Temple repair 2,000 grafts

[Dr. Jerry Cooley]

This patient had numerous procedures in the past including 3 scalp reductions and at least 10 transplants (the patient couldn't remember for sure). I estimated we could get about 2000 grafts to work with from the sides of the donor area. The most pressing need was to bring the temples out to match the low, transplanted frontal hairline. The frontal hairline had already been set too low and raising it was not an option. A session of 2,089 FUT grafts was performed (3462 hairs), resulting in a better balancing of the frontal and temple hair lines. The after photos were taken at the time of a second smaller touch up procedure.

[hdude46]

10 transplants and 3 scalp reductions! wow. Dr. Cooley, this may be an odd question but how come scalp reductions are seemingly a thing of the past, it seems if patients do scalp exercises they could get back a good amount of their scalp laxity?

 

Also, any more details on this patient as far as age and donor hair left?

 

Thanks!

[rpachigo]

Wow! This is very impressive. Cannot believe you could still find 2000 grafts and the work in that scarred temple region was excellent.

[hair_me_out]

Looks a lot more appropirate now, good work Dr. Cooley. 10 ops! Man, that's a lot.

[Dr. Jerry Cooley]

Thanks for the feedback. Scalp reductions aren't done today for regular pattern baldness for several reasons: 1) the scar down the center of the scalp 2) it causes decreased hair density and thinned skin down the sides of the scalp 3) it causes a problem in the back of the scalp called a 'slot' that is hard to correct 4) looks like it helps at first but the benefits disappear due to stretchback. When I trained in the early 90's, scalp reductions were still common and I'm glad I learned how to do it. I still use it for repair work, such as on people who have had traumatic scarring, see http://hair-restoration-info.c...071091493#7071091493.

 

I don't know any of the details on the prior transplants but suspect most of them were quite small, otherwise there is no way I could have still harvested 2000 grafts. This case is a cautionary tale, showing the long term problems of doing hair transplants on a young man without thought for future hair loss.

[Julius]

The temples look great, as a prospective ht patient it makes me so mad to see that poor blokes scaring from previous surgeries which butchered him.

[Shadow of the EMpire State]

One of the best transplants that I have ever seen in pictures. This deserves far more credit than it's getting in this thread. This result isn't merely "good"; it's amazing.

 

The subtle touch in the temple points sets this apart. Many docs ignore the temple point altogether, and even when they address them, they often look strange. This is top-drawer stuff.

 

Cooley's been around for years, and he never really gets his due. Perhaps it's because he doesn't advertise that much. In any event, I think he's pretty close to the top.

[Shadow of the EMpire State]

Does Cooley still do FUE?

[hdude46]

agree shadow.

 

dr. cooley, you say this is a cautionary tale. i take it this patient had these transplants many years ago and is now much much older? can you explain? thanks!

[Dr. Jerry Cooley]

When I say cautionary tale, I mean that I hope young men learn from this case when considering a transplant. Of course routine scalp reductions and plugs at the hair line are a thing of the past, so no one starting out today will have to undergo the extent of repair this patient did. I didn't really go into it, but he had to have plugs cut out and laser work, as well as numerous 'fill in' grafting sessions over the years.

 

As natural as today's grafting is, it should always be done in light of the possibility of future hair loss. For this reason, I usually try to keep a reasonable amount of donor hair in the bank for possible future use, rather than always trying to harvest to the max.

 

Thanks for all the feedback. I rarely do FUE, mostly for repairing donor scars. I am doing research with plucked hair as a source of donor grafts, with some encouraging results. If this research works out, we'll have a viable alternative to FUE in the future.

[hdude46]

dr. cooley, do u recall this patients age and are ou saying he is out of donor hair to due all the past transplants and scalp trauma?

[Dr. Jerry Cooley]

He is in his 40's. I did a final strip, getting about 600 grafts and the scalp is about tapped out for further strips because of all the prior transplants and scalp reductions. His only options now are FUE (possibly body hair) and the plucking if it works out.