5035 Grafts with Dr Cole (4463 CIT and 572 Beard Hair) July 2011

[Neil-UK]

I’ve just returned to London, UK, from Atlanta, where I received a hair transplant at Dr Cole’s office. I have detailed below my experiences for those of you who are interested.

I had a NW5A pattern that stabilised at about age 33. I am now aged 40. I was a hairpiece wearer who wished to replace my hairpiece with a transplant. I had not had hair surgery before. My objectives from the surgery were to create a new hairline and frontal region and get some coverage in the midscalp and crown.

I had a 3 day procedure that included the following:

1) 4463 CIT grafts i.e. FUE, not strip.
2) 572 beard grafts taken from below the jawline and placed in my crown.
3) Platelet rich plasma (PRP) to encourage hair growth in the recipient area. See below for details:

http://www.forhair.com/News_Release/Autologous_Platelet_Rich_Plasma_PRP.htm

4) A-Cell to promote healing in the donor area. It may reduce scarring and there is some evidence of regeneration of hair follicles at the extraction sites, which could possibly lead to some replenishment of donor hair.

http://www.forhair.com/Articles/Clinical_Applications_of_Acell.htm

Day 1, Tues 19 July 2011, 3888 CIT grafts

The main focus of the day was on the hairline, frontal region and to a lesser extent the midscalp and crown. I experienced no significant discomfort above the level of the initial anaesthetic injections. Surgery finished at 6.30pm, by which time the team had placed a remarkable 3888 grafts. When I saw their work I was amazed by the density of the frontal region and very pleased with the coverage further back and with the tidyness of the graft placement. It must have been a tiring day for the team but they maintained remarkable concentration and professionalism, reflecting their considerable experience. Saveth celebrated her 7th anniversary as a member of Dr Cole’s team today!

Day 2, Weds 20 July 2011, 575 CIT grafts

We started at 9am and had much less to do today, partly as a result of the team’s extra efforts the previous day. Dr Cole and his team extracted and placed 575 grafts in the crown, with work finishing at lunchtime.

Day 3, Thurs 21 July 2011, 572 beard grafts

Surgery lasted from 11.30am to 4.30pm and went at a more relaxed pace. The objective of the session was to transplant a small amount of beard hair so that I could consider whether beard hair might be usable as donor hair on a larger scale in future. Beard hair is coarse but might serve as “filler” hair in the crown (certainly not in the hairline). Dr Cole had earmarked an area in the lower crown for the beard grafts.

Post-op follow up, Mon 25 July

I returned to the office the following Monday so that Dr Cole could check that all was well and so that Kim could meticulously clean some of the surplus crusts off my recipient area.

Summary

The procedure gave good coverage and great frontal density and my post-op recovery was quick. Dr Cole and his team did a fantastic job and I was amazed by their ability to do such painstaking and meticulous work so diligently. As pictures are better than 1000 words I attach 3 before and after photos (after day 1, day 6 and 2 weeks), plus one of the beard donor area less than 4 days post-op. If any of you have any questions then please let me know.

Neil

[Follicle Death Row]

Congrats. Looks very solid.

[CVAZBAR]

Looks nice! What age did you start balding? When you say it stabilized, was it naturally or was it with medication? Are you in medication NOW after the HT? I would appreciate if you can answer these questions. Thanks

[Kiwi]

Hi Neil. How much did the procedure cost?

[Neil-UK]

Thanks for your support Follicle Death Row, CVAZBAR and Kiwi.

To answer your questions CVAZBAR, I first noticed that I was losing my hair at age 23 but the process probably started at about 20. I suffered a diffuse thinning on top that took me from an NW2 to an NW5A without going through NW3 and NW4. By the time I was aged 32 I was pretty close to the condition that you see in the before photos above. At 33 I started taking Propecia, when my hair loss stopped. Propecia seems to have saved the scraps of hair in the midscalp and forelock that you see in the photos. I hadn't lost any hair down the sides or back so expect that if I hadn't taken Propecia I would have stabilised as an NW5A fairly soon anyway once I had lost the remaining hair in the midscalp and forelock. I will continue to take Propecia for the foreseeable future. I don't think that there's much point in having a transplant unless you try to hang on to what you've got.

Kiwi, unfortunately I can't disclose the exact cost because I must respect Dr Cole's confidentiality regarding the contract that he and I had. However, I advised his office that there were interested parties asking about cost and his office said that they would be happy to receive your call if you do wish to discuss the cost of surgery.

