Senior Member HairCenter Posted December 19, 2015 Senior Member Share Posted December 19, 2015 While shaving the recipient area does provide some advantages, it is not feasible for many of the patients who come to see me. Most of my patients plan to take 7-10 days off from work with minimal detectability upon return. This patient is in his mid-40’s and came to us with type V hair loss. We started him on finasteride and performed non-shaven FUT consisting of 4,289 follicular units. We also performed PRP/ACell to strengthen the miniaturizing follicles that were still present on his scalp. Placement immediately after surgery. He is shown 17 months after the procedure. Given the large area of baldness he started with, he was very pleased with the result. He is contemplating a second procedure to add increased density that 4200 grafts on such a large area simply cannot provide. I represent Dr. Jerry Cooley online. All opinions are my own and do not necessarily represent those of Dr. Cooley. I am not a doctor. Learn more about Jerry Cooley MD and Hair Center in Charlotte, NC For complimentary consultations with one of the leading hair transplant doctors worldwide please contact us here. Hair Transplant Consultation With Jerry Cooley MD at HairCenter.com Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted December 19, 2015 Senior Member Share Posted December 19, 2015 Looks like nice donor considering his hairloss level. Nice job. Another 2 or 3k in the frontal half will help and persistent fore lock help out a lot too. The 4200 actually went further than I would expect considering the crown work as well. I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted December 19, 2015 Senior Member Share Posted December 19, 2015 So hes come a long way already. I would have another procedure for sure. Link to comment Share on other sites More sharing options...
Senior Member HairCenter Posted December 19, 2015 Author Senior Member Share Posted December 19, 2015 I agree that nearly 4300 grafts went further than one would expect. I believe this has to do with the use of PRP/Acell during the surgery. We see that it not only helps to return some diameter to existing miniaturized hairs but the quality of the hair seems higher early in the regrowth phase as well. A second procedure will help with density, indeed, but the great thing now is that it is simply an option to consider and not a necessity. I represent Dr. Jerry Cooley online. All opinions are my own and do not necessarily represent those of Dr. Cooley. I am not a doctor. Learn more about Jerry Cooley MD and Hair Center in Charlotte, NC For complimentary consultations with one of the leading hair transplant doctors worldwide please contact us here. Hair Transplant Consultation With Jerry Cooley MD at HairCenter.com Link to comment Share on other sites More sharing options...
Senior Member esrec Posted December 19, 2015 Senior Member Share Posted December 19, 2015 (edited) I'm curious, what was the dialogue like with this patient pre-op? What expectations were set and how were they different from that of a patient that allowed you to shave? Does a patient with non shave typically experience more shock loss and lesser yield? Solid outcome. Edited December 19, 2015 by esrec Link to comment Share on other sites More sharing options...
Pete-from-Farjo Posted December 21, 2015 Share Posted December 21, 2015 This is another impressive and well planned transplant by Dr. Cooley. Congrats. I am an online representative for Farjo Hair Institute Dr. Bessam Farjo is an esteemed member of the Coalition of Independent Hair Restoration Physicians I am not a medical professional and my words should not be taken as medical advice. All opinions shared are my own. Link to comment Share on other sites More sharing options...
Senior Member HairCenter Posted December 23, 2015 Author Senior Member Share Posted December 23, 2015 I'm curious, what was the dialogue like with this patient pre-op? What expectations were set and how were they different from that of a patient that allowed you to shave? Does a patient with non shave typically experience more shock loss and lesser yield? The patient expressed a need to have as little visible impact to his appearance as possible. Yes, most patients have this desire but the professional obligations of this patient made it mandatory. In a case like this there is more care necessary to prevent the destruction of what hair remained, which admittedly was not much, but it was enough that shaving would be an obvious change to those around him. The difference is that it takes longer to perform a procedure on a non-shaven patient. In general a non-shave patient will not experience any more shock loss than a shave patient but the threshold must be realized before any surgery is attempted. It takes years of experience to be able to understand what this threshold is and when shaving is an absolute requirement. Many patients can get away without shaving, but some cannot. I represent Dr. Jerry Cooley online. All opinions are my own and do not necessarily represent those of Dr. Cooley. I am not a doctor. Learn more about Jerry Cooley MD and Hair Center in Charlotte, NC For complimentary consultations with one of the leading hair transplant doctors worldwide please contact us here. Hair Transplant Consultation With Jerry Cooley MD at HairCenter.com Link to comment Share on other sites More sharing options...
