meets a person who is just amazing in his dedication, compassion, and personal ethics. Dr. Cooley is one of these. I could name a dozen different instances where he has shown this with me. And if one reads the posts of his other patients on this forum, you will see that he is this way with each of his patients. I paid for his professional skill, but I will be spending the rest of my life trying to find a way to pay him back for his personal considerations.

 

I don't want to leave out his staff, either. Ailene Russell is top-notch, both in her medical knowledge and in her approach to patients. His techs, the folks who do a lot of the grunt work and get little of the glory, are dedicated and skilled and patient-oriented.

 

Again, I'm not saying that Dr. Cooley and his staff are all of these things and the other physicians' services recommended here are not. I've read enough posts of these other physicians' patients here to see those qualities are pretty universal. I'm only stating my experience with Dr. Cooley.

 

For Those Considering Their First HT's, Do Your Legwork on HT Surgeons. Don't get swayed by fancy websites or promotions. Nor get too down in the weeds over cost. Yes, I know, an HT is not a cheap thing. But you will find that the quality surgeons all charge in the same ballpark of fees. If you get cited a fee that is significantly above or below their fees, then that should be a red flag.

 

Use your brain. Research. Read what other patients have to say. Ask questions. As I mentioned, I didn't know of this forum when I did my research into HT surgeons. One of the things that struck me immediately was when I e-mailed my questions--and they were reasonably detailed--to the hair mills, like Bosley and MHR, I got a terse, impersonal "We can't tell you anything until you come in for a consultation." That, more than anything else, turned me away from them. Certainly, any e-mail discussions with an HT physician will have the caveat that he cannot answer with specificity until he can examine you personally. But they can and will provide some pertinent information based upon what you tell them.

 

That's what makes this forum such a valuable tool. No poster here, even those few that decry HT's, wants you to have a bad experience. Read the posts, study their comments, evaluate them, and if you don't find an answer to your question already here someplace, ask it.

 

I titled this post "Journey's End". That's because, financially, for the time being, I've sunk all into HT's that I feel I can without sacrificing the financial health of my wife and myself. Right now, there are other things more demanding.

 

Beyond that, even though I have enough donor hair for one more HT, I think I may be better off waiting for medical science to catch up with my remaining baldness. If and when hair cloning becomes a viable resource, you bet I'll be jumping on that option. Fortunately, the "time for perfection of hair cloning-versus-me having the available funding" timelines work out just about the same.

 

So I guess what I'm really saying is "Journey's End" is really "Journey Interrupted Indefinitely".

 

I hope something I said here will be of help to those of you deciding on whether or not to have a hair transplant. It's one man's analysis, but reasonably objective, I think. Even so, it's just one more input. Don't stop with me. There are lots of posts here to learn from.

 

Hair Apparent

[TheEmperor]

Thanks for posting this. The general tone is cautionary and to be realistic. And that it is difficult to be realistic prior to having your own HT.

 

The part about looking at other pictures and trying to "do the math" about how your own HT would look is especially true. I've been doing that for over a year! I try to identify people with a similar pattern and hair type and then project what I would receive. I believe I can even look at someone's post op pics and predict their outcome based on the density, placement, and overall grafts.

 

Sometimes I think I'm being too optimistic and then I see guys like Jotronic who went from a N6-7 to a mostly full head of hair.

 

Other times I believe I'm being pessimistic and that I should just pull the trigger (and get started).

 

There are still lots of variables, the foremost being how many grafts the surgeon can get.

[MrJobi]

Very good post. I always tell newbies to do the research, have realistic expectations, and be patient ( also go to a coalition doc).

These days if one follows these guidlines there is no doubt the result will be very good. Of course these are always risks but a HT is a minor surgical procedure.

[Perfect Fit]

Great post especially for a new entrant like me. I have chosen my coalition doc and am currently weighing up FUE ve Strip.

[Bill - Seemiller]

Hair Apparent,

 

Thank you for sharing not only your hair restoration journey with us, but also what you have learned along the way. You have touched on many key concepts including careful research, physician selection, realistic expectations, and the illusion of density (altered somewhat by photography sometimes).

 

All said and "done", at least for now, I'm pleased to hear that you've had a pleasantly positive experience with Dr. Cooley. In reality, we always want more hair - especially those of us who are cursed with higher degrees of hair loss. I too would be a full NW6 if it weren't for the 7550 grafts I've received from 3 different hair restoration physicians.

 

Have you taken the opportunity to post your before/after pictures in our photo gallery? If you haven't already, I'd encourage you also to create a hair loss weblog to share your experience and pictures with us.

 

Thanks for sharing what you have learned and your hair restoration experience with us.

 

Best wishes,

 

Bill