If you have any further questions I would be happy to answer them as best I can. Thanks once again for your support.

Kind regards
Neil

[CVAZBAR]

Thanks Neil-UK. The reason I asked was because I seem to be in the same situation as you. I still have hair and not completely bald but I can tell that the pattern forming is similar to a NW5a just like you. I almost getting to 30 but I wonder if the pattern showing is the one I will stick with and maybe stabiliZe. Im not sure if I should take any medication since I don't like the drug. At the same time I'm trying ti figure out if it would prevent me from progressing to worst level. Im also a diffuse thinner all around but losing my hair down the middle. I dont seem to be losing hair on the sides. I just don't know if early patterns tell your future or if it's possible for a person to continue balding. You seem to believe your pattern would have stabilized even without med? So why do you continue to take it?

I'm not sure what to do? What would you recommend? What did your doctor tell you about your progression and future?

Thanks for your reply.

[Neil-UK]

Hi CVAZBAR

I understand the reason for your questions because not knowing how far my hair loss would progress has been a big problem for me for years. So see below for a lengthy reply to your questions.

My experience of Propecia has been that it is about 100% effective in retaining existing hair but only about 1% effective in recovering hair that has been lost. I have never had any side effects and I believe that the clinical trials showed that side effects occurred in only a small minority of cases. There are people who have taken Proscar, which is 5 times as strong, for years, so I’d be surprised if Propecia was unsafe.

I took minoxidil/Rogaine/Regaine for a year in my twenties and it did nothing for me, so I stopped taking it. My advice to anyone with early hair loss is to try the drugs to see if they help and if not stop taking them. I think the drugs are the first line of defence against hair loss. By far the best thing to do is keep as much of your hair as possible and only consider hairpieces and transplants after hair loss has developed.

I started taking Propecia when I was nearly 33 and regret not taking it earlier. It might have saved a bit more of my hair. I believe that it’s currently hanging onto the hair on the top and front of my head in the before photos above, which I agree isn’t much, but even if it’s just 1000 FUs then that’s better than zero. I think that NW5A is the limit of my hair loss for the following reasons:

1) I’ve shown no tendency (at age 40) to recede at the sides and back.
2) I suffered an early diffuse loss across the NW5A area, not a gradual recession of the hairline or expansion of a crown bald spot.
3) My hair loss stabilized 7 years ago (albeit with the aid of Propecia).
4) My grandfather was an NW5A.

I went for consultations with a few hair surgeons when I was aged 32/33. I asked them about my future hair loss and there was no agreement amongst them. One said that my hair loss was developed. Another said that some of the hair at the sides “looked vulnerable”. Another said that I could well recede to an NW7, although he said that he might change his mind if my hair loss stabilized, which it subsequently did. So there is a slim chance that I might tend towards an NW6-7 later in life, in which case Propecia could be doing more for me than I know. There’s no way of testing each hair to see if I’m going to lose it so it’s impossible to be 100% sure.

It was this uncertainty that led me to try a hairpiece rather than a transplant at age 33. I figured that if I lost more hair I could end up having transplant after transplant as I “chased the hair loss”. As I’ve hardly lost a hair since then I feel rather silly for not going for the transplant the first time. One advantage of a hairpiece is that it is reversible, so I could and did change my mind. You’re right though, not knowing where you will end up makes it tough to make a decision in the early stages of hair loss.

I hope that this helps. Let me know if you have any further questions.

Neil

[CVAZBAR]

Thanks Neil

It's really hard to make decisions with this crap. I've heard different stuff as well. Some say early patterns stick and others will say you can get to NW7. It's really hard. The one thing I do know is that my hair loss is almost identical to my father. It's practically the same pattern and even rate of loss. The difference is that my father started losing it at 50 and I started around 24. It took my dad around 6 years to see bald spots but seems he has been sticking with the rest. The question I have is, will the rest stick or be lost at a slower pace?

I'm watching his progression since it seems I'm following his path. I still don't have bald spots but i feel I'm a year or two away. I started losing my hair 5 years after my dad but was probably thinning around 21. My dad still sheds hair so I'm guessing he will lose the rest. His pattern is Nw5a but still has a hairline but diffused. He mostly lost mid scalp and crown.

My hope at this point is the new treatments coming out. That's the thing I'm leaning on. I can't think of a HT at this point. I can take medication but I know I won't get back the hair I lost and it's aggressive. I would probably consider it only if I knew it would save the rest. This is a bitch!

