dissapointed with plucking and acell any advice going forward ?

[ej]

Baldecristo

 

Yes the Dr informed me acell was experimental , the Dr is equally dissapointed with the donor area as I am, and im not accusing anyone .

 

I was specific to the donor area as that is my main concern , please dont forget the scar on the right side has healed ok , my post was to gain some feedback as to how to move on from this , my dissapointment is with the 2 donor areas shown ,as I expected at the very least a regular result , I assumed that at the very least the closure would be equal to an everday standard closure , there are no guarantees or promises with surgery and the Dr DID NOT make any . What was relayed to me was that the acell had beneficial qualities .

 

Lorenzo is right I think , acell is used to compliment surgery , please understand my point , the scars are more like patches of hairless scalp and less like scars however the procedure is to improve the appearence cosmetically , this is why im dissapointed , as the areas need either revising or grafting into , therefore is it not just better to use the standard closure in the first place ?

 

Azn guy thanks for the post and advice , my post was, and is for advice on how to move forward and what my options are as I would like to put this behind me and move on with my life

 

Thanks

 

 

EJ

Edited January 31, 2011 by ej
spelling

[lorenzo]

EJ looking at your before left side pictures your hair looks very sparse. This is why I though it was a revision because after one week there was little hair above or below the scar. The after pictures on the right side show an area without hair. You stated that it is not scar tissue so it is hard to understand what took place. I cant recommend what to do because I have a feeling that something more than the doctor skill is taking place regardless of acell. You were quite thin before the surgery (left side) where you stated you didnt have a scar.

Regardless I wish you the best.

[dakota3]

I also had Acell with plucking done with Dr. Cooley. While I can't say the scar has hair growing in it, I can say that it's appearance has slightly improved and it is not rigid or bumpy anymore. In fact if I run my fingers back there I can't even feel where the scar is. I think this like anything else needs to be perfected before we can see any spectacular results.

[azn_guy]

Do what the doctor suggests, or at least take it into consideration.

 

EJ, sorry it didn't work out for you. Dr. Cooley is definitely stands behind is work. Sometimes there are just some physiological things even Doctors can't overcome.

 

Dr. Cooley recommended a Scar Revision for me. I asked him "what are the chances of this happening again to me"

 

He said "I'm 99.9% sure the Scar Revision will fix this issue"

[ej]

Hi Lorenzo ,

 

The before pictures of the right hand side show the area as it was before my last procedure , you can see the scar , the surrounding hair never grew back ( shockloss ) from 8 yrs ago therefore its scar tissue surrounded by non hair bearing scalp , this is the area the beard grafts were placed in to ( see pic )

 

Re the left yes its sparse before the procedure and you can see two strips from earlier surgery , however the strip was taken slightly higher up ( see pic 4 ) even though there was little hair there prior, the area does seem to of expanded ( see pic 10 )

 

Im wondering whats best revision or fue appreciate its difficult to advise , but if you feel something else is taking place I would appreciate it if you could share your thoughts

 

Thanks

 

ej

Edited January 31, 2011 by ej
grammar

[Dr. Jerry Cooley]

This posting leaves out some important information. I was consulted by this patient to 1) improve the old donor scars from numerous procedures and 2) add hair to the front which was very thin despite all the work he’d had done. It was my understanding that these were equally important. I suggested FUT to fill in the front and described the new plucking procedure. Because it was so new and we did not have a clear idea of the success rate, there was no charge for the plucked grafts or use of ACell. The only fee was for 2,000 FUT grafts. This was not planned as a ‘one and done’ and there was discussion that multiple procedures would be necessary to fully correct his old donor scarring. No results were promised or guaranteed but I certainly did give him an optimistic assessment based on the early results I was seeing in other patients.

Looking at the results:

1) Plucked beard grafts in old donor scars: The patient’s scalp had extensive wide donor scarring from old procedures. We performed about 600 plucked beard grafts throughout this area. I have not seen the patient in person but from the photographs it appears that virtually none of them grew. We have since learned that plucked grafts do not grow well in scars and that the wider and denser the scar tissue, the lower the success. I understand the disappointment and upset by the patient as I too am extremely disappointed by the failure of the plucked grafts to grow in scar tissue. Looking at the photographs, there appears to be an improvement in the texture of the old scars from the multiple recipient sites made and implantation of ACell coated grafts. I believe this will make the area even more receptive to FUE grafts in the future (see below).

2) New donor scars: The patient had minimal donor reserves and minimal scalp laxity. Yet he desperately needed some density in the front central region of his scalp. Despite all the work he’d had done, there was a lack of density which was the primary factor contributing to his balding look. I identified 3 areas which I thought we could harvest from. We were able to obtain over 2,000 FUs which we used to transplant the frontal core. Because all the good, safe areas of his donor area had already been harvested, I had to go to areas that I would normally avoid. I wrongly assumed that ACell would ensure scarless healing of these donor strip sites. Two of the three sites stretched due to their location and are now creating a cosmetic problem. I have since learned that ACell doesn’t prevent stretching of donor scars, but it does eliminate the thick, dense scar tissue that would normally result. The texture of these new “hairless gaps” is softer and feels like normal skin, according to the patient. I believe that these areas will be very receptive to FUE grafts. I take full responsibility for creating this result and have offered to fix it (see below).

