3300 graft FUT with Dr. Cooley - 43 yr old male second procedure

[BJ47]

Hi all,

It's been a whirlwind couple of days, and I don't have the clinic photos and final graft counts in hand yet, but I wanted to put down some thoughts about my procedure with Dr. Cooley on Wednesday, December 14, 2022.  Dr. Cooley did my first procedure back in 2008, and when I felt it was time for a second go-around I didn't need to do any research.  I always knew I'd go back to see him.  Just as a frame of reference, he had over 10 years of experience with hair transplantation back in 2008, so add 14 more years to that and, yeah...the man and his team are absolute rockstars.  

My first procedure in 2008 was 2100-ish grafts to the hairline and frontal 1/3.  It grew in, matured, and all was well.  Like a dummy I stopped taking Propecia for a couple years and, of course, my hair loss progressed slowly.

For this second procedure, I reached out for a consultation in August of 2021, had a call with Lollie in October 2021, flew to Charlotte for an in-person consult in November of 2021, and scheduled an appointment for my surgery for mid-December of 2022.  Yep, about a year and a half from first inquiry to sitting back in Dr. Cooley's chair.  Was it worth the wait?  100%.  You're going to be enjoying your new hair for the rest of your life so you might as well go with a decorated surgeon with a track record for excellent results even if you have to stand in line for a bit.

Two days ago, on the morning of the procedure, I arrived as requested at 7 am.  I met with Angie, signed some paperwork, confirmed the number of grafts, and downed an antibiotic and a Valium before choosing some movies from a big binder.  I joked that I hoped to sleep through the procedure and probably wouldn't watch the movies and Angie mentioned that they like having movies on in the background while they work.  I said I would try to pick some movies they hadn't seen a million times and she said "Nothing Bourne!"  Too funny.

Dr. Cooley joined us and reviewed my chart and we talked about the game plan.  2500 grafts to the frontal 2/3 and 500 grafts to the crown (a "sprinking", he said).  Best to not be super aggressive with crown coverage just yet.  I use Toppik concealer and at least these 500 crown grafts would give those fibers something to cling to.  He drew a suggested hairline and it was spot on what I was expecting.  He took some "before" photos, which I hope to be able to share soon.  

Spoiler alert:  they harvested approximately 3300 grafts so I think my crown coverage is a bit more than we were anticipating.  Unlike some clinics that will charge you to transplant "extra" grafts they end up with, Dr. Cooley lets nothing go to waste and transplants every extra one at no additional charge.  As one of the technicians quoted Dr. Cooley saying, "I took them out, so I'm going to put them all back in."  That's a good man right there.

The thing I was most nervous about was the donor strip removal.  I laid face down on what looked like one of those sitting massage chairs and was injected with Versed to help relax me.  Dr. Cooley then numbed me up in the donor area.  He used one of those vibrating buzzy things with each injection of numbing med and I couldn't barely feel more than a tiny pinch each time.  I burn off sedatives relatively quickly and remained alert for the entire strip removal and suturing.  When it was over, Dr. Cooley asked "So the Versed didn't do anything for you?"  I responded "Well, I was awake for all of that, but it just didn't seem like a big deal."  Mission accomplished!

Apparently I bleed more than the average person, and Dr. Cooley adapted by using a different suturing technique that gives the same clean scar results he's known for but also helps control the bleeding better.  He explained what he was doing at each step to one of the other folks that was assisting him.  Way to pivot!

The doc made all the sites for the grafts while the technicians began dissecting the grafts from my donor strip.  Lunch break!  Dr. Cooley catered for the entire staff, and Dori was super helpful in taking my order and bringing me a plate with a chicken salad sandwich, the most amazing side salad, and a chocolate cookie for dessert.  I snuck out of the exam room to go brush my teeth right after.  Best not to have stanky breath with Dr. Cooley and helpers hovering inches from your face!  haha

After lunch the implanting of the grafts began.  Another shot of Versed (by my request) and I was in and out the rest of the day.  Super comfortable.  Shoes off, blanket pulled up to my chin.  Easy peasy.  Everything wrapped up about 5:30 pm.  Most of the staff had left much earlier but Dr. Cooley stayed behind to double and triple check all the graft placement, make tiny adjustments, and send me off with my post op care instructions.

I didn't get a lot of sleep that night since I was up every 2 hours to spray the grafts and it was difficult to find a comfortable sleeping position.  I took some ibuprofen to try to get ahead of any pain;  Dr. Cooley gave me a few extra injections of the numbing meds in the donor area at the end of the procedure and that helped greatly.

The next morning I had some breakfast, took the antibiotic and steroid pills I was given, and headed back into the office to get cleaned up.  My donor area was a bit tender so I took a pain pill.  Took another about 6 hours later.  They made me nauseous, a common side effect, so I've discontinued and have been just taking the occasional ibuprofens as needed.  

I had the most amazing shampoo ever, after which the technician combed through very delicately looking for any grafts that may have popped out during the washing and drying process.  He found a few and Dr. Cooley came in and put them back where they belonged.  3 popped grafts out of 3300.  That's impressive numbers.  The doc then gave everything an inspection one last time, asked if I had any questions, and encouraged me to contact him with any questions or concerns.  

Here are some photos taken when I got back home this evening after a day of air travel.  This is after the shampoo at the office and with constant spraying throughout the day.  All the longer hair are native and 2008 transplants, all the short stubbly hairs were transplanted yesterday.  I'll share the pre and immediately post-op photos when I get them as well as final graft counts. 

 

 

[TommyLucchese]

Nice write up. Looking forward to more pics.

Doesn't look like you retained too many of those original 2100 grafts, what did Dr Cooley say about it? 

[BJ47]

Here's a thread I started last year with more info and photos.  I ended up going for an in-person consult at Dr. Cooley's request November of 2021.  He examined my scalp, reviewed my chart from the first procedure, and asked if I had any 1 year post op photos without any sort of concealer.  I didn't, nor did I go in for a 1 year followup as he suggested at the time.  

He said most of the remaining hairs appear to be transplants with a bit of native hair still present in the middle tuft area.  He said there had definitely been continued native hair loss and believed this was the primary culprit.  I asked if the areas where there were *only* transplanted hair, like the hairline itself, was the sort of result he'd expect to see this many years later.  He agreed no, said that there could have also been some thinning of the grafts diameter-wise, and that "these days we can get the grafts closer together."  He also suggested I discontinue finasteride and begin a combo of dutatseride and oral minoxidil (which I've been on for a little more than a year).

It's also worth noting that I have a severe anxiety disorder and that stress in general is not great for hair.  I wonder how that may play into things as well.

 

Edited December 16, 2022 by BJ47

[BJ47]

Day 3, first home shampoo.  Starting to get tingly and itchy in the recipient areas.  Took my first home valium to get some sleep tonight and boy was it tasty.

[Yoni]

Any final result update? 

[BJ47]

On 10/8/2023 at 1:08 AM, Yoni said:

Any final result update? 

A quick bathroom mirror pic as I’m at the DMV to get a replacement driver’s license.  I’m a few weeks away from my one year mark.

[Gatsby]

Excellent result @BJ47 💯👌

[UKLad81]

Wow!! Cooley has knocked this out of the park it seems!! Would love to see other views but nevertheless looks brilliant!! Congrats!!