Dr Cooley - Hair loss thru the years

[Dr. Jerry Cooley]

This is an interesting case. In some ways, it is a 'worst case' scenario for young men seeking hair restoration. He first came to me in 2004 at the age of 16. His hair loss had actually started at age 14 and he had a strong history of balding on both sides of his family. He started finasteride and minoxidil with stablization of his hair loss. He came back five years later, wanting a transplant. As with all young men, I talked to him about the commitment this involves and to confirm he didn't want to try shaving his head as an alternative to hair restoration. We performed FUT of 2000 grafts to the front half of his scalp, with a conservative hairline and moderate density. He was very pleased with the result. He returned again five years later noting progression of his hair loss. He said he had continued his finasteride and minoxidil so I have to conclude that his underlying balding had pushed past the medical treatment; it would of course be much worse if he were not on these medicines. In Dec 2014, we performed FUT of 1,738 grafts, filling in the front and light coverage to the crown, as well as performing PRP/ACell. He just returned at 8 months with good results. By not dense packing, we still have plenty of grafts for future use. He plans to return periodically for PRP/ACell as needed. While this case in not typical, it does show the need for good planning and the importance of acknowledging the progressive nature of hair loss.

[BadBeat]

I think his hair looks great Dr. Cooley!

[PupDaddy]

Great planning and great work on this young man, Dr. Cooley!

 

He's now, what, 27? You kept him from living the past decade as "that really young, really bald guy," and now he's got himself a cosmetically appealing head of hair going forward.

 

I think his hair looks especially good in Photo #14.

[Spanker]

Great case.

[TakingThePlunge]

What an exceptional case! This young man is extremely lucky to have found his way to a skilled and ethical surgeon. The careful planning and conservative approach ahve served him well.

[pkipling]

Wow. Incredible results.

 

Thank you for presenting a case with a very young patient and demonstrating that while there are general "rules" for the best age to get a transplant, nothing is set in stone and it really does vary from person to person. I'm sure many doctors wouldn't have even considered a hair transplant on a 16 year old, so it's great to see you step up to the plate with a conservative (and confident) approach. Adolescence is hard enough as it is without having to deal with going bald, so I'm sure you saved him an enormous amount of grief and heartache.

 

Out of curiosity, how many more grafts would you say he has on backup? How many procedures did/do you anticipate over the years? And how are those predictions/anticipations holding up in real time?

[Dr. Jerry Cooley]

Wow. Incredible results.

 

Thank you for presenting a case with a very young patient and demonstrating that while there are general "rules" for the best age to get a transplant, nothing is set in stone and it really does vary from person to person. I'm sure many doctors wouldn't have even considered a hair transplant on a 16 year old, so it's great to see you step up to the plate with a conservative (and confident) approach. Adolescence is hard enough as it is without having to deal with going bald, so I'm sure you saved him an enormous amount of grief and heartache.

 

Out of curiosity, how many more grafts would you say he has on backup? How many procedures did/do you anticipate over the years? And how are those predictions/anticipations holding up in real time?

 

Pkipling

 

Thanks for the comments. Just to be clear, he came to see me for finasteride at 16 and we did his first transplant at 21, and his second at 26. We've used up almost 4000 FU's out of at least 8000 total available by strip (more after that with FUE). My donor assumptions at the beginning have played out as I would have expected but I did not expect his hair loss to progress the way it did from age 21 to 26 with him being on finasteride. By being conservative in this young man, we've kept enough grafts in the bank to address new areas of thinning and I'm hopeful the PRP/ACell will inhibit further thinning. He is exceptionally realistic and committed to the process.

 

Thanks to all for the positive feedback.

[hairshopeing]

Great approach and result qdos!

[Pete-from-Farjo]

Really interesting case. Just shows the benefit of sensible donor use and forward thinking.

 

Great job.

[pkipling]

Pkipling

 

Thanks for the comments. Just to be clear, he came to see me for finasteride at 16 and we did his first transplant at 21, and his second at 26. We've used up almost 4000 FU's out of at least 8000 total available by strip (more after that with FUE). My donor assumptions at the beginning have played out as I would have expected but I did not expect his hair loss to progress the way it did from age 21 to 26 with him being on finasteride. By being conservative in this young man, we've kept enough grafts in the bank to address new areas of thinning and I'm hopeful the PRP/ACell will inhibit further thinning. He is exceptionally realistic and committed to the process.

 

Thanks to all for the positive feedback.

 

Ahhhh. That makes much more sense. (I totally misread :rolleyes: ). Even still, the point remains the same. I feel like more often than not, guys who start losing their hair in their teenage years are left feeling the most hopeless, as the general consensus seems to be for them to wait until they're 25 to even consider a hair transplant - news that can be devastating to hear when you're a teenager going bald. While that may be a good general rule, it's nice to see a doctor responsibly consider breaking that rule. As you show here, depending on all the individual particulars of a case and with the right expectations, a conservative approach, and a solid game plan, there may be a solution for some of these guys.

[Janna]

Wise planning and great result.

[aaron1234]

Hair loss at 14?!? :eek: Life is cruel.

 

Thank goodness he found you Dr. Cooley. He looks good and his choice of style actually helps too!

[NoTakeBacks]

Extremely good planning; very ethical. Doesn't look unnatural at any stage. Saved him from being a 5/5A at 27. His hairline as of this year looks very natural at that density. Usually it's pretty hard to construct a natural looking hairline with so few grafts. If it didn't progress so rapidly and into the crown he'd be golden.

 

Great planning and great work on this young man, Dr. Cooley!

 

He's now, what, 27? You kept him from living the past decade as "that really young, really bald guy," and now he's got himself a cosmetically appealing head of hair going forward.

 

I think his hair looks especially good in Photo #14.

 

Agreed!