3) FUT results: It seems unfair to judge this case without looking at the results of the grafting to the frontal scalp. The patient had already been committed to longer hair to cover all his old donor scars, yet this made the lack of hair in his frontal scalp even more apparent. From what I understand, the 2,000 FUs have grown in well, yet no before and afters are presented. Also, on top of everything, the patient had an unfortunate incident in the post op healing phase where a relative accidentally slammed the car trunk down on his grafted area, creating a full thickness laceration. I have offered to fix this as well. It’s easy to second guess in retrospect and question whether the patient should have had strip FUT. Yet, he desperately needed more hair in the front and it seemed like the best option at the time.

Moving forward:

1) I believe that a combination of beard and scalp FUE will correct the two donor ‘scars’ I created.

2) Beard and scalp FUE will be even more effective in the old donor scars as a result of the area being ‘rejuvenated’ by wounding and ACell.

3) Plucked grafting should work well in his frontal scalp and to fix the area where he had the accident and to add some more density overall.

I have been in communication with the patient for two months now and have repeatedly offered all of this at no charge. I sincerely hope the patient takes me up on it. I am as anxious as he is to see this turn out well.

Dr Cooley

[dakota3]

I'd like to add a little more to my previous statement. To speak more to how proffesional Dr. Cooley is he also offered to continue to work on my scar as well and I think I had pretty decent results. "Better now then previous to the Acell". I think having reasonable expectations about these things will help prevent dissapointment. One of the first things he said when I started discussing the procedure with him is that there are no gaurantees. So I went into the procedure expecting nothing but hoping for everything. Almost 1 year later I am pretty satisfied with where I am "although by no means content". I am confident that Dr. Cooley continues to try to perfect his methods.

[Curious]

If you use the entire beard hair graft, including the bulb, you are more likely to have a successful result.

[Sparky]

"accidentally slammed the car trunk down on his grafted area"

 

Wow, that would really annoy me, for weeks after surgery I was really trying hard to be aware of such dangers, ducking extra low for things and putting my hands in front of me head, even when I knew there wasn't any danger.

Edited February 5, 2011 by Sparky

[The count Of Baldecristo]

I guess in general its nice that you experiment dr. Cooley and every doctor has to take decisions but it seems the guy is worst off now than before. I completely understand if he doesnt want to take your offer for a free repair after what happened to him its difficult to trust again your judjement after you ve been wrong on your assumptions and tactic the first time.

 

Maybe a refund is the best option in these cases so that the guy can search for more options with another doctor (if there are any).

 

Arent we expecting too much from patients when we ask them to consult their original doctor who are not happy with to fix their situation for them? I honestly think refunds in such cases where there is streched scars or very bad result should be mandatory. How much did the guy pay to be worst off than before?

[lorenzo]

The count I am not sure but acell is used to compliment a surgery not to replace it. I dont believe acell caused his transplant to be worse but maybe I am wrong.

 

 

Arent we expecting too much from patients when we ask them to consult their original doctor who are not happy with to fix their situation for them? I honestly think refunds in such cases where there is streched scars or very bad result should be mandatory. How much did the guy pay to be worst off than before?

 

 

I think alot of stuff should be mandatory concerning hair transplant. Especially training and standards, right now anybody that is a doctor can open a clinic and start doing transplants.

If refunds were mandatory, that would be great 90% of all doctor in the industry would go bankrupt. The doctor would all have to learn to give the best possible result. The top doc that give great results would be able to charge even $10 a grafts since the demand would be alot highter with less doctors.

 

In all fairness Count if somebody researchs properly the odds of a bad transplant are very mininum. Website like this make it alot easier to choose a proper doctor.

 

For the above case I dont know much about it expect that Dr. Cooley is an good ethical doctor.

[haircut]

We are just now learning what aCell can and can't do. The biggest question is auto-cloning. For those of us with depleted donor areas, that is what we focus on.

 

In that regard, many of us are anxious to see what Dr. Cooley does in this area as he is regarded as the pioneer.

[lorenzo]

We are just now learning what aCell can and can't do. The biggest question is auto-cloning. For those of us with depleted donor areas, that is what we focus on.

 

 

Haircut your comment are respectfully incorrect in my opinion. We dont know what Acell can or cant dothat is the problem. My understanding is that ACELL in most circumstances improves the scar some circumstances does nothing and now maybe (I dont believe it) can make it worse. The problems is nobody know why it doesnt work or maybe even why it works better sometimes compared to others. In hair transplants most top docs know 99% of the time when they look at somebody elses bad scar, bad grafts or lack of growth why it happens. In ACELL they have no idea.

 

In that regard, many of us are anxious to see what Dr. Cooley does in this area as he is regarded as the pioneer.

 

Although I know Dr. Cooley is a great and ethical doctor I believe pioneer is a strong and incorrect word. Many people have been sampled and test many forms of hair farming, cloning amost other things for probaly 30 years now.The scientist or doctor that figure it out will be considered a poineer. . Sampling a product to see how it can be used correctly may be considering an inivator. The doctor that can clone hair at 95-100% on 95% of the people with full lifetime growth in my opinion will be a pioneer.

From my understanding plucking hair and using ACELL has about a 40% rate of growth. But no test have stated how long these hair last for nor what the plucked area looks like after plucking a few times. No proper scientific test have been done. I am not a scientist so maybe I am wrong.

I think there is something with ACELL but not sure how long it will take until doctor can figure it out what it is.

Edited February 4, 2011 by lorenzo