[CVAZBAR]

By the way, how is your hair at the sides or your donor? From the pics it seems you have thin hair. Will you grow it out or keep a buzzed style? Can you still add more grafts in the future? It looks like you will get a nice result. I'm curious to see how it grows. It's looking good homie.

[CIT_Girl]

Neil,

Thank you so much for your kind words. Your two week photo looks great. We are glad that you had a great experience here at our clinic. We are passionate about our work and our patients. Dr. Cole’s goal is listen to his patients and their concerns as he prepares his patients for the present and the future.

[Kiwi]

@CIT_Girl - can you please tell us what the ballpark figure is for this sized procedure?

[Neil-UK]

Hi CVAZBAR

To answer your questions about my donor area, Dr Cole’s team estimated that I had 16485 FUs in my donor area, of which they harvested just over a quarter (although I suspect that there might have been a higher rate of harvesting at the edge of the donor above the ears in order to get finer hair for the hairline). The original density was slightly above average and my hair is wavy and coarser than average, so has good donor characteristics, although as you rightly point out, the hair at the sides tends to be finer. I attach a photo before the op that will give you an idea of how the hair at the sides originally was. I intend to let my hair grow back out to a similar kind of length i.e.5-6cm, although of course the density will be lower now.

Dr Cole advised me that he might be able to harvest a further 2000 scalp hairs in future, but I don’t think that I will use them unless I suffer further hair loss, which as discussed above is possible but unlikely. It’s good to have something in reserve. And as you rightly point out, the donor area might start to look thin if I push the envelope.

Also my procedure included 572 grafts of beard hair to see how they grow. If the results are good I might consider using beard hair as filler hair to make the crown a bit denser. Beard hair is worse than useless on the face so if a good use can be found for it on the scalp then so much the better. But I don’t want to consider this too much until I’ve seen the result of my first surgery, which won’t be for at least a year. I’ll keep you updated.

I agree that it’s tough to make a decision on how to confront hair loss with so much conflicting information and uncertainty. I wish you all the best with whatever approach you decide to adopt. Thanks for your support.

Neil

[CIT_Girl]

Hello Kiwi,

I apologize for the delay and thank for your interest in our clinic. Our pricing depends on the procedure you desire to have and the amount of hair loss you have. Here at our clinic we perform a variety of different procedures, for example, the C2G, Shaven, BHT, and repair. It is difficult to give you a ball park figure because each patient is different and each procedure is different.

The good news is a lot of physicians are doing FUE these days so the pricing varies with each clinic. Each physician has his own personal techniques when he performs hair transplant surgery. This means you can probably find an FUE procedure that fits your budget. For the most experienced physicians of course the pricing may be a little more.

[CVAZBAR]

Hi CVAZBAR

To answer your questions about my donor area, Dr Cole’s team estimated that I had 16485 FUs in my donor area, of which they harvested just over a quarter (although I suspect that there might have been a higher rate of harvesting at the edge of the donor above the ears in order to get finer hair for the hairline). The original density was slightly above average and my hair is wavy and coarser than average, so has good donor characteristics, although as you rightly point out, the hair at the sides tends to be finer. I attach a photo before the op that will give you an idea of how the hair at the sides originally was. I intend to let my hair grow back out to a similar kind of length i.e.5-6cm, although of course the density will be lower now.

Dr Cole advised me that he might be able to harvest a further 2000 scalp hairs in future, but I don’t think that I will use them unless I suffer further hair loss, which as discussed above is possible but unlikely. It’s good to have something in reserve. And as you rightly point out, the donor area might start to look thin if I push the envelope.

Also my procedure included 572 grafts of beard hair to see how they grow. If the results are good I might consider using beard hair as filler hair to make the crown a bit denser. Beard hair is worse than useless on the face so if a good use can be found for it on the scalp then so much the better. But I don’t want to consider this too much until I’ve seen the result of my first surgery, which won’t be for at least a year. I’ll keep you updated.

I agree that it’s tough to make a decision on how to confront hair loss with so much conflicting information and uncertainty. I wish you all the best with whatever approach you decide to adopt. Thanks for your support.

Neil

How are you doing Neil?? How is your progress?

[CVAZBAR]

Hello Kiwi,

I apologize for the delay and thank for your interest in our clinic. Our pricing depends on the procedure you desire to have and the amount of hair loss you have. Here at our clinic we perform a variety of different procedures, for example, the C2G, Shaven, BHT, and repair. It is difficult to give you a ball park figure because each patient is different and each procedure is different.