Senior Member esrec Posted December 23, 2015 Senior Member Share Posted December 23, 2015 Thanks for the explanation. For a long time I know the shave wasn't required but seems to have emerged more recently as it provides the doc added maneuverability. Makes sense. But good to see that a top doc can mitigate the risks in situations where needed. In fact, with the post-op waiting period being such a struggle for so many, holding onto more native post-op is a real benefit. Wonder how often the added convenience to the doc actually translates into better outcomes. Link to comment Share on other sites More sharing options...
Senior Member sutureless Posted December 23, 2015 Senior Member Share Posted December 23, 2015 There is no doubt significant improvement, but for the given amount of grafts of nearly 4300 - don't you guys think the coverage is thin?. Looks more like 1500 to 2500 graft result?. Unless the growth is in its early phase. Link to comment Share on other sites More sharing options...
Senior Member JON86 Posted December 24, 2015 Senior Member Share Posted December 24, 2015 I don't think this looks thin at all. This was a large area to cover and I am impressed he got so far into the crown. Dr Cooley does great work and his pictures are always honest. The lighting in the before and afters are always the same which speaks to his high ethics. I would be interested to see if the clinic has any prp only results that could be posted as a lot of us don't really know a lot about it. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted December 28, 2015 Senior Member Share Posted December 28, 2015 No, this is very, very good for 4,300 grafts. The baldness area was huge, and this is better than I would have expected. It's not a full head of hair, but it's not that sad, stringy mess that we frequently see when surgeons try to cover such a large area with so few grafts. An informed and educated patient should be extremely pleased with this result. Link to comment Share on other sites More sharing options...
Senior Member HairCenter Posted January 12, 2016 Author Senior Member Share Posted January 12, 2016 There is no doubt significant improvement, but for the given amount of grafts of nearly 4300 - don't you guys think the coverage is thin?. Looks more like 1500 to 2500 graft result?. Unless the growth is in its early phase. With all due respect, Sutureless, your comments are unusual given that you made much more positive comments about a case with a similar number of grafts. http://www.hairrestorationnetwork.com/eve/178085-dr-hakan-doganay-4290-grafts-over-2-days-13-01-15-14-01-15-jan-3.html I can appreciate that everyone has their own opinions but it's preferable to see opinions that are consistent. Thank you everyone for your comments. The patient is indeed very happy. I represent Dr. Jerry Cooley online. All opinions are my own and do not necessarily represent those of Dr. Cooley. I am not a doctor. Learn more about Jerry Cooley MD and Hair Center in Charlotte, NC For complimentary consultations with one of the leading hair transplant doctors worldwide please contact us here. Hair Transplant Consultation With Jerry Cooley MD at HairCenter.com Link to comment Share on other sites More sharing options...
Senior Member thisguy1 Posted February 19, 2016 Senior Member Share Posted February 19, 2016 There is no doubt significant improvement, but for the given amount of grafts of nearly 4300 - don't you guys think the coverage is thin?. Looks more like 1500 to 2500 graft result?. Unless the growth is in its early phase. I think the forelock hair gives the illusion of more hair than he had. He was able to hide a lot of bald areas and do sort of a combover from the forelock hair to cover things up when you view him from the face. When you do the overhead look you see the extent of baldness. Put another way take away his forelock hair preop and he'd look like a typical Norwood 5. One thing doctors can do on these reviews is describe ~how many grafts went where on the head in these large cases. For example it was 4300 grafts and I see improvement in his crown so for all we know 1000 of those grafts went into the crown alone. So that only left 3300 for the rest of scalp. So maybe describing crown vs hairline v remainder of scalp would be an interesting way to describe these large cases. Obviously not necessary for small cases or hairline only restorations. Re: unshaven comments - man that seems like a lot more work for the doctor to constantly be working around these hairs. Do they tie the hair up in little bundles to keep them upright and out of the way or how does it work? Obviously not everyone can shave but this certainly makes the job tougher for the surgeon. Jan 2016 - 3800 graft FUT with Dr. Konior NW 5A to 6. Docs whose results I am most consistently impressed with: Konior, Cooley (FUT), Hasson (FUT), Diep (FUE) (yeah I like the zig zag). Link to comment Share on other sites More sharing options...
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