Dr Cooley 3,421 grafts

[Dr. Jerry Cooley]

This patient is in his mid 50's and wanted 1) thickening of the entire scalp and 2) frontal restoration. He was doing testosterone replacement, which is becoming more common nowadays. Despite my recommendation, he did not initially want to do finasteride. About six months post op, he did decide to start taking it and has had no side effects.

 

We performed FUT of 3,421 grafts (1-749, 2-1,591, 3-856, 4-225; total hairs= 7399 hairs). We put about 2,500 grafts in the frontal scalp and 1,000 in the back. We also performed PRP/ACell to provide some overall thickening. As usual, we did not shave the recipient area, so he could return to work in 7-10 days.

 

He is shown 10 months post op. Also of note, he had some very low hairs in the front central area, going down to 6cm above the eyebrows. If we had built the hairline off this point, it would have created a very front heavy result, as well as requiring an inordinate number of grafts. What I do is design a hairline as if they were bald, and use electolysis to eradicate hairs below this line. In the op photo, the small red spots can be seen where we did this. After electrolysis, a certain number of hairs will always grow back. He was trimming these (see arrow) but plans to come back for another electolysis session to clean these up.

[Spanker]

Great case Doctor Cooley.

[2youngforthis]

gezz us this guy looks like he is ready for TV.. question. taking testosterone and fin at the same time???

 

never heard of taking both? seems like they would just cancel out, but then again i don't know anything about all that.

[BUSA]

plenty of men start to lose their test as they age so they replace it with test treatment to give them levels that they shud hav for their age. nothn is cancelled out. some men don't lose their test to much further in life some earlier.

 

gezz us this guy looks like he is ready for TV.. question. taking testosterone and fin at the same time???

 

never heard of taking both? seems like they would just cancel out, but then again i don't know anything about all that.

[Spanker]

I'd need a doc to confirm but I definitely feel like testosterone therapy can have a negative affect in terms of hair loss if your follicles ate dht susceptible.

[Gram]

For what it's worth, I work with a 54 year old guy who has great hair....nw1. About two years ago I started to notice him thin out quit a bit (diffused). I always wondered what was up/was discouraged that even after that long of holding the line, the mpb boogeyman can spontaneously appear. Come to find out he began T treatments 2 years ago. I highly doubt it's a coincidence.

[Spanker]

For what it's worth, I work with a 54 year old guy who has great hair....nw1. About two years ago I started to notice him thin out quit a bit (diffused). I always wondered what was up/was discouraged that even after that long of holding the line, the mpb boogeyman can spontaneously appear. Come to find out he began T treatments 2 years ago. I highly doubt it's a coincidence.

 

I doubt it too, but hair loss can definitely kick in that late too.

[Dr. Jerry Cooley]

For what it's worth, I work with a 54 year old guy who has great hair....nw1. About two years ago I started to notice him thin out quit a bit (diffused). I always wondered what was up/was discouraged that even after that long of holding the line, the mpb boogeyman can spontaneously appear. Come to find out he began T treatments 2 years ago. I highly doubt it's a coincidence.

 

Yes, testosterone replacement can accelerate hair loss because it is converted to DHT. If the patient is on finasteride, there will be much less DHT and hence the hair is protected. I actually prefer dutasteride in this situation because it gives more DHT suppression. I also talk to men about considering an aromatase inhibitor to prevent a build up of estrogen in this situation. Most men can get the benefits of testosterone replacement without hairloss by managing their hormone levels intelligently. I work with their other physician (who is giving them their testosterone) to make sure we're on the same page.

[Pete-from-Farjo]

Really nice result

[thisguy1]

Great result and I can only imagine the look of shock the first time you bring up removing hair from the front of a patient's head when he has walked in to get more hair but it turned out nice. He seems to have nice hair characteristics as well from afar.

 

Thanks for posting results so often here - I think more doctors would be well served by doing the same. It is nice to go back thru old history and see a few dozen cases, esp 3500-4000 graft cases.

 

That said I am bummed no new case posts since October.

[HairCenter]

Hello thisguy1,

 

We appreciate your comments about Dr. Cooley's results. Regarding his posting frequency, there have been several results posted by the clinic since October. I have gathered the URLs for each of these subsequent posts to share here for your review.

 

 

2241 grafts...

http://www.hairrestorationnetwork.com/eve/181881-dr-cooley-2241-grafts-one-year.html#post2455852

 

3049 grafts...

http://www.hairrestorationnetwork.com/eve/181780-dr-cooley-3049fu-prp-acell.html#post2454793

 

1213 grafts...

http://www.hairrestorationnetwork.com/eve/181626-fue-dr-cooley-1213-grafts-%40-10-months.html#post2453390

 

4289 grafts...

http://www.hairrestorationnetwork.com/eve/181923-dr-cooley-unshaven-fuss-4289-nw5.html

 

4693 grafts...

http://www.hairrestorationnetwork.com/eve/182461-dr-cooley-4693-grafts-16-months.html

 

1819 grafts...

http://www.hairrestorationnetwork.com/eve/180293-dr-cooley-1-819-grafts-hairline-1-4-year-followup.html

 

1756 grafts...

http://www.hairrestorationnetwork.com/eve/182371-dr-cooley-hairline-result-1756-grafts-via-fuss.html

 

1888 grafts...

http://www.hairrestorationnetwork.com/eve/182180-female-1888-grafts-w-acell-scar-revision.html

Edited February 19, 2016 by Unregistered

[Loki]

Yes, testosterone replacement can accelerate hair loss because it is converted to DHT. If the patient is on finasteride, there will be much less DHT and hence the hair is protected. I actually prefer dutasteride in this situation because it gives more DHT suppression. I also talk to men about considering an aromatase inhibitor to prevent a build up of estrogen in this situation. Most men can get the benefits of testosterone replacement without hairloss by managing their hormone levels intelligently. I work with their other physician (who is giving them their testosterone) to make sure we're on the same page.

 

Dr. Cooley I am in a very similar situation... Recently I have switched from Propecia to a topical fin because I was tanking my DHT... I know it will go systemic but do you think it has a chance to localize and become more effective?

[thisguy1]

Hello thisguy1,

 

We appreciate your comments about Dr. Cooley's results. Regarding his posting frequency, there have been several results posted by the clinic since October. I have gathered the URLs for each of these subsequent posts to share here for your review.

 

Thanks I'll keep an eye out for your posts, I was searching for threads under his name as the original poster only.