The good news is a lot of physicians are doing FUE these days so the pricing varies with each clinic. Each physician has his own personal techniques when he performs hair transplant surgery. This means you can probably find an FUE procedure that fits your budget. For the most experienced physicians of course the pricing may be a little more.

How is this patient doing? Can you share anything on Neil?

[Kiwi]

Hello Kiwi,

I apologize for the delay and thank for your interest in our clinic. Our pricing depends on the procedure you desire to have and the amount of hair loss you have. Here at our clinic we perform a variety of different procedures, for example, the C2G, Shaven, BHT, and repair. It is difficult to give you a ball park figure because each patient is different and each procedure is different.

The good news is a lot of physicians are doing FUE these days so the pricing varies with each clinic. Each physician has his own personal techniques when he performs hair transplant surgery. This means you can probably find an FUE procedure that fits your budget. For the most experienced physicians of course the pricing may be a little more.

I want the best results which is why I'm asking you.

Also do you guys transplant nape hair?

[northeastguy]

Neil.... not sure if you are still around but was hoping to get an idea of how well your beard grafts took?

[youngin]

Incredible results. Would like to know how it looks now.

[ITNEVERRAINS]

I’ve just returned to London, UK, from Atlanta, where I received a hair transplant at Dr Cole’s office. I have detailed below my experiences for those of you who are interested.

I had a NW5A pattern that stabilised at about age 33. I am now aged 40. I was a hairpiece wearer who wished to replace my hairpiece with a transplant. I had not had hair surgery before. My objectives from the surgery were to create a new hairline and frontal region and get some coverage in the midscalp and crown.

I had a 3 day procedure that included the following:

1) 4463 CIT grafts i.e. FUE, not strip.
2) 572 beard grafts taken from below the jawline and placed in my crown.
3) Platelet rich plasma (PRP) to encourage hair growth in the recipient area. See below for details:

http://www.forhair.com/News_Release/Autologous_Platelet_Rich_Plasma_PRP.htm

4) A-Cell to promote healing in the donor area. It may reduce scarring and there is some evidence of regeneration of hair follicles at the extraction sites, which could possibly lead to some replenishment of donor hair.

http://www.forhair.com/Articles/Clinical_Applications_of_Acell.htm

Day 1, Tues 19 July 2011, 3888 CIT grafts

The main focus of the day was on the hairline, frontal region and to a lesser extent the midscalp and crown. I experienced no significant discomfort above the level of the initial anaesthetic injections. Surgery finished at 6.30pm, by which time the team had placed a remarkable 3888 grafts. When I saw their work I was amazed by the density of the frontal region and very pleased with the coverage further back and with the tidyness of the graft placement. It must have been a tiring day for the team but they maintained remarkable concentration and professionalism, reflecting their considerable experience. Saveth celebrated her 7th anniversary as a member of Dr Cole’s team today!

Day 2, Weds 20 July 2011, 575 CIT grafts

We started at 9am and had much less to do today, partly as a result of the team’s extra efforts the previous day. Dr Cole and his team extracted and placed 575 grafts in the crown, with work finishing at lunchtime.

Day 3, Thurs 21 July 2011, 572 beard grafts

Surgery lasted from 11.30am to 4.30pm and went at a more relaxed pace. The objective of the session was to transplant a small amount of beard hair so that I could consider whether beard hair might be usable as donor hair on a larger scale in future. Beard hair is coarse but might serve as “filler” hair in the crown (certainly not in the hairline). Dr Cole had earmarked an area in the lower crown for the beard grafts.

Post-op follow up, Mon 25 July

I returned to the office the following Monday so that Dr Cole could check that all was well and so that Kim could meticulously clean some of the surplus crusts off my recipient area.

Summary

The procedure gave good coverage and great frontal density and my post-op recovery was quick. Dr Cole and his team did a fantastic job and I was amazed by their ability to do such painstaking and meticulous work so diligently. As pictures are better than 1000 words I attach 3 before and after photos (after day 1, day 6 and 2 weeks), plus one of the beard donor area less than 4 days post-op. If any of you have any questions then please let me know.

Neil

Looks great

I only did a few beard grafts in the previous strip scars at Dr. Cole's at the end of March, as that's my next procedure, but I was amazed at the heal time, in 4 days there was no visible sign of donor extraction. Those beard hairs are well trained I guess.